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State's Medicaid enrollment growing, spurred by Affordable Care Act

healthcare reform_rgbJACKSON — Mississippi’s Medicaid enrollment has grown since January, even as top elected officials continue to oppose expanding the program.

Medicaid director David Dzielak told legislative budget writers Friday that the biggest reason for the enrollment increase is a new type of income calculation.

He said that under the federal health overhaul law, the Affordable Care Act, administrators are now required to ignore a portion of people’s income when they apply for Medicaid or the state Children’s Health Insurance Program. That allows more people to qualify for coverage.

Mississippi’s Medicaid and CHIP enrollment, combined, went from 714,338 in January to 775,176 in September, Dzielak said. That’s an 8.5 percent increase.

He said he expects the rate of growth to slow down soon.

Under the Affordable Care Act, states have the option of expanding Medicaid to people earning up to 138 percent of the federal poverty level, or about $15,000 a year for one person. In Mississippi now, the income cutoff is about $5,500 for one person, and many able-bodied adults are not eligible for Medicaid coverage regardless of how little they earn.

Gov. Phil Bryant, Lt. Gov. Tate Reeves and House Speaker Philip Gunn, all Republicans, oppose Medicaid expansion because they say they don’t believe the federal government’s promise to pay most of the expenses.

The Affordable Care Act says the federal government would pay 100 percent of medical expenses for 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. Reeves said Medicaid’s budget has grown by hundreds of millions of dollars in the past several years, and the state can’t afford to pump more into the program.

“I don’t anticipate Mississippi’s going to expand Medicaid in the 2015 session,” Reeves told reporters after Friday’s budget hearing.

Rep. John Moore, R-Brandon, who also serves on the Joint Legislative Budget Committee, said Friday: “It’s relatively hard to get on Medicaid, which it should be.”

Because Mississippi is one of the poorest states in the nation, it also receives the most generous portion of federal funding for its Medicaid program. The federal government pays about 73.6 percent of Medicaid expenses in Mississippi during the current federal budget year that started Wednesday. That is up slightly from about 73.1 percent in the federal budget year that just ended.

Dzielak is requesting just over $1 billion from the state budget to pay for Medicaid during fiscal 2016, which begins July 1 — the first time the program’s request has crossed from millions to billions.

During the current budget year, legislators set aside $885 million of state money for Medicaid, and Dzielak said the programs needs another $99.5 million before June 30. The director said the biggest reason for rising expenses is not the increase in enrollment: “It’s due to the ever-escalating medical services cost.”



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