Leaders reach agreement on Medicaid as legislators work late to finish budget

March 27--JACKSON -- The disagreement that stalled the passage of the budget bill for the Division of Medicaid appeared to be worked out late Monday, clearing the way for passage of the $6.1 billion state-support budget to fund agencies ranging from education to health care to law enforcement.

The process was delayed Sunday when the House voted not to pass the budget for the Division of Medicaid until an agreement was reached on a so-called Medicaid technical amendments bill. That bill puts legislative parameters on the agency that provides health care to more than 700,000 Mississippians -- primarily the disabled, poor pregnant women, poor children and the poor elderly.

If that technical amendment bill died, more control of the agency would have been turned over to Gov. Phil Bryant. House members, saying they did not want to lose that control, stalled passage of the Medicaid budget until an agreement was reached on the technical amendments bill.

That agreement was reached only minutes before a Monday night deadline. The agreement, reached by key House and Senate leaders, is expected to be voted on today.

The Senate refused to agree to the House proposal that the Mississippi Hospital Association be allowed to operate a managed care company for Medicaid beneficiaries.

But House Medicaid Chairman Chris Brown, R-Nettleton, and Rep. Jason White, R-West, a key House negotiator, said under the agreement there will be a commission established to study the feasibility of allowing a health care provider, such as the Mississippi Hospital Association, to operate a managed care company.

The Division of Medicaid awarded three contracts this summer, totaling more than $2 billion, to three private insurers to operate managed care companies in the state. The Hospital Association was not awarded one of the contracts. Some House members claimed the bid process conducted by the Division of Medicaid was rigged against the hospitals. But the contracts have been upheld thus far on appeal.

Their effort, House negotiators have said, has been to help struggling Mississippi hospitals -- especially small rural hospitals. White said there were other provisions of the agreement reached late Monday that would enhance their reimbursements for treating Medicaid patients.

Senate Medicaid Chairman Brice Wiggins, R-Pascagoula, has said he opposes giving a contract to a group that lost in the bid process.

Managed care companies receive a specified amount of money to provide health care for the Medicaid recipients. They currently cover about 70 percent of the state's Medicaid population.

While Medicaid has been a point of contention in recent days as legislators worked to pass an overall budget, other agencies have been funded with limited debate.

The education budget, for instance, did not elicit as much debate as it often does. Funding for the Mississippi Adequate Education Program was increased $3.1 million to $2.2 billion. The increase in Adequate Education, which provides the state's share of the basics to operate local school districts, was to pay for increases in health insurance for education employees.

At one point, the House was advocating for spending an additional $8 million for the education school funding formula when there were efforts to rewrite the Adequate Education Program. But when those efforts died in the Senate, extra money went away.

At the funding level approved Monday, the Adequate Education Program will be underfunded about $240 million for the upcoming fiscal year.

Overall education, including MAEP as well as other programs, received an increase of $4.2 million to $2.74 billion, according to information compiled by the legislative staff. There was additional money (totaling nearly $8 million) in those education funds shifted to early childhood learning efforts and for a program that provides salary bonuses for faculty in A and B level schools and for schools that improved a letter grade.

In total, the state budget being worked on for the upcoming fiscal year, beginning July 1, will be $6.1 billion or $22.4 million more than what was appropriated during the 2017 session. In general most agencies were level funded, though programs to improve the state's beleaguered foster care system received an additional $30 million.

Efforts to use the budgeting process to try to force legislative leaders to allow the membership to vote on enacting a lottery was narrowly rejected in the House.

[email protected] Twitter: @bobbyharrison9

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