MEDICAID BUDGET STYMIES LAWMAKERS
By Bobby Harrison
Daily Journal Jackson Bureau
JACKSON – The Mississippi Legislature will meet again today to try to reach an agreement on the state’s $1.8 billion Medicaid budget.
Currently, the House and Senate are involved in an old-fashioned standoff. The Senate does not like the House position; the House does not like the Senate position. Thus far, neither has budged, even though members still were trying to reach an agreement late Friday.
Key legislators – known as a conference committee – were working to reach a compromise.
“I don’t know what in the world will come out of conference,” said House Speaker Tim Ford, D-Tupelo, as he took a Tums antacid tablet after it became obvious the two chambers still were far apart.
They have been far apart for some time now.
Last week, House and Senate members left the state Capitol without an agreement on Medicaid. They came back Friday, hoping to reach a consensus. They will continue trying for that elusive consensus today.
At the heart of the disagreement is a pilot program of managed care that a substantial majority of senators want to include in the Medicaid budget. A substantial majority of House members do not like the pilot program, even though it would be offered to Medicaid patients on a voluntary basis.
Under the managed or “capitated” care plan, the state Medicaid Division would contract with health maintenance organizations. These HMOs would be paid a flat free to contract with health-care providers, such as doctors, hospitals and pharmacists, to provide for the medical needs of the Medicaid patients.
The health maintenance organizations would get their money and provide the services whether health-care costs were extensive or minimal. On patients who had open-heart surgery, the health maintenance organization probably would lose money. On Medicaid recipients who require little or no medical care, the company would make money.
Supporters believe the system will curb skyrocketing Medicaid costs in part because the health maintenance organizations would stress preventive care. Preventive care is generally less expensive than providing the medical needs after someone gets sick.
Opponents say they do not know enough about the system. And some fear medical care would be curtailed to save money.
For whatever reason, a majority of House members do not like the program. They voted 107-8 last week against a managed-care pilot program that consisted of 22 counties.
After that defeat, the Senate and House negotiators took the pilot counties out of the Medicaid budget. The new plan involved setting up a committee to study managed care.
But Friday, the Senate voted 40-11 against eliminating the pilot programs.
That vote sent negotiators back to the drawing board.
Room to compromise
Lt. Gov. Ronnie Musgrove, who presides over the Senate, said there still is room for compromise. One compromise would be to reduce the size of the pilot program, which is currently 22 counties. But Musgrove also stressed that he agrees with the House position that the study committee is needed
The Legislature originally had intended to come back Friday to deal with any bills vetoed by Gov. Kirk Fordice. The session was scheduled to end at 6 p.m. today.
But legislators had to extend the session to April 19 to consider the Medicaid budget. Under the state Constitution, all appropriations bills, such as for Medicaid, must be passed five days before the end of the session.
So if the two chambers do not reach an agreement soon, they probably will leave without funding Medicaid. They then would be called back into special session by the governor.
Medicaid is a federal-state program that helps provide health care for the needy and disabled.