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Health care execs concerned if Medicaid is not expanded

ACROSS MISSISSIPPI — Some Mississippi hospital administrators say they worry about bad financial consequences if the state doesn’t expand Medicaid under the federal health care overhaul.

Specifically, they worry hospitals will have to continue providing care for uninsured people even if the federal government stops reimbursing part of the expense.

Officials say there’s a lot of uncertainty about whether the reimbursement will continue in states that choose not to put more people on Medicaid, the federal-state health insurance program for the needy.

Republican Gov. Phil Bryant has said for months that Mississippi can’t afford to put another 300,000 people on Medicaid, even with the federal government paying most of the tab from 2014 to 2017.

Chris Anderson, CEO of the Pascagoula-based Singing River Health System, said Wednesday that it makes financial sense to put thousands of currently uninsured people into the program.

“I absolutely think the state should proceed with expanding Medicaid,” Anderson said in an interview after he spoke to a Senate Public Health subcommittee.

“I realize there are pros and cons and there is some cost. But if we do not expand, we are taking taxpayer dollars from the state of Mississippi and we’re giving it to other states,” Anderson said. “It is going to strengthen other health systems in other states at the expense of Mississippi, already the poorest state in the country.”

He wasn’t alone in that sentiment.

Gary Marchand, president and CEO of Gulfport-based Memorial Hospital, said that in 2009, about 10 percent of the hospital’s patients were uninsured. By 2012, he said that had risen to “slightly north of 13 percent,” which he attributed to a stagnant economy.

Marchand said if some uninsured people are put on Medicaid and others buy private insurance through an online exchange, Memorial Hospital would face lower expenses of providing care for those with no insurance coverage.

The federal health care law that President Barack Obama signed in 2010 originally was designed to reduce the number of uninsured Americans by requiring people to buy private coverage, some of which is government-subsidized, or by putting more low-income people onto Medicaid. As more people became insured, the federal government was supposed to decrease its payments to hospitals for providing care for the uninsured.

The U.S. Supreme Court last summer upheld most of the law but said Medicaid expansion is optional for states, not mandatory.

Dr. David Dzielak, director of the Mississippi Division of Medicaid, said he doesn’t know when Washington will give a firm answer about continuing or canceling reimbursement to hospitals for uninsured care in states that don’t expand Medicaid.

Lee McCall, CEO of Winston Medical Center in Louisville, said about 33 percent of the patients at his rural hospital are uninsured, and many of them go to the emergency room for nonemergency treatment.

“They have a shortage of physicians in our community, and so without individuals being able to get into their local doctor, they come to the ER for primary care,” McCall said.



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