Governor proposes putting Medicaid eligibility with DHS

Northeast Mississippi Daily Journal (Tupelo)

Oct. 28--JACKSON -- Gov. Phil Bryant will ask the 2018 Mississippi Legislature to move authority for determining the eligibility for those applying for Medicaid benefits to the Department of Human Services.

"Gov. Bryant has asked the Division of Medicaid to submit a plan to transfer eligibility determination responsibilities to the Mississippi Department of Human Services," said Clay Chandler, a spokesman for Bryant. "The governor believes doing so would increase efficiency and ultimately save taxpayers money. This method was successfully used until 2004."

Rep. Steve Holland, D-Plantersville, former House Public Health chairman and considered one of the chamber's experts on Medicaid-related issues, said Medicaid always has had its own eligibility workers and it would be bad policy to remove them.

"Human Services is a social service agency. Medicaid is a health insurance agency. The twain don't meet," Holland said.

Human Services currently determines eligibility for other federal programs, such as Temporary Aid for Needy Families and the Food Stamp program.

People have had the ability to apply for Medicaid through Human Services while applying for other federal welfare-related programs.

But in 2004, in his first year in office, then-Gov. Haley Barbour pushed through legislation adding 400 Medicaid eligibility workers and increasing the number of Medicaid offices throughout the state. Those actions were taken in coordination with a new, controversial requirement imposed by Barbour that people re-apply annually in person at Medicaid offices to remain on the program.

The then-governor said the annual, in-person re-certification mandate would help weed out fraud and save money. Others said the program was costing the state money and putting an undue hardship on poor, often disabled Medicaid recipients.

The federal Patient Protection and Affordable Care Act banned the annual, in-person re-certification effort for Medicaid, which is a program paid for primarily through federal funds.

Chandler said moving Medicaid eligibility checks to Human Services would put Mississippi in the mainstream. He said all but four states determine Medicaid eligibility either through similar departments of human services or through departments of health.

But Holland said determining Medicaid eligibility requires special training because of the combination of poor health and poverty of many of the applicants.

Rep. Chris Brown, R-Aberdeen, the chairman of the House Medicaid Committee, was unavailable to comment on Bryant's proposal.

According to a letter Bryant sent to Medicaid Executive Director David Dzielak and Human Services Executive Director Johnny Davis, the governor also wants Human Services to handle Medicaid's enrollment procedures and waiver requests. State Medicaid agencies often ask for federal waivers to enact procedures not commonly allowed by regulations or not specified in law.

There has been talk in various states of imposing a work requirement on Medicaid recipients. Holland said people who make such proposals do not understand how Medicaid works in Mississippi.

"Ninety-five percent of all nursing home residents (in Mississippi) are on Medicaid," Holland said. "What are they going to do, require nursing home patients to work?"

According to information compiled in December 2016, there were 711,197 Medicaid recipients in the state with a majority of those -- 56 percent -- being children. In addition, 23 percent of the recipients were disabled while 9 percent were elderly and the rest were either pregnant women or the low income parents of children.

bobby.harrison@journalinc.com Twitter: @bobbyharrison9

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