A day after the board of the Atlanta hospital voted to change its governing structure to attract a financial infusion, Georgia political leaders on Tuesday balked at the price tag.
Grady's board called for a written guarantee that the state will spend $30 million a year to prop up the hospital, which serves a large number of poor and uninsured Georgia residents.
"I have no intention of signing an unenforceable document that seeks to bind the state to a specific, annual appropriation," Gov. Sonny Perdue said.
Lt. Gov. Casey Cagle echoed that sentiment, calling the resolution adopted by the Grady board a starting point.
"You can't enter into a contract that's going to go on for eternity, and that's really what has been requested," Mr. Cagle said.
Through a spokeswoman, House Speaker Glenn Richardson declined to comment.
The Grady board asked for a written commitment from all three leaders pledging state dollars.
They are also asking the state to pump money into the state's cash-strapped network of trauma centers. Grady is one of the state's few level-one trauma centers.
A stalemate could lead lawmakers to pass legislation requiring the hospital to adopt nonprofit status without any guarantee of additional state money.
Mr. Cagle said "the worst-case scenario" would be if lawmakers came back to the Capitol without a resolution in the Grady funding crisis.
"The mood of the Legislature is to ensure that Grady stays viable, and maybe change would be in order," Mr. Cagle said.
The state already funnels about $47 million to Grady, mostly through Medicaid payments. State and federal money to the hospital totals $222 million, state officials said.
The Fulton-DeKalb Hospital Authority -- Grady's current 10-member board -- voted Monday to create a 17-member nonprofit governing board.
But the move came with strings. The handover is contingent on a $300 million commitment over several years from the business, charitable and philanthropic communities, in addition to the $30 million from the state.
The board has faced heated criticism as activists have accused it of abandoning its mission to serve poor -- and largely minority -- residents in favor of a plan backed by the city's business establishment.
Kevin Bloye, the spokesman for the Georgia Hospital Association, said the state has an obligation to boost funding for Grady, which serves a high number of the uninsured.
"Other hospitals can turn to their private payers to make up the costs, but Grady has nowhere to go," Mr. Bloye said.