EDITORIAL: Worries about Medicaid

Tuesday’s start of the 2010 legislative session includes worries about Medicaid, the state-federal health insurance program providing service to more than 600,000 Mississippians (about 20 percent of our state’s population) 59 million nationwide (low-income pregnant women, children, individuals with disabilities and seniors).
Many governors, including Gov. Haley Barbour, worry that some versions of national health insurance could significantly increase Medicaid eligibility and cause states to spend a lot more money for their matching share, the mechanism that draws down federal funds to pay for a majority of Medicaid’s costs.
Barbour, among others, particularly Republicans, has strongly denounced what he sees as a forced increase and financial burden on the states.
Barbour, chairman of the Republican Governors Association, said in a statement on Dec., 20, said, “It is already clear that the states cannot afford any new Medicaid costs. It is increasingly obvious that the Senate Leadership must not know how the proposed changes will affect the states. The Senate should abandon its current approach to Medicaid and find common ground,”
Barbour believes that placing “15 million-20 million more people into the Medicaid
program albeit with promises of enhanced federal funding” could cost Mississippi $200 million more in state spending.
The National Governors Association, of which Barbour is a member, considers Medicaid’s role “vital (to) productivity, competitiveness and quality,” and it says health care reforms are necessary. Among those is “modernization of Medicaid … because of the program’s long-term fiscal outlook. Medicaid accounts for more than one fifth of total state spending. Increases in state spending on Medicaid have been driven by a combination of factors, including rising health care costs, fluctuations in enrollment and increases in demand for services for individuals with complex medical needs. … Medicaid has become the nation’s de facto source of long-term care coverage as well as a critical source of coverage for individuals eligible for both the Medicare and Medicaid program – known as the dual eligibles … some of the most expensive Medicaid enrollees. While they represent only about 18 percent of the Medicaid population, they account for about half of Medicaid spending. Comprehensive Medicaid reform must focus both on reforming Medicaid and on strengthening other forms of health insurance and long term-care services and supports.”
The national health reform outcome remains uncertain, but it is reasonable to expect representatives and senators both to consider the financial impacts on the states, most of which have initiated deep budget cuts and/or tax increases.
Mississippi legislators wrestle every year with funding Medicaid, and any broad new mandates would prove more problematic.

NEMS Daily Journal