Impact of Supreme Court Decision on Mississippi Medicaid
Yesterday the United States Supreme Court upheld the healthcare reforms commonly called “Obama Care.” But, the Court did say that states should have the option to expand their Medicaid rolls without facing any penalty. A key component of the law was insuring many uninsured people by reducing the Medicaid qualification limits. Medicaid already covers over 600,000 Mississippians, and this addition would bring coverage to one in every 3 in the state as a Medicaid beneficiary. Expanding Medicaid will add around 400,000 additional Mississippians to Medicaid rolls, and according to Lt. Gov. Tate Reeves, would cost the state about $1.7 billion over 10 years. For a law that supposedly did not result in a tax increase, one has to wonder where else this extra money is supposed to come from – if not higher taxes, then through deep cuts to education and transportation, according to Gov. Phil Bryant.
While the U.S. Supreme Court upheld most of the law Thursday, it said the federal government can’t withhold Medicaid money from states like Mississippi that choose not to expand Medicaid coverage to more low-income adults. Given the high cost to the state, Republican lawmakers in Mississippi have already stated that such expansion is unlikely.
Top Republicans in Mississippi say the state can’t afford to expand its Medicaid program to cover more people under the federal health care overhaul. Some Democrats, however, say the state should jump at the chance to provide coverage for its more than half million uninsured residents. Mississippi already has a very high percentage of its population on Medicaid. The Affordable Care Act says that beginning in 2014, states must expand Medicaid coverage to people whose income is up to 133 percent of the federal poverty level. That means that everyone in a family of 4 with income of less than $30,500 would be covered by Medicaid as their primary insurance. Currently, Medicaid only covers such families below around $23,000. While the federal government pays for most of this increase in the early years, it will be left to poor states like Mississippi to find ways to pay for the billions of dollars in extra expense in later years. And, unlike the federal government who can simply borrow or print the extra funds, States like Mississippi will be required to raise taxes on the 2/3 of the population who would not qualify for the expanded Medicaid coverage to pay for healthcare for the 1/2 who would.
The Clarion Ledger reports that Gov. Phil Bryant said Thursday that Mississippi would have to make deep cuts to education and transportation to cover expenses for an estimated 400,000 new people on Medicaid.
“I understand there is some leeway in the decision to not penalize states for not complying with Medicaid requirements, and we’re going to look at that,” Bryant said in a brief interview with The Associated Press.
Rep. Greg Snowden, R-Meridian, said he believes the Medicaid portion of the reform legislation was a huge concern.
“We could easily put a third of the state on Medicaid,” Snowden said. “We’d match (the funds) of course, and they’d pay us a generous rate.
“But (the matching state funds) could come out of education funding or public safety,” he said. “If this didn’t get struck down, I don’t know where we would have gotten the money.”
But Rims Barber, director of the Mississippi Human Services Coalition, said the law creates “a wonderful opportunity for Mississippi to serve its citizens.”
He urged legislators to enhance the Medicaid program “to include those people for whom the federal government will pay the full cost for three years and 90 percent of the cost afterwards.”
“This is a bargain for our state and a real opportunity for our people and for our health care system,” Barber said.
Sen. John Horhn, D-Jackson, said the state can’t afford to not offer more Medicaid coverage to its citizens.
Mississippi had 641,454 people enrolled in Medicaid in May, the most recent figure available. That’s about 22 percent of its 3 million residents.
The U.S. Census Bureau said Mississippi had about 618,000 uninsured residents in 2010, or 21 percent of the population.
“As a state, we historically have been slow to expand Medicaid,” Horhn said. “And the question still remains whether Mississippi will decide to expand.”
