Medicaid Uncertainty Has Consequences

JACKSON, Miss. (AP) — As Mississippi lawmakers passed dozens of budget bills Monday, Lionel Collins went to the Capitol to remind officials how their financial decisions will affect his life.
Collins, a 34-year-old Jackson resident, said he has had “crippling arthritis” his entire life. He uses a wheelchair and relies on home health care.
Collins said it’s urgent for lawmakers and Gov. Haley Barbour find a way to keep Medicaid in business when the state’s new budget year begins Wednesday.
“I receive personal care services, and I need my Medicaid in order to continue receiving those services,” Collins said.
Legislators scrambled to approve bills paying for everything from public schools to highways to prisons. Medicaid, however, was still not up for consideration. House and Senate negotiators were waiting late Monday to hear whether Barbour would accept a proposal to fund Medicaid, the government health insurance program for the needy.
When the special session started Sunday, Barbour initially allowed lawmakers to consider only special fund agencies, which get their money from fees or specific taxes such as the gasoline tax that goes to the Mississippi Department of Transportation.
On Monday, Barbour expanded the agenda to let lawmakers debate most parts of the $6 billion general fund, the largest part of the budget.
Collins was among about 75 health advocates who rallied in the Capitol rotunda to urge Barbour to support Medicaid, a massive program that covers about one in every four Mississippi residents. The agency needs a budget. Legislators also need to authorize the program to stay in existence beyond Tuesday — a common procedure, as most state agencies come up for reauthorization every few years.
“Our entire health care system would fail without Medicaid,” House Public Health Committee Chairman Steve Holland, D-Plantersville, told the group.
Democratic Attorney General Jim Hood said last week that if there’s still no Medicaid plan when the new fiscal year starts, a court order would be needed to keep operating the program. Republican Barbour, however, believes he can run the program by executive order.
The governor wants to put a $90 million tax on hospitals to help fund Medicaid. Lawmakers’ latest proposal would start the tax at $60 million a year, then increase it gradually. The Mississippi Hospital Association has lobbied hard against it, saying it would hurt facilities’ finances. Health advocates worry the hospitals would pass price increases along to patients.
Barbour said Sunday that he believes budget bills for most agencies will be signed into law on time.
Lawmakers are considering proposals to prevent an increase in the price of car tags. They’re also debating whether to pass the second cigarette tax increase of the year. In May, the state excise tax on all cigarettes jumped 50 cents — from 18 cents a pack to 68.
The House approved a bill Monday that would add 20 cents a pack to cheaper cigarettes made by companies that did not participate in Mississippi’s 1997 settlement of a massive lawsuit against big tobacco firms. The Senate on Sunday approved an increase of 25 cents a pack for the cheaper cigarettes. The two chambers must agree on a figure before a bill can go to the governor.
Mississippi lawmakers usually finish the budget by early April, three months before the start of the fiscal year. They waited longer this year because they wanted to see how federal stimulus money will affect state government.
Legislators had said for months that the state would have a $5 billion general fund. In the past several days, they’ve started saying the figure is closer to $6 billion with the addition of federal stimulus funds and other chunks of money, including $40 million from Hood’s settlement of a state lawsuit against Microsoft and millions of dollars from the anticipated sale of contraband cigarettes seized by law enforcement agents several weeks ago.
The on-again, off-again regular session ended in early June. Longtime lawmakers say this is the first time in decades for Mississippi to be in danger of starting a fiscal year without a spending plan. News archives show that on July 1, 1968, Mississippi started the 1969 fiscal year with no budget.

Emily Wagster Pettus, Associated Press