EDITORIAL: Medicaid

By NEMS Daily Journal

Mississippi’s legislative leadership and Gov. Barbour came to agreement on Medicaid funding late Monday night, and Tuesday morning’s acid-edged approval of the funding method by the Mississippi Hospital Association sent the measure into the processes of the Legislature, where its welcome was anything but ecstatic.
What happened Tuesday unfolded exactly as had been forecast: Some legislators acted as free agents once the controversial Medicaid legislation arrived for consideration. It was first dramatically amended by the House Medicaid Committee, but those amendments were rejected, then it passed as agreed by negotiators and was released for immediate Senate consideration.
Speaker Billy McCoy had announced late Monday night that a leadership agreement had been struck on Medicaid (the health insurance program for poor Mississippians), but he also had warned earlier that Barbour and others could not expect dissident legislators to meekly fall in line if they differed with what had been hammered out.
We believe enactment essential because the state constitution does not envision extended running of legislatively established agencies by executive order.
Barbour had said he would run the Division of Medicaid under emergency powers if the 2010 budget deadline was not met. Attorney General Jim Hood said the governor cannot assume that role without a court order.
This important legislation debated on the last day of the fiscal year, less than 12 hours before the start of the 2010 budget year, should have been resolved weeks if not months ago. The governor and the Legislature both bear responsibility for placing their ideologies and hard positions ahead of the continuing care of 600,000 Mississippians dependent on Medicaid.
The Mississippi Hospital Association, which grudgingly agreed to back the leadership compromise, also did its share of drawing lines in the sand, protecting its institutional interests first, although in good conscience from its perspective.
We agree with the hospital association’s passion to prevent Barbour from running the Division of Medicaid by executive order, but its politics played into the problems leading to Tuesday’s irresponsibly delayed voting.
It is no wonder the whole issue ended with all the clatter of a trainwreck.
We also believe those opposed to moving toward managed care in the Medicaid program aren’t realistically facing a future filled with managed care, probably nationwide by federal mandate.
We believe managed care, correctly administered, could lead to better outcomes in treating high risk illnesses like diabetes, heart diseases, cancer and strokes, all disturbingly prevalent in Mississippi, near the top of national indices.
We hope future Medicaid program authorizations increase its use, in parallel with strong education components about its possible advantages.