Governors Fear Added Costs in Health Care Overhaul

The fraying of the nation’s Medicaid system has many indicators, and one of them is Connie Baugh’s stockings.

Ms. Baugh received a letter the other day from the state saying that as a result of budget cuts, Medicaid could no longer pay for the compression stockings that support her circulation and keep her aching leg ulcers from flaring. “I thought, oh God, another problem,” recalled Ms. Baugh, a 77-year-old retired dietitian.

At $239 a pair, the stockings are more than one-third the value of the monthly Social Security check she lives on.

Such cutbacks, in response to the recession that has eroded state finances even while swelling Medicaid ranks, is the reason Washington’s Democratic governor, Christine Gregoire, is among governors from both parties who fear the implications of the health care overhaul now being devised in Washington, D.C.

The governors worry Congress will give the states expensive new Medicaid obligations without providing enough new money to pay for them.

“We can’t afford to have Congress raise the eligibility for Medicaid coverage without paying for it,” Ms. Gregoire said in an interview.

If anything, the states’ fears were stoked further last week when House lawmakers drafting health legislation reached a cost compromise with conservative Blue Dog Democrats that would force states to take on a greater Medicaid spending burden than an earlier version of the bill.

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