As the poorest state in the country, Mississippi will eitherbenefit the most or suffer the worst from Sunday’s passage ofnational health care reform, local lawmakers said.

District 92 Rep. Becky Currie, of Brookhaven, was one of countlessRepublicans nationwide bracing for the impact of the bill, whichpassed the U.S. House of Representatives late Sunday night. Shesaid the bill’s massive expansion of the federal Medicaid programwould bring unattainable costs to Mississippi, pointing out theprogram has been a year-to-year funding dilemma for the state foryears.

“It will bankrupt us. We can’t pay for the Medicaid we have now,”Currie said. “You never do anything you can’t pay for, and we can’tpay for this.”

Even though Mississippi receives a federal Medicaid match that iscomparatively favorable – four to one – the state has experiencedlong-standing problems in coming up with its share of the match,Currie said, and expanding the Medicaid rolls would require morematching dollars. Currently, Medicaid covers 600,000Mississippians, about 20 percent of the population.

The health care bill will expand Medicaid to cover citizens up to133 percent of the federal poverty level, which stands at slightlymore than $29,000 per year. Childless adults would be eligible forthe first time in 2014, and the federal government will pay allcosts for first-time eligible recipients through 2016.

The change comes at a time when lawmakers continue struggling witha fiscal year 2010 budget that is a half-billion dollarsdown.

Work is just now getting under way on the FY 2011 budget, which isexpected to be short by an estimated $800 million. The nextbudget’s shortfall will likely exceed $1 billion.

“A lot of people believe we should sign up more people forMedicaid. We send a dollar and get back four dollars, but you stillhave to come up with your dollar,” Currie said. “We can signeverybody up for it, but if you can’t come up with the dollar tospend to get the four dollars, you’re in trouble.”

Currie also lamented the bill’s impact on small businesses. Thebill will not require businesses to offer coverage, but employerswill be fined $2,000 per employee when employees receivegovernment-subsidized coverage. Companies with 50 or fewer workersare exempt from the plan.

“I don’t see how it could not hurt small businesses,” shesaid.

District 39 Sen. Cindy Hyde-Smith, D-Brookhaven, shared Currie’sconcerns over an expanded Medicaid roll. She said Gov. HaleyBarbour’s early predictions that such a move would cost Mississippian additional $200 million were conservative.

“Looking at the Medicaid budget we have right now and knowing thereare going to be more people who qualify to receive Medicaid, Icertainly in no way see how this state can afford our Medicaidbudget to increase or double,” Hyde-Smith said.

Hyde-Smith said lawmakers would begin doing the math to determineMississippi’s actual cost under the new laws, predicting that aspecial session may be necessary to implement the necessarychanges.

“I don’t know where the state can come up with this money whenwe’re cutting everything else,” she said.

Just as Currie and Hyde-Smith prepare for the worst, District 91Rep. Bob Evans, D-Monticello, was celebrating Monday morning. Evanscalled health care reform’s passage an historic moment, predictingthe new laws will “be a boon for Mississippi.”

“Every federal program that’s ever come down the line, Mississippihas gotten more than the lion’s share of the benefits, and thiswill be no exception,” he said. “When you’re the poorest state inthe nation and the object is to help poor people, you don’t have tobe Albert Einstein to figure out Mississippi will greatly benefitfrom this bill.”

Evans agreed that expanding the Medicaid rolls would bring morecosts to the state, saying lawmakers would have to prioritize thestate budget to meet the new requirements. He said the majority ofthe funding for the Medicaid expansion would come from the federalgovernment, which pays Mississippi an 84 percent match.

“We in Mississippi will do what we have to do to come up with therest of it. We always have,” Evans said. “This is a bill that isgood for the average people out there – wage earners, people whoare trying to make a living, people who are rolling the dice withno insurance.”

District 53 Rep. Bobby Moak, D-Bogue Chitto, declined to comment onthe health care bill without first having read it.