Dems work on Miss. Medicaid expansion proposal

Miss. Dems: Federal timetable for hospital cuts gives new urgency to Medicaid expansion debate

Associated Press

JACKSON, Miss. (AP) -- Democrats in the Mississippi Legislature say they're working on proposals to keep Medicaid alive and funded in the budget year that starts July 1.

They say they're doing this in case Republican Gov. Phil Bryant calls a special session before the end of June.

However, Bryant said last week he believes he can run Medicaid without legislative authorization — even with no budget in place.

House Democratic Leader Bobby Moak said there's new urgency because a federal agency on Monday released proposed rules for how it would reduce Medicaid payments to hospitals that treat large numbers of uninsured patients. If the rules are adopted by the federal Centers for Medicare and Medicaid Services, changes could start taking effect in a few months.

Mississippi hospital leaders worry they'll face a financial crunch by losing federal money while still seeing large numbers of patients who don't have private insurance or Medicaid.

"It's just a bad deal for the hospitals," House Democratic Leader Bobby Moak of Bogue Chitto said Tuesday.

Bryant has said repeatedly that he believes Mississippi can't afford to put more people on Medicaid, the federal-state health insurance program for the needy, aged, blind, disabled and low-income families with children.

In a statement Tuesday, Bryant spokesman Mick Bullock said the proposed rules issued Monday by the federal government would be temporary, even if they're adopted. In two years, the federal government could change the way it calculates payments to hospitals.

While all states would lose money under the proposed rules issued Monday, those with higher shares of uninsured residents would lose less. That means Mississippi would lose less than, for example, Colorado, which is expanding Medicaid.

"While Mississippi's projected cuts may be less than previously anticipated, this temporary proposal is further evidence that Obamacare and its effects remain unclear and that it would be reckless to sign onto a massive entitlement expansion under this train wreck of a law," Bullock said Tuesday.

Mississippi has about 3 million residents. Roughly 640,000 are already enrolled in Medicaid, and lawmakers estimate another 300,000 could become eligible if the state expands the program.

Under the federal health care overhaul that President Barack Obama signed into law in 2010, states have the option of expanding Medicaid to people making up to 138 percent of the federal poverty level, which is an annual income of about $15,000 for one person. Under current standards in Mississippi, the upper income level for Medicaid eligibility is about $5,500 for one person. Even under that standard, the state program still does not cover many people who don't have children.

During the three-month regular legislative session that ended in early April, Democrats said they wanted a chance to debate Medicaid expansion in the House. The session ended without an agreement to keep Medicaid alive after the current budget year ends June 30, either with or without expansion. Medicaid is one of several agencies that comes up for review and reauthorization ever few years.

Lawmakers also ended the regular session without passing a separate budget bill for Medicaid. So, both the authorization and the funding are unresolved for now.

Moak and many other lawmakers say the governor can't run Medicaid if the program is not authorized or funded. But Bryant said he thinks he can run it and those who don't agree with him can challenge him in court.

The health overhaul law was designed to reduce the number of uninsured Americans by putting more low-income people on Medicaid and requiring others to be covered by employers' plans or by other options such as health exchanges run by state governments working alone or in cooperation with the federal government.

Federal officials earlier this year rejected a Mississippi health exchange proposal, citing lack of support from Bryant. The exchange had been submitted by Insurance Commissioner Mike Chaney, a Republican. An exchange is an online marketplace where people can buy health insurance. Under the health care law, each state must have an exchange by 2014.

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