By Bobby Harrison/NEMS Daily Journal
JACKSON – Republican Gov. Phil Bryant called last week’s special session to fund and to reauthorize the Division of Medicaid for the new fiscal year, which begins Monday.
Everyone knew legislative Democrats would try to make the special session, at least in part, about expanding Medicaid to cover those earning up to 138 percent of the federal poverty level, or about $15,000 annually, for an individual.
But House Democrats also tried to make the session about enacting a state-based health insurance exchange, as proposed by Republican Insurance Commissioner Mike Chaney. A state exchange, House Democrats argued, would allow more Mississippians with no health care coverage to take advantage of a federal subsidy to help them purchase private insurance. Without a state-based exchange, Democrats say at least 60,000 uninsured people in 32 counties will not have access to an exchange that is supposed to provide cheaper rates and possible federal subsidies.
The Republican majority was able to block both proposals, yet Bobby Moak of Bogue Chitto said the Democrats were successful because they brought attention to both issues.
The exchanges are separate from Medicaid expansion, but also part of the Affordable Care Act. Residents in every state are supposed to be able to go to the exchange to purchase insurance at presumably a reduced rate, and people within certain income levels will receive a federal subsidy or tax credit to help with the purchase.
If a state does not create its own exchange, which must receive federal approval, the Affordable Care Act requires the federal government to establish one.
Chaney was working on an exchange, but it was rejected by federal officials – at least in part because it was opposed by Bryant, an ardent opponent of the Affordable Care Act.
But, according to information provided thus far through federal officials, no private insurance provider has signed up to participate in the exchange in 36 of Mississippi’s 82 counties.
The counties include Alcorn and Tishomingo in Northeast Mississippi. A bulk of the counties where no private insurance has signed up to participate are in the south Delta region, extending over to east central Mississippi, southwest Mississippi and a scattering of other counties, including relatively populous Jones and Hancock on the Coast.
House Democrats argued that under Chaney’s plan there were multiple private insurance providers participating in every county.
Rep. Cecil Brown, D-Jackson, said whether a Mississippian receives the tax break or not could depend on what side of a county line he lives.
“That is not right,” Brown said. “All our people pay taxes. All we want to do is ensure people in all the counties receive the tax credit they are entitled to receive.”
Rep. Lester “Bubba” Carpenter, R-Burnsville, who voted against the state-based exchange even though Alcorn and Tishomingo counties, which he represents, are not covered under the federal exchange, said he does not want to be seen as encouraging the Affordable Care Act.
“I feel like we would be encouraging the federal government into our state” by developing a state exchange instead of the federal one, Carpenter said. “We would basically be saying we are for Obamacare.”
The enrollment for the exchange does not begin until October. Some Republicans, like Carpenter, said they believe the federal government will ensure all of the counties are covered by then. Blue Cross, for instance, according to published reports is expected to offer plans nationwide.
Bryant said he believes the exchange will not work whether it is state-based or run by the feds.
“I do not believe a local exchange would be any better,” he said.