Leaders in Medicaid waiting game
It was a somber but frank discussion on the financial future of Mississippi. Gathered around the table was a bipartisan group of legislators – all representing the leadership of the Mississippi House of Representatives.
The main subject of discussion was the impact of the Patient Protection and Affordable Care Act (Obamacare) on Mississippi and how Mississippi is going to react.
The gathering was of small group of newspaper editors and publishers with the House leadership, who were taking time out of a busy legislative budgeting schedule to break bread with the state’s newspapers to frankly discuss issues.
To set the stage, in attendance were the House leadership members led by Speaker Philip Gunn, R-Clinton, and joined by his handpicked leadership team of Speaker Pro-Tempore Greg Snowden, R-Meridian; Rep Herb Frierson, R-Poplarville, chairman of the House Appropriations Committee; Rep. Preston E. Sullivan, D-Okolona, chairman of the Agriculture Committee; Rep. George Flaggs, D-Vicksburg, chairman of the Corrections Committee; and Rep. Jim Beckett, R-Bruce, chairman of Public Utilities. These are the folks who guide legislation through the Mississippi House.
The leadership team consists of a bipartisan group of four Republicans and two Democrats.
For that night, however, the party labels had been left at the door. There was no political jockeying, just frank discussion and a lot – a lot – of listening. For the record, those party labels seemed to had been left at the door long before, as this group seems to work as one!
On the table is $10 billion dollars of federal money paid over 10 years for the state to expand Medicaid.
For the first three years, the federal government pays 100 percent of Medicaid expansion. At year four and until year 2020, Washington promises to cover 90 percent of the cost, leaving Mississippi to pick up the tab for the remaining 10 percent.
The question is what happens in 2021? Who pays the expansion tab going forward?
It is free money! But how expensive is free money?
The first answer is the $1.6 billion of new money the state has to ante up over the next 10 years ($160 million per year) to start the ball rolling. The next question is where is that money coming from? And from what state agency budget is that money coming? Education?
Adding to the equation is the fact that by 2017, one-third of state employees are eligible for retirement and the state retirement fund is hurting. The state may have ante up more money there.
The flip side is without Mississippi signing on to Obamacare, the local medical communities across the state are hit and hit hard.
Local hospitals will see their Medicaid reimbursement slashed – something like an estimated $10 million at King’s Daughters Medical Center here in Brookhaven.
Physicians, too, will see their reimbursements slashed. Some may decide to opt out of Medicaid, seeing only patients covered by private health insurance.
Gunn is listening as he feels the pressure from both sides.
At the moment, the House leadership is waiting for the outcome of the Nov. 6 elections. Should Republican Mitt Romney win the election, they will have breathing room. If President Obama wins, then the clock starts ticking.
The wild card is the controversial Supreme Court decision.
While that decision did not nullify Obamacare as so many states had hoped, the decision did give the ability for states to opt out. As Snowden pointed out, “If enough states decide not to participate, it (Obamacare) is a house of cards.”
So it is a waiting game for House leadership.
Write to Bill Jacobs at P.O. Box 551, Brookhaven MS 39602, or send e-mail to firstname.lastname@example.org.