Lawmakers’ disagreement shows divide over Medicaid expansion
Published: April 9,2013
Tags: health, health benefits, health care, health care reform, hospital, insurance, lawmaker, legislative, legislator, Legislature, low income, medical, medicine, politician, Politics, poor, public health, uninsured
JACKSON — Two lawmakers who spoke at a press luncheon yesterday disagreed about whether Mississippi should expand Medicaid, reflecting the partisan split that left the health program in limbo when the House and Senate ended their three-month session last week.
Democratic Sen. David Blount, of Jackson, said adding an estimated 300,000 people to Medicaid — most of them working poor — makes sense because Mississippi would receive billions of federal dollars over 10 years, and that money would support health care jobs.
“We ought to recognize a good deal when we see it,” Blount told about 35 people during luncheon sponsored by the Capitol press corps and Mississippi State University’s Stennis Institute of Government.
Republican Rep. Andy Gipson, of Braxton, said the state can’t afford to pay its share of expansion, and he doesn’t believe federal money is guaranteed.
Under the federal health overhaul that President Barack Obama signed into law in 2010, the federal government will pay 100 percent of medical expenses for the newly qualified Medicaid enrollees from 2014 to 2017. The federal share would be reduced to 90 percent by 2020, with each state paying the balance.
“Knowing that the federal government may pay for a portion of it for the next two or three years is not enough comfort for me to go ahead and say, ‘You know, let’s expand this and take on the whole program,’” Gipson said. “Certainly, we don’t have the funds to do that.”
The federal law says states have the option to expand Medicaid to people making 138 percent of the federal poverty level. That’s an income of about $15,000 for one person. In Mississippi now, the income cutoff to enroll is about $5,500 for one person, and the state program does not cover many able-bodied adults, regardless of income.
Medicaid is a government health insurance program for the needy, and it’s funded by state and federal money. The Mississippi program enrolls more than 640,000 in a state of about 3 million people.
Mississippi lawmakers ended their regular session last Thursday without passing a Medicaid budget or authorizing the program to stay in business beyond June 30. Gov. Phil Bryant will have to call them back for a special session before the end of June. The state’s 2014 fiscal year begins July 1.
Some lawmakers say they’re waiting to see whether the federal government will stick with a plan to phase out payments to hospitals for treating large numbers of uninsured patients. Those are called disproportionate share payments, and several Mississippi hospital administrators have said the loss of that money could lead to layoffs.
Democrats and Republicans in the Legislature are blaming each other for the Medicaid impasse.
“To this point, in Mississippi, it has largely been a partisan issue, but I don’t think it has to be a partisan issue,” Blount said Monday. “To me, it’s a dollars and cents issue and a public health issue.”
Blount cited a study by the state university system that showed Mississippi would spend about $1.1 billion, cumulatively, over 10 years to expand Medicaid. The study also said the federal government during that time would spend about $12.5 billion on Medicaid expansion in Mississippi.
Gipson said Mississippi already struggles to pay for the existing Medicaid program. He said he wants lawmakers to reauthorize the current program and approve the budget before July 1.
“I’m for supporting the program we do have,” Gipson said.
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