Close up image of a caretaker helping older woman walk

California Governor Arnold Schwarzenegger (R) has fired off another letter to Congress warning that current Medicaid expansion proposals would put undue stress on state budgets that are already stretched thin.

Under the U.S. House of Representatives’ healthcare reform proposal, H.R. 3200, states would be required to pay for a portion of federally mandated expansions to the Medicaid program. Schwarzenegger on Tuesday reiterated his position that the federal government should assume the full financial burden of any Medicaid expansion. The California Medicaid rolls would expand to 8.6 million people, up from the current 7 million, the governor wrote. Adding all those people to an already fiscally unsustainable program would only make the situation worse, he said. California was $26 billion in debt at the end of the last fiscal year. Many state legislatures, including California’s, have cut services to the elderly, including nursing home care, and other public programs to balance their budgets.

Schwarzenegger urged Congress to either fully fund the expansion, saving many states like California from further financial woes, or consider additional cost-saving measures. Among his suggestions were medical malpractice reform, individual mandates to buy health insurance, and universal coverage.