The leader of a powerful House committee Tuesday expressed philosophical and financial concerns regarding the expansion of Medicaid, an issue that is sure to be a hot topic during the 2013 legislative session.

     District 97 Rep. Sam Mims, chairman of the House Health and Human Services committee, touched on Medicaid expansion and other government issues during his visit with the Brookhaven Lions Club.

     The U.S. Supreme Court this year upheld the federal Affordable Care Act, but ruled that states can opt not to expand Medicaid as the law sought and not be punished by the federal government. Mims, R-McComb, said he is philosophically opposed to Medicaid expansion because of concerns about increasing the role of government.

     “By expanding Medicaid, you are definitely expanding the role of government,” Mims said.

     On a related note, Mims pointed out that 500,000 to 600,000 Mississippians are currently on Medicaid. Expansion would add 300,000 to 400,000 more, resulting in about one-third of the state’s 3 million population being on Medicaid.

     “I just think that’s the wrong approach,” said Mims, adding that the focus needs to be on finding jobs for citizens.

     Finally, Mims said, there is the issue of how the state can afford expansion.

     “We simply do not have the money to expand the Medicaid program,” said Mims, who is also a member of the House Appropriations committee.

     Medicaid expansion supporters contend that Mississippi, as one of the poorest and unhealthiest states in the nation, cannot afford to bypass an infusion of federal dollars to expand the program. The federal government will pay 100 percent of Medicaid during the first three years before its percentage is scaled back to 90 percent by 2020.

     Still, state Republican executive and legislative leaders say Mississippi cannot afford the $1.6 billion that Medicaid expansion will cost over the next 10 years. Such an expenditure has been called a “budget buster.”

     The outcome of next month’s elections could play a role in how Mississippi moves forward on the Medicaid expansion issue. Republicans have vowed to attempt to modify or repeal the health care reform law, thus giving state leaders some leeway, but they would likely need to make a decision on expansion sooner if Democrats retain the presidency and the majority in the U.S. Senate.

     Regarding state spending, Mims applauded Republican leadership in the area of budget work this year. He said the state has a $5.5 billion balanced budget that saw about $220 million set aside for future needs in a difficult economy.

     “We know the next four years will be very challenging,” Mims said.