CATEGORY: EDT Editorials
Mississippi legislators wrestling fitfully and angrily with the Medicaid appropriation isn’t a unique legislative situation, but it always is a troubling one.
Few, if any, other programs funded and controlled by the Legislature affect as many Mississippians from the cradle to the grave. Medicaid, matching federal with state funds, pays for the medical care for thousands of poor and disabled people and a majority of the nursing home care provided in Mississippi. Its $1.8 billion budget is the largest item in Mississippi’s total budget.
The fight this year centers on the idea that Medicaid should earmark part of its budget for pilot programs in managed care through a health maintenance organization in 22 counties. The counties would be mostly in the Delta and along the Gulf Coast. All participation would be voluntary on an individual basis, with health care providers chosen by people based on options offered in an actual marketplace setting where programs would be fully explained. Pilot programs are used to determine if new and different approaches can more efficiently spend tax dollars and better serve the people who are supposed to be helped.
Those favoring the idea of a pilot HMO program prevailed in the Senate. Those opposing a pilot program and supporting the status quo prevailed overwhelmingly in the House. The disagreement between the two chambers went to a conference committee. A conference committee is the usually decisive and final forum for differences in bills before they are sent back to both chambers for passage.
The Medicaid conference committee eliminated the pilot program and opted for a year-long study of options within Medicaid, to be chaired by Republican Sen. Jim Bean of Hattiesburg.
The House quickly adopted the conference report. The Senate stalled in its debate on a technicality unrelated to the substance of the issue. That delay from last week to today has given senators strongly favoring the pilot program time to rebuild their energy for a fight to reject the conference report and insist on a voluntary pilot program.
We believe those favoring a pilot program have the stronger position, even if it is not the prevailing one on final passage.
The reform of Medicaid programs isn’t isolated. The huge cost nationwide has driven a widespread search for better ways to apply these valuable dollars. It is widely believed, based on the politics and financial pressures in the Congress, that significant changes will be necessary in order to stretch the diminishing growth in federal Medicaid dollars.
Begin now, without mandates, to find options best suited to Mississippians. Try on our own , without orders from Congress, to find more efficient ways to supply health care and spend public funds.
Rational experimentation, opponents should remember, is a proven way to answer questions.