State governors may be key to the success of federal health reform efforts, and a coalition of 22 Democratic governors has joined the call for enactment of a health care system overhaul, providing Democratic lawmakers with an important support base for their efforts.

Twenty-two Democratic governors wrote to congressional leaders on October 2 to urge passage of health care reform legislation by the end of this year.

"Many of the provisions [in the health reform bills] will allow states and territories to achieve long-term savings and help cover those who currently go without coverage," the governors wrote. "We recognize that health reform is a shared responsibility and [that] everyone, including state governments, needs to partner to reform our broken health care system."

The letter was hailed as a victory by the Obama administration, which has sought to broaden support for health care reform beyond just Democrats in Congress.

"These governors know that without reform, health care costs will continue to rise, and they will continue to struggle to balance their budgets," said Health and Human Services Secretary Kathleen Sebelius in a written statement. "Reform will help give our states the relief they need and give the American people the security and stability they deserve."

Six Democratic governors and all the Republican governors declined to sign the letter.

Governors of both parties have expressed concerns over some versions of health care reform that would reduce the number of uninsured in part through major Medicaid expansion, since the program is jointly funded by federal and state money. Such expansion would require new state spending at a time of rising budget deficits.

Other recent support from outside the Beltway included letters from 1,057 state legislators from all 50 states sent last month to Obama and congressional leaders urging enactment of health reform, including the controversial public health insurance option. The effort was organized by the Progressive States Network, a liberal advocacy group.

Earlier supporters of health care reform include state Medicaid officials, who told authors of the Kaiser Family Foundation's Commission on Medicaid and the Uninsured annual survey (see Health Reform Advances With MH Amendments on Board), released in September, that they supported the principles underpinning federal reform, including strategies to expand coverage to the uninsured.

A copy of the governors' letter is posted at <www.democraticgovernors.org/news/press_releases?id=0288>.