SID SALTER: GOP’s Frierson points to cost side of Medicaid expansion

By Sid Salter

Medicaid expansion won’t come without budgetary consequences in Mississippi. That’s the message circulated this week by the Republican chairman of the House Appropriations Committee to the state’s education lobby leaders as the time left for reauthorization of Medicaid for FY 2014 draws shorter.
With pressure from Democratic colleagues in the Legislature, public health advocacy groups and most of the state’s hospitals growing for Medicaid expansion, state Rep. Herb Frierson, R-Poplarville, sent a letter to every college president, community college president, county and municipal school district superintendent and others in positions of leadership in public education from kindergarten to graduate school in Mississippi.
“I just wanted people who look to the Legislature for education funding to be armed with the facts about how the state’s budget pie gets divided and to know that Medicaid expansion isn’t something that can be done without consequences for every other function of state government,” Frierson said.
Frierson said the letter was in response to post-2013 regular session inquiries from education leaders about why education funding had not improved on pace with improvements in the state’s economy since the depths of what he called the “Great Recession.”
The Pearl River County lawmaker answered that question bluntly: “The primary reason is the Medicaid program: The greatest impact on the funding education since the beginning of the recession has been the growth in spending for the Medicaid program.”
Frierson cited an analysis of the percentage of growth of all state General Fund appropriations for the past decade against the percentage of growth in state Medicaid appropriations over the same period. The chairman’s numbers showed that from Fiscal Year 2004 through FY 2014, the total of state General Fund appropriations had grown by 38.6 percent with a 10-year average growth rate of 3.86 percent per year. But over the same period, Frierson said General Fund appropriations for Medicaid increased by 136 percent, a 10-year average growth rate of 13.6 percent per year.
More telling in terms of illustrating the difficulty the recession placed on state lawmakers in budgeting were Frierson’s numbers that show total FY 2009 state General Funds appropriated (counting reappropriations and deficits) at $5.020 billion compared with FY 2014 total General Fund appropriations (counting reappropriations, deficits, and the proposed post-conference Medicaid funding level) of $5.032 billion – a difference of some $12 million.
Reminding education leaders of facts they already well knew, Frierson’s letter cited FY 2009 as representing the highest comprehensive level of education funding K-IHL and FY 2008 as representing the last time the Mississippi Adequate Education Program was fully funded.
From that basis, Frierson addressed why he believes K-IHL wasn’t funded at the FY 2009 level in the FY 2014 budget – a budget that he said saw K-IHL underfunded by $264.9 million, Medicaid increased by $182 million, Human Services increased by $25.9 million, Corrections increased by $68.7 million, debt service increased by $86.3 million and mental health cut $48.4 million.
Frierson cited legal and logical reasons why spending was up in Human Services, Corrections and debt service and why funding for education and mental health was down. But the bottom line for Frierson was growth in spending in the Medicaid program.
“It is obvious that when more money is provided for the Medicaid program, there is less money available for other agencies and programs, including for K-IHL (education),” Frierson said.
For pro-education Democrats, Frierson’s framing of the interrelationship of education and public health funding in Mississippi represents a difficult argument to ignore or rebut. With one-time money gone, lawmakers must now make those value judgments in crafting a solution.
SID SALTER is a syndicated columnist. Contact him at 601-507-8004 or sidsalter@sidsalter.com.