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Lawmakers disappointed with inaction over Medicaid plan

Area lawmakers voiced disappointment with a late Wednesdayruling by Hinds County Chancery Judge William Singletary thatpassed the buck on Gov. Haley Barbour’s controversial plan to cut$90 million from Medicaid, but each legislator felt gruff for adifferent reason.

All the lawmakers oppose the plan, and were hoping to seeSingletary either rule in favor of the hospitals or squash thegovernor’s plan altogether. Both results would have delayed theMedicaid revision process long enough to allow the Legislature totake back the reins when the 2009 regular session begins inJanuary.

Singletary said his court had no jurisdiction to rule on theplan, which has yet to receive approval from the federal Center forMedicare and Medicaid Services.

“The governor told us CMS had approved the preliminary plans,and if they approved the preliminaries I don’t know why theywouldn’t approve this,” said District 92 Rep. Becky Currie,R-Brookhaven. “I think everyone is confused that [Singletary]didn’t go ahead and do something. I really thought [the ruling]would bring us back to the table.”

Currie said the governor’s plan – which would increase hospitaltaxes, significantly reduce hospitals’ Medicaid reimbursement ratesand refund the money with UPL (Upper Payment Limit) payments, whichhospital administrators say is an unreliable federal reimbursementprogram – is unfair, and could “destroy” rural health care.

Even after its slow demise in the Legislature, Currie is stillhoping to see lawmakers approve a plan similar to 2008’s SenateBill 2013, the legislation proposed to pay for Medicaid’s $90million shortfall with a $167 per day hospital bed assessment. Thebill was widely supported by hospital administrators and theMississippi Hospital Association before its support fell apart overthe summer amidst increasing House and Senate support for fundingMedicaid with increased cigarette taxes.

“The hospitals should have stuck behind SB 2013,” she said. “Ifthey hadn’t gone through the back door to the House leadership[seeking cigarette tax increases], we would have had SB 2013 and wewouldn’t be in this mess. They may want to get back behind SB 2013and see if the governor would call us back for 15 minutes to passit and move on.”

District 91 Rep. Bob Evans, D-Monticello, said Singletary’squestioning of his own jurisdiction was appropriate, but hebelieves that Barbour’s proposal is on a dead end road. He was justhoping to see the cuts put down as soon as possible.

“If he gets federal approval, the hospitals will jump right backin front of Singletary and go from there,” said Evans, who expectedthe judge would then reject the plan.

Evans believes the Medicaid funding solution will ultimatelyhave to come from the Legislature. Even if Barbour and thehospitals contest each other all the way to the state SupremeCourt, he said, the case would still come back.

“As many justices that are in contested election races, I don’tbelieve they’ll want to get their hands in this,” he said.

District 53 Rep. Bobby Moak, D-Bogue Chitto, fought offdisappointment over Singletary’s ruling, pointing out that it mayactually lengthen the fight.

“Under the political realities going on right now, if Singletaryhad ruled in favor of the hospitals the issue may have gone forwardto the supreme court quicker,” he said. “Under this scenario, itwill take longer, and historically this administration (the courts)has been closer in line with the governor.”

Moak agreed with Evans that the state’s hospitals would be readyand waiting with another lawsuit if the governor were to gainfederal approval for his plan.

“The governor has a long way to the goal line on this,” Moaksaid.

Barbour’s Medicaid plan is set to go into effect Monday, Sept.1, but the start date could change depending on the response fromCMS.