WASHINGTON (AP) — The nation's Republican governors, seeking a voice in Congress' upcoming debt debate, pushed Tuesday for looser restrictions on how states spend money on health care for poor and disabled Americans.

States, they argued, should be allowed to design their own Medicaid programs and operate them with a lump payment every year from the federal government, and then be held accountable for the results. Outdated or inappropriate federal guidelines now make it more burdensome and frustrating to provide a health care safety net that's one of the biggest expenses for cash-strapped states, the governors said.

Medicaid should be custom-designed by each state to best provide care to children, the poor and disabled without federal rules and the waivers required to get around them, their report said.

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