House rejects Medicaid expansion

Northeast Mississippi Daily Journal (Tupelo)

Feb. 09--JACKSON -- House Democrats made an unsuccessful effort to expand Medicaid Thursday, saying such an expansion would benefit Mississippi's struggling hospitals, the working poor and the overall economy of the state.

Rep. Robert Johnson, D-Natchez, offered an amendment to the so-called Medicaid technical amendments bill to establish what would be known as accountable care organizations throughout the state, in which health care providers would be able to work together to provide health care to the Medicaid expansion organization.

As Johnson explained his amendment, he never said the phrase "Medicaid expansion," which has become a lightning rod to many Republicans who oppose the Patient Protection and Affordable Care Act, known as Obamacare.

The Republican majority tabled the amendment (effectively killing it) by a 70-43 margin without its leaders engaging in debate on the issue on the House floor. No Democrat voted against the amendment and no Republican voted for it.

Mississippi is one of 19 states not expanding Medicaid as is allowed under the federal law to cover those making up to 138 percent of the federal poverty level -- $33,948 annually for a family of four.

When the ACA was passed in 2010, Mississippi's Republican leadership said they would not expand Medicaid, a key part of the federal law. In the early days, Democrats made efforts in the legislative process to convince the leadership to accept the expansion. The Republican leadership said the state could not afford the expansion.

Johnson and Rep. Steve Holland, D-Plantersville, argued that legislators cannot afford not to expand Medicaid if they want a good health care system in the state.

Johnson said currently, the federal government will pay for 95 percent of the health care costs provided to Medicaid expansion beneficiaries. He said the expansion would generate $43 million per year in federal spending in the Tupelo area and generate $1.22 billion to the state of Mississippi and create 2,000 jobs.

Holland said the expansion would be especially beneficial to Tupelo-based North Mississippi Medicaid Center, that employs nearly 7,000 people in the region, but is struggling financially, in part, because of the number of patients it treats with no health care insurance.

Holland said Mississippi taxpayers are subsidizing the states that have expanded Medicaid.

Johnson said, "59 percent of the people covered (through an expansion) work every day and don't have health care."

The amendment was offered to the technical amendments bill that will reauthorize the agency and determine the types and limits of the coverage that will be provided by Medicaid.

The proposal the House passed Thursday will not expand Medicaid, but does void the three contracts (totaling more than $2 billion) awarded this past year by the state Division of Medicaid to managed care companies. A large portion of the Mississippi Medicaid population (about 70 percent) is in managed care programs where the companies receive a set amount of money to provide health care to the beneficiaries.

Multiple legislators have complained that they do not believe the bid process where the three companies received the contracts was fair. Plus, they were upset a company formed by a coalition of Mississippi hospitals did not receive one of the contracts.

The legislation passed Thursday does not mandate that the hospital coalition receive one of the contracts, but contains wording that would give the group a better chance of obtaining a contract.

Some House members questioned whether it was proper to void contracts already entered into by the state.

Differences in the technical amendment bills passed by the House and Senate most likely will be hammered out in March near the end of the session. The Senate bill does not alter the managed care contracts awarded last year by the Division of Medicaid.

bobby.harrison@journalinc.com Twitter: @bobbyharrison9

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