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Lawmakers getting last shot at Medicaid fix

With the resumption of a special session Monday morning, theLegislature will likely be facing its final opportunity to resolveMedicaid’s $90 million funding gap before Gov. Haley Barbour movesforward with a revised set of program cuts that he says require nolegislative input.

The governor’s new plan will allow him to decrease hospitals’reimbursement rates, institute a lesser round of Medicaid servicecuts that he claims will affect less than 1 percent of the healthcare community and raise hospital taxes as a way to make up theprogram’s deficit. The money will later be made up by increasedfederal UPL (Upper Payment Limit) payments to hospitals.

Barbour has been working with the federal Centers for Medicare andMedicaid Services to craft the new plan.

Local legislators are under the impression the governor will allowthem one last shot at passing Senate Bill 2013 – the legislationcontaining a $167 per day hospital bed assessment as a means offunding Medicaid that the governor, Mississippi HospitalAssociation and Senate prefer – before he proceeds with the newplan.

“If we don’t pass it, the governor is gonna dissolve the session,because he doesn’t have to have us anymore,” said District 92 Rep.Becky Currie, R-Brookhaven. “Then, we’ll go home and what thegovernor has planned will take effect. That’s the only choice hehas.”

Currie said the governor’s new proposal is very similar to one ofthe first such hospital assessment plans proposed early in theregular session. The proposal, even though supposedly less harmfulto health care providers than a series of cuts abandoned by thegovernor last week, is still not a good thing for Mississippi’shospitals, she said.

“No, I don’t like it,” Currie said. “But before one person loses ajob or has their hours decreased, or we have health care servicesdecreased, I’d rather have this plan. This is better than any ofthe above in that respect.”

The new plan is not better than SB 2013, Currie said. She said SB2013 was originally written as a better alternative than theproposal now being presented by the governor, and believes theHouse should have passed it along with the Senate.

“Then we wouldn’t be in this mess,” Currie said. “The Houseleadership wanted to play politics, and they played it. Now,they’ve gotten cut off at the knees, and they can either vote tosave their hospitals or they can vote against it. They can taketheir pick.”

District 53 Rep. Bobby Moak, D-Bogue Chitto, said the House wouldbe in a race Monday morning to produce a new Medicaid funding plan,most likely a tobacco/assessment hybrid bill, and send it to theSenate quickly. He believes the Senate plans to take up new itemsexpected to be added to the session’s agenda and adjourn quickly,leaving the House to make the choice as outline by Currie.

If the Senate beats the House out the door, however, Moak said theHouse would just follow suit and let the state’s hospitals play outtheir legal options.

“I don’t believe there’s enough support in the House to pass thebed tax,” Moak said. “When the governor finally brings [the newcuts] forward, I think the hospitals will sue him again, and in myopinion they will be successful again.”

District 91 Rep. Bob Evans, D-Monticello, believes Moak’spredictions are likely. He said the Democrat-led House is unlikelyto institute SB 2013 as a last-ditch effort.

“If it’s going to be take it or leave it, I cannot imagine it willbe anything but a leave it,” he said. “I think SB 2013 has beendead in the water for months.”

Evans said he suspects the House will use its last-minuteopportunity to present another form of tobacco tax, either inconjunction with smaller pieces of SB 2013 or a stand-alone tobaccotax increase. He said an increased tobacco tax of $1 per pack wouldprovide the state with more than twice the $90 million required tolocally fund Medicaid. And with economic times like they are, thestate cannot afford to “leave that money on the table.”

Evans admitted that any tobacco taxes sent to the Senate willprobably be turned away as they have been throughout the specialsession. He said, though, the House would not be to blame if thegovernor moves forward.

“If he does something unilaterally without the approval of theLegislature, that’s his baby,” Evans said.

Whatever the House does with its time Monday will have a directeffect on the options available to the Senate, said District 39Sen. Cindy Hyde-Smith, D-Brookhaven.

“We’re just seeing what the House is going to do,” she said. “We’rejust going to have to wait and look at what surfaces.”

Amid rumors of adjournment in the Senate and tobacco tax bills inthe House, Hyde-Smith said she would not surprised if both chamberswere sent home and the issue taken up again in January during the2009 regular session.