Obama budget could affect state Medicaid debate

By Bobby Harrison/NEMS Daily Journal

JACKSON – Mississippi’s Republican leaders believe they were provided ammo for their position of not taking up expansion of Medicaid this year by of all people, President Barack Obama.
They hailed the president’s budget proposal released Wednesday because it delays cuts in a program that partially reimburses hospitals for the uncompensated care they provide.
Under the federal Affordable Care Act, cuts in the Medicaid disproportionate share hospital (DSH) payments were to begin in October. The program was to be dramatically cut over time under the rationale that hospitals would be treating far fewer people without health care coverage because of the expansion in Medicaid allowed under the act.
But Mississippi’s Republican leadership has fought the expansion, saying the state can’t afford it. That fight led to the 2013 session ending last week without Medicaid being funded or authorized past June 30. The Legislature is expected to come back in special session to resume the fight over Medicaid expansion.
On Wednesday, Republican leaders said Obama’s proposal to delay the cuts reinforces their position that they do not need to address Medicaid expansion this year.
“I am pleased to see that President Obama’s budget delays cutting these payments until 2015,” Gov. Phil Bryant said. “I have long advocated that cuts to this program should not be used to affect budgets in states that choose not to expand Medicaid. This move should give us additional time to make a reasonable decision about any changes to the Medicaid program.”
Gwen Combs, vice president for policy for the Mississippi Hospital Association, said that $148 million in cuts to the state’s hospitals, beginning Oct. 1, in another federal program are not addressed by the Obama proposal. And the president’s proposal to delay about $500 million in DSH cuts nationwide to hospitals still would have to be approved by Congress.
Plus, under his proposal, the cuts would be delayed for one year and the $500 million in cuts scheduled to be enacted in October would be spread out over the 2016-17 fiscal years.
“This would just delay it,” Combs said of the Obama proposal.

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