OUR OPINION: Stop Medicaid wreck through negotiations

By NEMS Daily Journal

An atmosphere of palpable uncertainty exists in the aftermath of the 2013 legislative session, with lawmakers obviously thinking about how the state’s Medicaid program can be salvaged from a procedural death on deadline in the regular session.
Democrats, pushing for an expansion of the Medicaid system under terms of the federal Affordable Care Act, blocked the program’s required renewal so that benefits stop July 1 – unless Republican Gov. Phil Bryant calls a special session to hammer out an agreement or some workable alternative is proposed.
Mississippi clearly must have Medicaid, which provides health insurance coverage for a broad category of poor, elderly and otherwise disadvantaged people – 630,000 of them statewide.
An additional 300,000 people, broadly called “the working poor,” could become eligible under the ACA, known more generally as Obamacare.
All the Republican statewide officials object to Obamacare as a matter of political principle and preference.
What must happen is to find a way to stop fixating on expanded health insurance coverage as Obamacare. The expanded coverage, which would be paid fully by the federal government for three years, is about Mississippians who need health insurance, not about the president.
In addition, expanded coverage potentially would erase some of the uncompensated care deficit that falls squarely on the private sector and taxpayers. So far, states representing 53 percent of the nation’s population have said they will expand coverage, which provides some advantages in quality of life and economic magnetism.
As reported Friday by the Associated Press, “Medicaid would be expanded to bring in low-income adults, mainly people with no children at home but also some parents. In states that accept the expansion, those making up to 138 percent of the federal poverty level – about $15,400 for an individual – would be entitled to receive Medicaid. The federal government would pay 100 percent of the expansion’s cost for the first three years, starting in 2014. Washington’s share would gradually phase down to 90 percent.”
Arkansas is considering an alternative that technically would not be a Medicaid expansion but would use federal funds to purchase private insurance coverage at no or very low cost to eligible Arkansans through the state’s insurance exchange, which is already operational.
The AP’s Friday article said, “ … 17 states are weighing options, with some actively negotiating with (HHS Secretary) Sibelius to see if the new enrollees can be covered through private plans.”
We hope legislators on both sides of the aisle and the issue can see enough light to explore and seriously discuss those alternatives to the usual way of providing coverage through Medicaid.
Mississippi’s health insurance exchange has been fully structured, but Gov. Bryant blocked its implementation by objection to HHS even though the exchange was designed by Insurance Commissioner Mike Chaney, Bryant’s fellow Republican, also elected statewide.
Bryant has said he will call a special session only if there’s pre-agreement and that the agreement reflects his hard-line views.
Gubernatorial leadership needs to reflect more flexibility on an issue of such vital importance to more than 900,000 Mississippians potentially impacted by a standoff, not to mention the adverse impact on the state’s economy.