Representatives divided on health care proposal

Published 6:19 pm Thursday, July 12, 2012

A local representative is calling Republican resistance to a Medicaid expansion short sighted, while Brookhaven’s GOP representative believes caution should shape the way forward.

     “On issues like this, you can’t just pick up the party mantra,” said District 53 Rep. Bobby Moak, D-Bogue Chitto, speaking of a proposed expansion in Medicaid eligibility under the Affordable Care Act of 2010.

     However, District 92 Rep. Becky Currie said she would be “cautious” about any expansion of Medicaid rolls.

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     “There’s only so much money,” Currie said. “If you put more people on the service but you still have the same amount of money, either the provider gets paid less or the patient gets less care.”

     The Supreme Court decision upholding the health care reform act’s individual mandate as constitutional also determined states may choose not to participate in an expansion of Medicaid.

     Gov. Phil Bryant promptly issued a statement indicating resistance to a Medicaid expansion.

     Moak, the House Democratic leader, dismissed Bryant’s statement.

     “With all due deference, I don’t think he’s looked at the numbers,” Moak said. “You have got to put some homework into the decision-making process.”

     In his statement, Bryant said, “I would resist any expansion of Medicaid that could result in significant tax increases or dramatic cuts to education, public safety and job creation.”

     Moak believes that is rhetoric rather than policy analysis.

     “If he wants to pit cuts in health care against cuts in education, that’s political theater,” Moak said.

     However, Currie said the federal government has not yet released or written many policy details about a Medicaid expansion. As a result, Currie said states may have to wait for more information.

     “It’s such an unknown; I think we’re all going to live and learn,” Currie said.

     Under the health care overhaul act, families of four with an annual household income up to approximately $31,000 would be eligible for Medicaid. Right now, a family of four cannot have an annual income of more than approximately $23,000 to be eligible.

     Moak said about 330,000 would be added to the state’s Medicaid rolls under the expansion.

     Federal money would cover 100 percent of Medicaid costs during the first three years of the expansion. After that, federal funds would scale back until they hit 90 percent of Medicaid costs, with state’s providing 10 percent of the remaining costs.

     Moak said Mississippi can’t afford to turn down three years of expanded federal money.

     “At the end of three years we will not have sent the federal government one nickel,” Moak said. “For a small state like Mississippi, it’s a virtual no-brainer.”

     Federal funds already cover about 73 percent of Medicaid costs in Mississippi, according to the Kaiser Family Foundation, a non-partisan policy and data analysis organization.

     Moak believes the model set forth for a Medicaid expansion could actually save the state money be reducing the amount of uncompensated care in the state.

     “Mississippi has a lot of uncompensated care,” Moak said. “People show up and use emergency rooms like doctor’s visits because they don’t have any money and they don’t have insurance.”

     According to a Mississippi Democratic Trust press release Moak referred to, uncompensated care cost $525.5 million in the state last year, with $315 million not covered by any federal reimbursement program and, instead, passed on to taxpayers.

     “We are covering in cost $315 million, without expanding today,” Moak said. “Taxpayers are eating that right now.”

     Moak said even with the state’s 10 percent Medicaid match under an expansion, Mississippi would still come out ahead fiscally because of the reduction in uncompensated care.

     However, according to the Kaiser Family Foundation’s data, an expansion in Medicaid rolls would require Mississippi to pay from about 4 to 5 percent more for Medicaid between 2014 and 2019 than it would have to do without the expansion.

     And that’s what worries Currie.

     “We’re back to who’s going to pay for it,” Currie said.