Expansion estimates vary Report: State Medicaid costs could increase to $1.7 billion by 2020

By Bobby Harrison/NEMS Daily Journal Jackson Bureau

JACKSON – Mississippi will expend between $429 million and $581 million between 2014-19 and receive between $9.9 billion and $11 billion in federal funds if the state expands its Medicaid program as part of the new health care law.
Those were the findings of a 2010 study of the Urban Institute, a nonpartisan economic and social policy research center based in Washington, D.C.
A study conducted by Milliman, a national actuarial company at the behest of the state Medicaid Division, estimates the costs to the state could total as much as $1.7 billion by 2020.
Opponents of the Medicaid expansion cite the Milliman study as their reason for opposition. But supporters of the expansion question many of Milliman’s findings.
A study by the Arkansas Department of Public Health contends that state will save $372 million in the first six years by participating in the expanded Medicaid program.
The Patient Protection and Affordable Care Act expands Medicaid to cover people earning 133 percent of the federal poverty federal level of about $14,400 annually. Estimates are that the Medicaid expansion would provide health care to between 200,000 and 430,000 additional Mississippians.
The Supreme Court has ruled that states do not have to participate in the Medicaid expansion.
Most of Mississippi’s Republican leadership has indicated they have no plans to participate in a program created by the Democratic president.
gov. Bryant against it
Mick Bullock, a spokesman for Gov. Phil Bryant, said the governor “has no intentions of expanding Medicaid. Any expansion of Medicaid could result in significant tax increases or dramatic cuts to education, public safety and job creation.
“In Mississippi, adding a projected 400,000 individuals to the Medicaid rolls would increase administrative costs by $17 million the first year and $36 million the second year. Total estimated cost to the state for the first three years of Medicaid expansion is $110 million. Simply put, Mississippi cannot afford a Medicaid expansion.”
Most poor adults do not qualify for Mississippi’s existing Medicaid program. Currently in Mississippi about 600,000 poor pregnant women, poor children, the disabled and a segment of the elderly population are in the Medicaid program.
The federal government provides Mississippi about 74 cents of each dollar spent on Medicaid.
For the Medicaid expansion, the first three years, starting in 2014, the federal government will provide 100 percent of the costs. After that, the federal share will stair-step down each year to 90 percent in 2020 where it will remain.
But Bryant said there are other costs the state will incur. For instance, Bryant and others worry that people who currently qualify for the Mississippi Medicaid program but have not signed up, will be added if the program is expanded to cover those earning up to 133 percent of the federal poverty level. For those who already qualify under existing law, the federal government would pay under the current match rate of 74 percent.
Roy Mitchell of the Mississippi Health Advocacy Program has said in earlier presentations that the cost of the new enrollees to an expanded Medicaid program would not be as much as those currently in the program. People with high medical costs, such as pregnant women, the elderly in nursing homes and the disabled, are already in the program.
The people added to an expanded Medicaid program would generally be healthy, resulting in less costs to the state, Mitchell contends, saying that the administrative cost of an expanded program is being overstated.
state leaders look at law
While Bryant is adamant in his opposition to the expansion, other key state leaders are saying they should at least look at the ramifications.
Lt. Gov. Tate Reeves said he is focused on helping elect Republican presidential nominee Mitt Romney, who has said he would repeal the new health care law. But in the meantime, Reeves added he has his staff “studying the new law daily” in case it is not repealed.
House Speaker Philip Gunn’s office also has indicated that the ramifications of the new law are being considered.
But House Appropriations Chair Herb Frierson, R-Poplarville, said, “I don’t think we are going to do it if I had to guess. I would be surprised if we opted in.”
Rep. George Flaggs, D-Vicksburg, is urging Reeves and Gunn to form a special joint committee to look at the issue, especially considering the conflicting numbers about what the program will cost Mississippi.
Plus, Flaggs has said the economic impact of the additional federal dollars should not be discounted.
Rep. Kelvin Buck, D-Holly Springs, said he and others would make efforts to get the state to deal with the issue during the 2013 session.
“I am going to ask the chairman of the Insurance Committee to look at it,” Buck said.


bobby.harrison@journalinc.com