WASHINGTON -- As the National Governors Association began its winter meeting, 13 governors expressed alarm yesterday that they were about to run out of federal money for a popular program that provides health insurance to children.
They appealed to Congress and the Bush administration for swift action to protect hundreds of thousands of children who could lose benefits. The full association is poised to endorse that appeal.
In a letter to Democratic and Republican leaders of Congress, the 13 governors said that "health insurance for some of our states' most vulnerable citizens is in jeopardy."
"Without quick congressional action," the letter said, "our states, all facing federal shortfalls, will be forced to make harsh decisions affecting the lives of thousands of families."
Such decisions could include freezing enrollment, restricting eligibility, increasing premiums charged to low-income families or reducing benefits such as dental and vision care.
Seven of the 13 governors who signed the letter are Republicans.
They included Gov. Sonny Perdue of Georgia, chairman of the Republican Governors Association; Gov. Tim Pawlenty of Minnesota, vice chairman of the National Governors Association; and Gov. Haley Barbour of Mississippi, a former chairman of the Republican National Committee.
The Democrats warning of shortfalls in their states were Govs. Martin O'Malley, John Baldacci of Maine, Rod R. Blagojevich of Illinois, Chet Culver of Iowa, James E. Doyle of Wisconsin, and Deval Patrick of Massachusetts.
The program in question, the State Children's Health Insurance Program, covers more than 6 million children in families that have too much income to qualify for Medicaid but not enough to buy private insurance.
Gov. Janet Napolitano of Arizona, a Democrat, noted that "many states have expanded, or have proposals to expand, eligibility" for the child health program. "The president's budget is problematic in that regard," Napolitano said.
In his budget this month, President Bush proposed reducing federal payments to the states for coverage of children with family incomes exceeding twice the poverty level.
By contrast, Napolitano is trying to expand eligibility by raising the income limit in Arizona to 300 percent of the poverty level, from 200 percent.
In New York, Gov. Eliot Spitzer, a Democrat, wants to increase the limit to 400 percent, from 250 percent. (A family of four is considered poor if its annual income is less than $20,650.)
Congress is conducting a comprehensive review of the program, which was created in 1997 with bipartisan support and is up for renewal.
By most accounts, the program has been effective, reducing the number of uninsured children by about 25 percent, to 8.3 million in 2005.
The 13 governors said their states need immediate short-term assistance and could not wait for Congress to revamp the program.
Georgia has announced that it will "discontinue enrollment" in its program, known as PeachCare for Kids, on March 11.
The federal government spends $5 billion a year on the Children's Health Insurance Program. Bush wants to continue that level of spending, and he is seeking an "additional allotment" of $4.8 billion over the next five years.
That is considerably less than what states would need to continue their programs with current eligibility rules and benefits. New estimates from the Congressional Budget Office show that the states face shortfalls of $700 million this year and a total shortage of $13.4 billion from 2008 to 2012.
In a separate letter to Congress, the National Governors Association criticized a Bush administration proposal to cut federal Medicaid payments to public hospitals and nursing homes. The White House says the changes are needed to ensure the "fiscal integrity" of Medicaid and to curb "excessive payments."
The association denounced the proposal, saying it "will result in cuts of approximately $5 billion in federal Medicaid spending over five years."
Moreover, governors said, the proposal usurped the states' authority to decide how to finance their share of Medicaid.