Vehicle for Medicaid expansion remains alive

By Bobby Harrison/NEMS Daily Journal

JACKSON – Legislation that could be used to allow Mississippi to expand its Medicaid program as part of federal law remained alive Tuesday in the Legislature.
The legislation, which passed the Senate Public Health Committee, does not include language expanding Medicaid, but it is written in such a way that it could be amended at a later time to expand the state-federal health care program.
“I think it is good to have more options than less options,” said Sen. Hob Bryan, D-Amory, who massaged the legislation through the Public Health Committee on a key deadline day.
Tuesday was the deadline for bills to pass out of committee in their chamber of origin.
What is at issue is legislation to re-authorize the state Medicaid program. If the program is not re-authorized this session, it would cease to exist when the new fiscal year begins July 1 unless Gov. Phil Bryant was able to run the program through executive order, which more than likely would result in a court skirmish.
Last week, House Democrats killed legislation in that chamber to re-authorize Medicaid because it was not written in such a way that it could be amended to include the Medicaid expansion.
The federal Patient Protection and Affordable Care Act gives the states the opportunity to provide Medicaid coverage to people earning up to 138 percent of the federal poverty level or about $15,000 annually.
Byrant and other Republican leaders have said Mississippi cannot afford to participate in the expansion because by 2020 state will have to pay 10 percent of the costs.
For the first two years, the federal government pays all the costs of the expansion and then it starts stepping down to 90 percent by 2020.
Many Democrats say the state cannot afford to reject the huge infusion of federal funds to provide coverage to a group of people who currently do not have insurance – primarily the working poor.
Senate Public Health Chair Dean Kirby, R-Pearl, said Tuesday he is against the expansion because he is concerned about the costs to the state. But he said he wants to keep alive language that would allow the state to expand Medicaid while officials learn more about the federal law.
Hospitals and other providers have expressed concerns about how they might be impacted if the state does not participate in the expansion.
Under the law, federal payments to hospitals for a portion of the uncompensated care they provide are supposed to be phased out under the assumption people would have coverage through the Affordable Care Act and hospitals would be treating far fewer people with no insurance.
But if Mississippi does not participate in the Medicaid expansion and the payments for uncompensated care are lost, many worry about the impact on the state’s hospitals.
On Tuesday, in the Public Health Committee Sen. John Horhn, D-Jackson, tried to amend the bill to opt into the federal expansion.
Bryan was opposed, saying,”I think it is useful to have a vehicle alive (for the expansion), but I don’t think it is a battle we fight at this time.”
Horhn said, “This is a shot. I am going to take it.”
Horhn’s amendment was defeated, but no one offered an amendment to remove language that would allow Horhn or another legislator an opportunity to try to expand Medicaid at a later date.
bobby.harrison@journalinc.com