By Bobby Harrison
Daily Journal Jackson Bureau
JACKSON – Gov. Phil Bryant’s proposals totaling more than $12 million to enhance access to health care for uninsured Mississippians are pending in the Legislature.
But some question whether the governor’s proposals are the most efficient use of scarce state funds.
Legislation in the Senate would provide $3.2 million to provide grants to federally qualified health centers and rural health clinics while a House proposal would provide $4.8 million for the two sets of clinics designed to provide health care to the poor and indigent.
Nicole Webb, a spokeswoman for Bryant, said, “The governor’s intention with both of these bills is to increase access to primary health care services across the state. Many of the patients served by these clinics have incomes below 200 percent of the federal poverty limit, and many are also uninsured.”
The Republican Bryant and the House and Senate leadership have been steadfast in refusing to expand Medicaid to cover people earning up to 138 percent of the federal poverty level as is allowed under the federal Affordable Care Act.
“I won’t say this is the governor’s alternative to expanding Medicaid, but the idea is to try to increase health care in rural areas to the uninsured and indigent without expanding Medicaid,” said Sen. Terry Burton, R-Newton, one of the sponsors of the Senate bill. “It certainly does not cover everything, but it makes a difference.”
Republican leaders have said the state cannot afford the Medicaid expansion and they fear the federal government might renege on its commitment to provide the vast majority of the money for it.
But based on the governor’s proposal and based on what the Legislature appears poised to pass, it is likely state government will be spending more to provide health care to the poor in the coming year.
Sen. Hob Bryan, D-Amory, and others say the governor’s plan is “a hodgepodge” that only maintains the status quo and does little to expand access to health care while the state is losing millions per day in federal health care funds by refusing the Medicaid expansion.
Bryan said the governor has not presented a plan “that is rational and efficient for the taxpayers… I think he has an obligation to have a comprehensive plan, have a serious conversation about how we are going to deal with people who do not have insurance.”
The governor also has recommended to the Legislature that $4.4 million be appropriated to the state’s hospitals to offset a portion of the funds they will lose by not expanding Medicaid.
The estimate is that as many as 300,000 Mississippians, earning around $15,000 for an individual or up to $32,000 annually for a family of four, will be eligible for Medicaid health care coverage under the expansion.
Last year studies conducted on behalf of the state Division of Medicaid estimated that over a seven-year period the expansion would cost the state a cumulative $450 million while receiving $8.6 billion in federal funds.
Other studies have indicated that the program would be no cost or minimal cost to the state general fund when the jobs and other economic activities generated from the expansion are factored in. For the first two years, starting this past January, the federal government will pay the full cost of the health care costs under the expansion, though there will be some administrative costs to the state.
Bryant’s proposals are to expand the hours of operation of locations of 21 federally qualified community health centers across the state. The state already appropriates about $4 million to the centers. He also wants to expand the number of locations of the centers and the operations of what are known as rural health clinics that are set up to provide health care in rural areas across the state.
The governor’s proposals would establish state money that would be awarded to the clinics on a competitive basis to help pay for programs that enhance health care access.
Bryan said those clinics do good work, but the scope of the care provided at the clinics is limited.
It is too early in the legislative process to determine how successful the governor will be with his proposals.
But what is clear is that Bryant and the legislative leadership are considering enhancing health care access in the state, but are giving no consideration to expanding Medicaid.