OUR OPINION: Medicaid debate will keep on going

By NEMS Daily Journal

The recently concluded session special session of the Mississippi Legislature retained the status quo in Medicaid, the federal-state health care program for low-income people. The program was reauthorized and funded at the current level, and expansion was rejected.
As noted in Daily Journal Capitol correspondent Bobby Harrison’s report today, about half the states are either in the same boat as Mississippi in rejecting Medicaid expansion or are still debating the issue. It’s almost entirely a partisan issue, as Republican leaders fight against anything that looks like “giving in” to Obamacare, the Affordable Care Act that provides full federal funding for the Medicaid expansion in the first three years.
But some Republican governors, seeing the potential upside of an expansion and the hit that hospitals will take without it, have advocated that their states participate.
Mississippi has made its decision for the coming year. It should revisit the issue in the 2014 regular session of the Legislature, as even some Republicans apparently are indicating privately is a possibility.
One of the reasons – aside from the positive impact of providing health insurance to mostly working Mississippians who can’t afford it, which is what the expansion would do – is the effect on reimbursement rates for hospitals. They stand to lose if Medicaid is not expanded.
State Auditor Stacey Pickering announced last week that his office will undertake a study on the financial sustainability of community-owned hospitals in the future. The impact of the new federal health care law is a big part of that, and Pickering believes the information gathered will be valuable not just for the 41 hospitals in Mississippi owned by local governments, but also the not-for-profits like North Mississippi Medical Center.
While Obamacare remains unpopular – especially so among Republican elected officials at all levels – it remains the law of the land and that won’t change anytime soon. Mississippi’s decision to turn down an infusion of $8.6 billion in federal dollars in exchange for a state contribution of $450 million over seven years appears to be a classic example of cutting off your nose to spite your face. Republican leaders in other states, and even one or two in Mississippi, who’ve managed to look beyond the partisan dimensions of the issue have recognized this.
Round 1 of the Medicaid debate is over, but there will – and should be – more to come.