The enormity and complexity of the nationwide health care situation offers no easy solutions to the issues involving reductions, changes and regulations for federal funds for patient care, so opportunities for continuing discussions and debates about the best policies repeatedly arise.
Mississippi Gov. Phil Bryant’s proposal to spend $4.4 million in state funds to help offset the loss of federal funds for hospitals in Mississippi is a case in point.
The Affordable Care Act will cause reductions in funds for reimbursing hospitals who treat substantial numbers of patients with no insurance, which qualifies them for what’s called disproportionate share hospital payments (DSH).
The ACA also offers a remedy for that reduction in its plan for expanding Medicaid, the state-administered health insurance program for the elderly, disabled, poor pregnant women and poor children. Most of Medicaid’s funding comes from the federal government.
Gov. Bryant and many legislators so far have not budged in their opposition to Medicaid expansion because it is part of what’s called Obamacare, and Republicans generally oppose that national program on political and policy grounds.
However, Medicaid expansion is not universally despised and rejected by Republican governors because it would inject large sums of new health insurance money into participating states’ economies, pay for additional hospital expenses for more of the uninsured, and require an advantageous state match.
Under ACA, the Medicaid expansion covers people earning up to 138 percent of the federal poverty level or about $15,000 annually for an individual or about $32,000 for a family of four. That would mean an additional 300,000 Mississippians could have Medicaid insurance, adding to the 640,000 already on the program in the state.
We hope more open minds will allow a full debate on Medicaid expansion in the 2014 legislative session, which begins in little more than a month.
Medicaid doesn’t discover newly poor people under the plan; it would offer coverage to mostly working Mississippians who cannot afford health insurance but who need it, as does everyone else.
Proponents of Medicaid expansion have pointed out that according to Bryant’s Medicaid officials the expansion would cost the state $7 million the first year for $70 million in federal funds and over a seven-year period will cost the state a cumulative $450 million while receiving $8.6 billion in federal funds, Capitol Bureau Chief Bobby Harrison reported last week. That appears to be a good deal and ought to be considered.