Gov. Phil Bredesen (D-TN) is concerned about healthcare reform's impact on Medicaid.

Democratic and Republican governors may not see eye to eye on many issues, but they have similar opinions on one issue: healthcare reform. Efforts to reform the system won’t do enough to curb spending and could wind up costing the states billions of dollars they don’t have, they believe.

At the annual meeting of the National Governors Association over the weekend, state leaders met with Obama Administration officials to discuss their role in the healthcare revamp. Topping the list of concerns was the possibility that increased enrollment in Medicaid could further states’ fiscal woes. Because the cost of the program is split between state and federal governments, any spending increases would leave states, many of which are already cash-strapped, on the hook for more than they can afford, The New York Times reported. A recently introduced House bill calls for a $438 billion increase over 10 years.

Nursing homes and senior living facilities receive the bulk of their funding through the Medicaid program. Many of the governors at the NGA meeting told Obama officials that their states’ Medicaid programs already have trouble reimbursing providers, and that further Medicaid budget gaps are expected once the federal stimulus money runs out, according to the Times.