Meridian Star

May 26, 2013

Medicaid: Renew and fund it now


The Meridian Star

MERIDIAN —     On four separate occasions during the 2013 Regular Session, House Democrats voted to kill Mississippi’s Medicaid program. With a supermajority required to pass, the Democratic minority had enough votes to defeat Republican efforts to extend the existing program for another year.

    Medicaid is now scheduled to go out of business July 1, courtesy of House Democrats. If that happens, more than 700,000 Mississippians currently on Medicaid (low-income, aged, blind and disabled adults and children) will lose health coverage. Nearly 18,000 nursing home residents must consider new living arrangements. Beneficiaries of specialized medical services, including cancer treatments, organ transplants, and dialysis, will be cut off.

    Over 1,000 state employees will lose their jobs, and 30 Medicaid offices around the state will close. The State of Mississippi before July 1 will spend $250,000 of your taxes just to mail legal notices telling people their Medicaid is going away. Again, all thanks to House Democrats.

    Democratic leaders say they don’t really want to kill Medicaid, and I believe them. However, their reckless actions show they are willing to imperil health coverage for 700,000-plus current Medicaid recipients (not to mention scaring these people to death) simply to make a partisan political statement about the Affordable Care Act (“Obamacare”).

    Each state has the option, but not the obligation, to expand Medicaid coverage under Obamacare.Democrats want to add 300,000 essentially able-bodied “working poor” to the Medicaid rolls, which would put around one million Mississippians (1 in 3) on the program. Legislative Republicans are dubious about our state’s long-term ability to afford this massive expansion, and agree any final decision is at best premature.

    The truth is that even without expansion, mandatory Obamacare regulations will cost Mississippi as much as $436 million more before 2020, and a full expansion likely would cost over $1 billion. Slick, left-leaning advocacy groups tout extravagant claims that Medicaid expansion would create thousands of new jobs and bring prosperity to Mississippi. The reality is, as our senior state economist says, “the state will not see a positive return on its investment with Medicaid expansion. It should not be considered economic development.”

    Many of our state’s doctors are skeptical about Medicaid expansion.  Recently, the president of the State Medical Association said “physicians fear that an expansion of Medicaid may not be financially sustainable and will impose on the state unintended consequences that will weaken provider capacity, which is inadequate now.”

    Doctors understand the goal should be to make citizens healthier. Yet a recent study from Oregon reveals no evidence that Medicaid coverage actually improves the physical health of the very population targeted for expansion (low-income adults aged 19-64). Statistically, the generally “working poor” are no healthier with Medicaid coverage than they were when uninsured! Given this looming specter of lackluster performance, why would any state rush to expand?

    Indeed, less than half the 50 states will expand Medicaid in 2014, and some others are pursuing alternative expansion-based models. Nineteen states have rejected expansion outright, and another seven are leaning against it.

    A big worry has been that hospitals will be hurt without Medicaid expansion if the Federal government cuts uncompensated care subsidies (DSH monies) now paid to them.

    We’ve recently received good news that eliminates any urgency on this. The Feds announced this month that Mississippi will experience only a very small reduction in Medicaid DSH payments during 2014, a total (effectively only about $2 million less) easily dealt with by hospitals and/or the Legislature.  (Although the Obama administration may also cut MediCARE DSH payments, MediCARE, unlike MediCAID, is a completely Federal program the state has nothing to do with).

    Governor Bryant likely will call a Special Session before July 1 so that Democrats can reconsider and vote to continue the current Medicaid program they have previously voted four times to kill. Every day of a Special Session costs taxpayers over $30,000.                                                        

    Medicaid expansion will not be on the Special Session agenda. Under our Constitution, the Governor has the sole power to define the session’s purpose, and the Legislature cannot “go outside of the call” to take up other matters. Governor Bryant will not include Medicaid expansion within his call, and neither the Senate nor the House will defy him. Whether to continue the existing Medicaid program will be the only issue on the table.

    It is a cruel thing for the House Democratic leadership to use 700,000-plus current Medicaid recipients as their political pawns. This partisan stunt must end. Our existing Medicaid program should be renewed in full and funded without interruption or delay. House Republicans pledge to do just that when we return to Jackson.

 

    Rep. Greg Snowden (R-Meridian) represents Clarke and Lauderdale counties in the Mississippi Legislature.  Snowden is Speaker Pro Tempore of the Mississippi House of Representatives and he also serves as Chairman of the House Republican Caucus.