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FROM: Terri Gaffney, RN
DATE: February 19, 1997 RE: National Governors' Association Winter Meeting The nation's governors addressed issues ranging from Medicaid and welfare to transportation and technology during their winter meeting held February 1- 4, 1997, in Washington, D.C. Specifically, the National Governors' Association (NGA) voted unanimously to oppose federal caps on Medicaid spending. Instead, the governors believe the program must be restructured and propose to work with the Clinton Administration to "develop equitable and effective cost-containment strategies." The NGA health care reform policy additionally calls for a repeal of the Boren amendment, which requires states to reimburse Medicaid providers at "reasonable and adequate rates." On other health issues, NGA adopted policies calling for automatic approval of Medicaid managed care proposals and greater authority to move Medicaid beneficiaries into home and community-based care programs. The NGA urged Congress to add more state flexibility to the Employee Retirement Income Security Act (ERISA) that federally regulates self-insured health and retirement plans. This would allow states to have greater authority over the growing number of self-insured employer health plans that currently escape state consumer protection laws and state health insurance reform initiatives. Addressing the issue of managed care, the governors asked Congress to repeal the "75-25" rule, which prohibits states from enrolling Medicaid beneficiaries in health maintenance organizations that do not draw at least 25 percent of their enrollment from the private insurance market. In addition, the policy proposes that the governors, Congress and the Administration work together in developing federal quality standards for managed care plans. The nation's governors also agreed to help legal immigrants keep welfare benefits, however, they decided not to ask Congress to amend the Welfare Reform Act at this time. The resolution calls for Congress and the Administration "to ensure that the immigration system and its requirements are fair to both citizens and noncitizens and meet the needs of aged and disabled legal immigrants who cannot naturalize and whose benefits may be affected." Other initiatives include an agreement between the White House and NGA to establish a new mechanism for coordinating federal and state technology efforts. Under the new "US Innovation Partnership" the White House and federal agencies will designate liaisons to work with states to remove regulatory barriers to the adoption of new technologies in such areas as telemedicine, environmental technologies and the building and construction industries. Additionally, the governors are focusing efforts on children -- boosting efforts to give children the best start in life -- specifically the critical formative period from before birth to age three. NGA is working on several activities to promote an agenda for states centered on the first three years of a child's development. In March, NGA will convene a panel of experts to develop a comprehensive resource guide for governors and host a conference for state policy-makers. NGA Chairman, Governor Miller (D-Nevada) appointed a six-member task force on children to assess current state and federal policies and develop recommendations to address early childhood issues. Joining him on the task force are Gov. George Voinovich (R-Ohio), Gov. Lawton Chiles (D-Florida), Gov. Tom Ridge (R-Pennsylvania), Gov. Lincoln Almond (R-Rhode Island) and Gov. Howard Dean (D-Vermont). The winter meeting was chaired by Governor Bob Miller (D-Nevada). Governor George Voinovich (R-Ohio) is serving as Vice-Chair. Further information can be obtained from the National Governors' Association's web site located at http://www.nga.com.
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