Hospital payments in question under health care law

By Bobby Harrison/NEMS Daily Journal

JACKSON – A key question if Gov. Phil Bryant gets his wish and Mississippi opts out of a Medicaid expansion under the new health care law is whether the state will lose $210 million in federal funds used to compensate hospitals for care of the uninsured.
Under the federal legislation, Disproportionate Share Hospital payments are slated to be phased out under the assumption that most people will have health insurance either through the Medicaid expansion or other provisions of the Affordable Care Act.
But House Appropriations Chairman Herb Frierson, R-Poplarville, said some are making the argument the federal government cannot phase out the DSH payments in states that do not participate in the Medicaid expansion.
“That is a big question,” Frierson said. “Do the DSH payments go away?”
The Supreme Court upheld the constitutionality of the Affordable Care Act last month, but did say a provision of the law that would halt Medicaid payments to states that do not participate in the expansion could not be enforced. Frierson said some interpret that to mean the federal government could not phase out the DSH payments to the states that opt out.
But Ed Sivak, executive director of the Mississippi Economic Policy Center, which supports Mississippi participating in the expansion, said it is his understanding the Supreme Court ruling would not stop the phasing out of the DSH payments.
Shawn Rossi, vice president of marketing for the Hospital Association, said it appears federal officials do not think the retention of the DSH payments is “an option under the Supreme Court’s ruling” because the court left intact all the rest of the law.
Changes could be made to the law after the November general election. Republicans have vowed to repeal the law if they win.
Under the federal law, people earning up to 133 percent of the federal poverty level (about $14,400) per year would be eligible for Medicaid. Under current Mississippi law, Medicaid covers primarily poor pregnant women and children, the disabled and certain segments of the elderly population.
The current DSH payment program does not reimburse hospitals for all uncompensated care. According to the Mississippi Hospital Association, about $315 million of care is not reimbursed each year after the DSH payments to the state of $210 million.

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