The following highlights health issues mentioned in governors’ recent state of the state addresses.

• Rhode Island: In his Feb. 10 speech, Gov. Donald Carcieri (R) said that to survive the current economic downturn there are three steps that need to be taken including implementing the new Global Medicaid Waiver. He said, \"Too many [Rhode Island] families are painfully experiencing the loss of jobs, health care and their homes,\" adding, \"We need the unions to realize that our cities and towns cannot afford business as usual -- they cannot afford the wages, the pensions, the health care and the work rules that were bargained for.\" Carcieri continued, \"The world has changed dramatically. The cost of defined benefit pension plans and health care have spiraled out of control. These costs are crushing our taxpayers -- most of whom don’t have such pensions and health benefits. This is not about picking on anyone -- rather this is about picking up the burden together, for the sake of our children, our seniors on fixed incomes, and those truly dependent upon us. This is about pulling together to get us through this severe downturn\" (Carcieri speech text, 2/10).
  
  
• West Virginia: In his Feb. 11 speech, Gov. Joe Manchin (D) lauded some of the state’s recent health care accomplishments, including expanding CHIP eligibility, requiring children to take physical education in school and providing healthier foods in school vending machines -- all of which contributed to a decline in the state’s childhood obesity rate. Manchin also proposed that the state purchase dentistry equipment for primary care clinics to improve access to dental care for low-income residents, and he requested that dentists in the state volunteer one day each month in primary care clinics. In addition, Manchin spoke about the importance of adopting health care technology, including electronic health records and telehealth applications, and said that efforts to detect and prosecute medical fraud need to be increased. One of the larger goals needs to be increasing the number of state residents with health coverage and providing more residents with better access to care. Manchin said he has asked the state insurance commissioner \"to work with insurance carriers to establish new, affordable benefit packages that will increase coverage options for those unable to afford the insurance products currently available.\" Manchin also spoke about expanding Medicaid eligibility by applying for a federal waiver \"to design a program of basic medical and preventive care coverage using the medical home concept that has worked well for the agency in the past.\" He added that he would propose increasing the state cigarette tax if it is necessary to offset the increased costs of these programs (Manchin speech text, 2/11).

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