CECIL BROWN: Expansion would address costly uncompensated care

By Cecil Brown

Democrats in the legislature recently offered a compromise proposal to end the standoff on Medicaid expansion. Under our proposal, Mississippi would adopt Republican Insurance Commissioner Mike Chaney’s idea for a state-based health insurance exchange. We will then use the billions of new federal dollars we will receive under the Affordable Care Act (ObamaCare) to allow the 300,000 working Mississippians who are currently uninsured and whose income is less than 138 percent of the federal poverty level to purchase individual private sector health insurance policies through the insurance exchange.
There are a number of advantages to this proposal. First, it answers the question of what happens if the federal government reneges on its promise to pay 100 percent of the cost of Medicaid expansion for the first 3 years and as much as 90 percent in subsequent years. The answer is simple. If that happens, the insurance premiums don’t get paid and the individuals’ coverage ends. There is no ongoing cost to the state.
Secondly, the bulk of the administrative cost of the new program is borne by the private insurance companies who write the policies.
Third, the program will bring competition into the equation. Assuming multiple insurance companies participate, as they have in other states, the newly insured will be able to choose insurance coverage to meet their specific needs.
Fourth, such an arrangement eliminates the problem of “churning” – the situation where an individual’s income is below the 138 percent threshold in some years and above it in others. (A self-employed person, for example.) Under this plan the newly covered will have private sector insurance policies that can be retained regardless of income.
In years where his or her income is below the 138 percent threshold, the premiums will be paid by the new federal money.
Finally, because these 300,000 relatively low income Mississippians will have private health insurance, the incidence of uncompensated health care will be substantially lowered.
Our choices are clear. We can refuse to participate in any way and leave 300,000 working Mississippians without health insurance, devastate our hospitals as their federal funds are cut and lose the opportunity to grow our health care economy with the estimated 9,000 new private sector jobs such a plan will create. Or we can accept this compromise proposal which will allow Mississippi taxpayers to benefit from the billions of federal dollars that are available to us through the Affordable Care Act, improve the health care opportunities for 300,000 of our fellow Mississippians and create thousands of new private sector jobs.
This plan will require legislation and approval by the federal department of Health and Human Services (HHS). We have met with HHS and feel very good about our chance of receiving their approval.
However, the first step is for the state to adopt the plan.
Democrats look forward to working with our Republican colleagues and the Governor in crafting the details of the plan in a special legislative session before the end of June.
CECIL BROWN is a member of the House of Representatives, District 66, which is in Jackson. Contact him at 416 E. Amite St., Jackson, MS 39201.

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