[Congressional Record Volume 155, Number 145 (Thursday, October 8, 2009)]
[Extensions of Remarks]
[Pages E2481-E2482]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 GOVERNOR OF UTAH EXPRESSES CONCERNS WITH UNFUNDED MANDATES IN HEALTH 
                                 REFORM

                                 ______
                                 

                            HON. MIKE ROGERS

                              of michigan

                    in the house of representatives

                       Wednesday, October 7, 2009

  Mr. ROGERS of Michigan. Madam Speaker, I rise today to express 
concerns regarding health reform proposals which would create unfunded 
state mandates. Legislation currently before the House would 
dramatically expand the Medicaid program and place over $35 billion in 
new liabilities on state budgets over the next ten years. In addition, 
these proposals would expand the federal government's role in 
administering Medicaid, which would severely handcuff states' ability 
to run their own programs and preempt state authority to manage 
Medicaid eligibility and benefits.
  Over the last several weeks, governors have expressed concerns over 
these proposals. I would like to submit for the Record the following 
letter from the governor of Utah:

                                               September 15, 2009.
       Dear Senator Bennett, as Governor of the State of Utah, I 
     am aware of the critical importance of health system reform 
     in our country. However, I believe the best place for 
     innovation and policy change is in the individual states, as 
     we have a greater understanding of the specific needs of our 
     citizens. This effort is already underway in Utah, with great 
     success. I am worried, however, that the direction of the 
     current language of federal health system reform bills will 
     preclude state-directed reform and place a detrimental burden 
     on states' budgets. Therefore, I am contacting you in order 
     to forge a partnership to enact reform that will benefit not 
     only the citizens of Utah, but will benefit everyone 
     throughout our great country.
       In Utah, we have a good system of public medical programs 
     that provide for our neediest population. However, the weight 
     of the current programs strains our state budget. So far, we 
     have managed to fully fund the existing programs, although it 
     becomes more challenging each year. The extension of Medicaid 
     to additional populations, as discussed in proposed federal 
     healthcare legislation, will amount to an unfunded mandate 
     that would create financial havoc for our state.
       While I understand the idea that everyone must ``share in 
     the pain,'' and appreciate the Administration's commitment to 
     reforming healthcare without increasing the size of the 
     federal deficit, to force Medicaid cost increases onto states 
     will simply shift massive cost increases to the states. As I 
     am sure you know, Utah, like most other states, is suffering 
     from the negative impacts of a nationwide recession. As we 
     prepare the state's fiscal year 2011 budget, we face 
     continued cuts to agency budgets and reduced government 
     services on top of painful reductions made last year. The 
     unfunded mandate of a forced Medicaid expansion will only 
     exacerbate an already dire situation. If required to increase 
     our Medicaid program as envisioned in Washington, Utah, and 
     most every other state, will be forced to find the money to 
     do so through other means. This will require states to either 
     raise taxes or continue to cut budgets in areas currently 
     suffering from a lack of funding, such as public and higher 
     education. We must work together to ensure that no new 
     requirements for states to fund health care for additional 
     populations pass.
       This does not mean, however, that the State is ignoring or 
     has forgotten about middle-income uninsured families in Utah. 
     Quite the contrary, the aggressive health system reform being 
     pursued in Utah is designed to address the healthcare needs 
     of those families in a manner that does not shift additional 
     burden to the State.
       As mentioned above, Utah has made remarkable progress 
     toward health system reform. One of the cornerstones of our 
     State's efforts is the introduction of a defined contribution 
     health benefit system and implementation of the Utah Health 
     Exchange, which provides the technology to make that market 
     work. This new market approach is proving to be very popular. 
     In fact, in just nine days, following the official launch of 
     the Utah Health Exchange, 136 of Utah's small businesses 
     signed up to contribute to health care coverage for their 
     employees, representing approximately 7,000 covered lives.
       It is essential that federal legislation not derail this 
     promising effort to provide insurance in a new way to Utah's 
     small business employees, who are the backbone of our 
     economy. When fully implemented, the Exchange will help 
     individuals and employees access the information they need to 
     make informed choices about their health and health care, as 
     well as their health insurance. This tool has a standardized 
     application process and allows people to apply for a broad 
     range of coverage electronically; which further increases 
     access to affordable coverage.

[[Page E2482]]

       To me, the highlight of the Exchange is that it is almost 
     entirely run by the private sector. The State brought 
     together a technology company, a finance company, and many 
     different insurers who have worked out the necessary details 
     to provide a platform for this new marketplace. We were able 
     to go from a signed bill to a functioning exchange in just 
     five months. This is the very definition of forging 
     unprecedented partnerships to find solutions that government 
     alone cannot provide. The driving force behind any proposed 
     exchange must continue to be private sector ingenuity, with 
     government assisting in the appropriate ways.
       I look forward to working with you in a similar manner to 
     ensure that federal and state healthcare reforms are 
     compatible and will result in success for the citizens of our 
     great State. I believe that together we can develop workable 
     alternatives to the traditional Washington D.C. ``one-size-
     fits-all'' solution. We must continue to recognize that 
     states are the laboratories of innovation and that the best 
     solution to our nation's challenges is to empower states to 
     serve their unique populations in the best ways possible.
       Please contact me if there is any way I can be of 
     assistance with this very important issue.
           Best Regards,
                                                  Gary R. Herbert,
     Governor, Utah.

                          ____________________