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Medicaid reform needed in Mississippi

With election season upon us, one growing issue that has popped up on the political radar screen in recent months is Medicaid Reform or Medicaid Expansion depending on your political leaning. Generally, those who are opposed like to use the phrase Medicaid Expansion, while those who support the idea like to say Medicaid Reform.

Expansionists prefer to tie the issue to Obamacare and that such expansion will result in higher taxes to taxpayers. Reformers would tell you otherwise that the reform plan would actually be a tax savings mechanism that will benefit Mississippi by taking advantage of current law to benefit taxpayers.

Serving as a member of the Board of Trustees at King’s Daughters Medical Center for the past four years — as treasurer and finance committee chairman for the last two — I can tell you the Expansionists are just playing politics — pure red meat politics!

As introduced by the Mississippi Hospital Association early this year, Medicaid Reform will be good for Mississippi. Modeled after the same plan put into Indiana law in 2014 by Vice President Mike Pence when he was Indiana governor. It has worked well for the conservative Republican led state.

Bottom line is that the cost of the reform program is born by the participants and hospitals. Participants pay a $20 per month premium.  To reduce overcrowding in our emergency rooms and encourage members to seek care in more appropriate settings, the plan requires a $100 co-pay for each unnecessary emergency room visit.  Participants by the way are those who are working, but earn too much to qualify for Medicaid but not enough (138 percent of the federal poverty level — $17,400 for an individual or $35,000 for a family of four) to be able to afford premiums of a healthcare plan through their employer or individually. Hospitals across the state will pick up the remaining cost of the insurance. Mississippi taxpayers pay nothing!

How so you might ask? Well the payments by both the participants and the hospitals are matched 9 to 1 by the federal government resulting in an estimated $1.35 billion dollars annually to the Mississippi Division of Medicaid depending upon enrollment.  Funds then are then distributed to Mississippi hospitals and healthcare providers as payment for services provided. 

Beyond the numbers, Medicaid Reform is an economic development issue for Mississippi but more importantly for Southwest Mississippi. A recent study by Navigant reported that 31 hospitals in Mississippi are at financial risk of closing — nine of those hospitals, 29 percent, are located in Southwest Mississippi. KDMC is not on that list! But hospitals in Franklin, Lawrence, Jeff Davis, Walthall, Adams counties and others are on the list.

In the economic development arena attracting and recruiting industry becomes even more difficult if the medical community is weak. Industrial prospects do not just look at the home county but the surrounding counties too — not enough positive check marks for each and we miss the cut.

Call it what you want, Medicaid Reform or Medicaid Expansion, this state has reached critical mass in the health care industry. Our political leaders must honestly address it now.  Election years are always the best time to ask questions then voice your opinion at the ballot box.    

Bill Jacobs is a board member at KDMC and the former owner/publisher of The Daily Leader.