Medicaid back in Barbour’s hands

Published 5:00 am Tuesday, August 5, 2008

The door is open for Gov. Haley Barbour to try and plug theDivision of Medicaid’s $90 million funding gap on his own authorityafter the Legislature departed Jackson Monday afternoon withoutreaching a compromise on a funding solution.

House Democrats tried one last time to pass a funding billcontaining a mixture of increased tobacco taxes and hospitalassessments, but Republicans united against an effort to suspendthe rules for introducing new legislation and prevented the billfrom being brought up for a vote.

After the failed effort, the Senate adjourned and the Housefollowed suit, effectively ending the 2008 special session. SenateBill 2013, the legislation containing the $167 per day hospitalassessment touted by many as the best solution for fundingMedicaid, was never heard from.

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Even though months of legislative back-and-forth that ultimatelycost taxpayers more than $600,000 ended with no immediate solution,District 53 Rep. Bobby Moak, D-Bogue Chitto, said at least one goalwas accomplished during the special session.

“If there’s a positive to it, it has effectively stopped thegovernor from making cuts to Medicaid to date,” he said. “It hasnow allowed hospitals to move into the judicial system.”

Moak believes either the Mississippi Hospital Association, or agroup of hospitals acting independently, will once again file suitagainst the governor to block Medicaid cuts and will ultimately besuccessful. He said it is not even clear if the governor canactually legally institute his proposal.

“I think he’s got better ground than he’s had in the past, but not100 percent solid ground,” Moak said. “No one hospital can make adetermination at this stage as to how much they will lose, and thegovernor has to make that clear to them. That’s one of the possibleflaws in his argument.”

Moak said the governor may have a chance to win a possible lawsuitover Medicaid, and that possibility is what frightens District 91Rep. Bob Evans, D-Monticello.

Evans called Monday “a taxing day” and blasted the governor, HouseRepublicans and the Senate for the failure of the last hybrid bill,the Senate’s refusal to allow a tobacco tax increase and thepossibility of Medicaid cuts.

“From an economic and social aspect, [the hybrid bill] wascertainly better than anything the governor had come up with,” hesaid. “If anyone in the medical community loses their job overthis, they can trace it right back to the Governor’s Mansion andhis doorman, [Lt. Gov.] Phil Bryant.”

Evans said the House would make more attempts at a tobacco taxincrease to fund Medicaid during the 2009 regular session.

“It’s not over with – we live to fight another day,” he said. “Weleft $175 million on the table this year, and I’m certainly goingto be a muckraker who brings that up again.”

District 92 Rep. Becky Currie, R-Brookhaven, was upset at the endof the special session for the House’s failure to introduce SB2013, which she has advocated as the best Medicaid funding solutionsince its inception.

“The only way we could have helped the hospitals today was if thatbill could have been voted on,” she said Monday. “I believe that ifit had come up, House members would have voted it in because it’ssuch a better option that what’s about to happen now. There’snothing out there to safeguard the hospital.”

Currie, who joined other Republicans in voting to block theintroduction of the hybrid funding bill, said she took part inshooting down the possible solution to try and force the issue onSB 2013.

“The Senate said they weren’t going to take up any bill except SB2013, and there was no point [in passing the hybrid bill],” shesaid. “We continue to pass bills and no one takes them up. Whydon’t we just pass something we know we can get done?”

Currie said the Legislature should have passed SB 2013 and adjustedit as necessary next session, possibly even including an increasedtobacco tax. She expects the Legislature to return to anotherspecial session before January to deal with such a tax – which isexpected to be recommended by Barbour’s ongoing tax studycommission – “so he can control what he does with the revenue.”

Currie also believes hospitals around the state will unite to filesuit against the governor, but she has little faith in theirsuccess. Barbour’s loss in a previous suit was what left the dooropen for the latest Medicaid cut proposal, she said.

While local legislators were irked by the conclusion of the specialsession for varying reasons, one official with an up-close reasonto be dissatisfied is King’s Daughters Medical Center ChiefExecutive Officer Alvin Hoover.

Hoover and other hospital officials around the state are anxious toexamine the details of the governor’s new Medicaid proposal, whichhas been kept fairly exclusive.

“They didn’t fix anything with Medicaid, and that’s disappointing,”he said. “I’m very skeptical that [the governor] has a plan thatreally works. He should pay a little more attention to hospitals,and yet he’s trying to balance the budget on our backs.”

Hoover said MHA would be studying the proposal in the coming weeksand hospitals would respond based on the findings.

Immediate problems with the proposal include the use of UPL (UpperPayment Limits) to reimburse hospitals, Hoover said.

“We’ve only been getting one of those a year, and it has been fouror five months late,” he said. “Immediately we’ll have some cashflow issue at hospitals, and we’ve got problems with that. It’s notjust as simple as saying, ‘I’ll cut this money out and put it backover here.’ It’s a completely different formula.”