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Former HHS Secretary Says States Will Play Big Role in Health Care Change

By Cheyenne Hopkins, CQ Staff

October 26, 2006-- Inaction by the federal government will sway states to take the lead on overhauling health care, said former Department of Health and Human Services Secretary Tommy Thompson on Thursday.

Thompson, speaking to reporters, said that if Democrats take control of the House or both chambers, he expects any health care legislation to be stalled by a divided government. However, he remained hopeful that a health information technology bill would be passed. The Senate passed its health IT bill, S 1418, on Nov. 18, 2005, and the House passed its version, HR 4157, on July 27. No conferees have been named.

In the absence of federal action, Thompson said he expects states to take the lead with their own health care proposals and he even predicted that at least 20 states would follow the lead of Massachusetts.

In April, Republican Massachusetts Gov. Mitt Romney signed a law that will require the state's 6.4 million residents—550,000 of whom are uninsured—to obtain health care coverage by July 1, 2007. The law also will subsidize premiums on a sliding scale for people earning below 300 percent of the federal poverty level. Thompson said he also wants to require all uninsured to get coverage but not through a national universal plan.

Thompson, now chairman of the Deloitte Center for Health Solutions and a partner at the law firm of Akin Gump Strauss Hauer and Feld, has continued to push health care issues since leaving the federal government.

He predicted action on health care to be stalled until the 2008 presidential election, when he expects health care and energy to be the leading issues in the election. He also cited 2013 as a critical year for health care. By 2013, he expects Medicare to deplete its surplus and start drawing money from the Treasury.

Thompson was speaking to reporters on Thursday to push his "Medicaid Makeover" plan he introduced in August. His proposal would shift more of the costs for caring for the elderly—including long-term care, one of the most costly services covered by Medicaid—to the federal government, with state governments assuming the acute care needs of all Medicaid beneficiaries under 65. In the interview on Thursday, Thompson called Medicaid, a state–federal partnership, a "failed program."

Thompson discussed his plan at the National Governors Association meeting in August. Formerly the governor of Wisconsin, he said the response to his plan has been slow because governors are waiting until after the elections to act on health care.

Since the speech, he has met with Romney as well as Republican governors Jeb Bush of Florida and Haley Barbour of Mississippi.

Of President Bush's work on Medicaid, Thompson said, "I think the Bush administration has done more than any other to bring Medicaid to the forefront." But he added, "Am I satisfied? No, I'm not."

He again attributed slow federal action on Medicaid to politicians waiting until after the election to act.

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