Medicaid Expansion Debate Continues

By: Mike McDaniel Email
By: Mike McDaniel Email

Democratic lawmakers are putting forth a plan they hope will be a compromise on whether to expand the state’s Medicaid program. That decision is a controversial one which is also split along party lines.

It has been a sticking point at the state Capitol ever since Mississippi was given the option of whether to expand the state's Medicaid program under what's known as Obamacare.

Democrats want an expansion, while Republicans are against it.

"All we've asked for is let us debate it," said Democrat Rep. Cecil Brown. "Let's get a vote and let's see where we are."

Democrats said Wednesday they're willing to work with GOP leadership and Gov. Phil Bryant, who has concerns on whether disproportionate share payments will still be paid to local hospitals under an expansion.

That federal money is paid to hospitals to offset their costs of treating patients without insurance. Bryant says he believes the money will still be paid without an expansion.

Democrats argue the money would either be greatly reduced or eliminated and leave many hospitals having to get rid of staff to make up for the loss.

"People will lose jobs and people will lose access to healthcare, particularly in our rural communities," said Democrat Sen. David Blount.

Bryant maintains it's simply a threat from the White House to expand Obamacare and a move the state can't afford.

"It's intimidation to try and ask states to use primarily if they will a state exchange as a vehicle to expand Obamacare," Bryant said.

To strike up a deal, Democrats are making an offer. They want to include a trigger clause in legislation that an expansion would only happen if those payments are reduced. If the payments remain, an expansion would not happen.

"We don't agree with his concerns but that's O.K.," Brown said. "He's the governor. He has every right to be concerned. We just say, O.K. if you're right we won't expand. If you're wrong, we will expand. That seems to take care of the argument he's making."

For any of that to happen lawmakers will have to revive a Medicaid re-authorization bill that died Tuesday. That bill authorizes the program to continue operating in the state.

Democrats hope they can bring the bill back to life and get the ball rolling on expansion legislation.

"This is an opportunity for all of those who say that they care about moving the state forward. This is one of the things we can do," said Democrat Rep. Robert Johnson.

If an expansion does happen in Mississippi, an estimated 300,000 people would be added to the Medicaid rolls. Under this plan, Democrats say legislation will allow time for a wait and see approach on what will happen from the federal government.

Bryant says the proposal will not be approved by both sides.

"I would say that they're looking at the wrong Capitol. They need to be looking at the Capitol in Washington. This is a federal law," said Bryant.

"The bottom line is that it takes care of those people in the state of Mississippi who we need to take care of, working, voting people every day," Johnson said.

Bryant says the state can't afford an expansion even though the he says the federal government is promising to pay for it.

"I'm not prepared to trust the Obama administration at this time and I'm not going to pass that bill," the governor said.

Under the U.S. Supreme Court's ruling on the Affordable Care Act, known as Obamacare, states aren't mandated to expanded Medicaid, but rather given the option.

That, Bryant says, means the federal government can't withhold hospital reimbursement payments for any state not expanding.

"You can't punish us for not expanding Medicaid and if you do we have a legal standing and we're exploring that possibility," Bryant said.

Bryant says if Obama administration is really worried about healthcare, reimbursement payments would not be cut or even used as leverage.

"For Democrats to hold a current Medicaid recipient hostage is just something that should not be done and shame on them for doing that," said Bryant.

Meanwhile, Democrats say all they want is for the matter to at least be brought to the House and Senate floors for debate.

"Just get some legislation before us and let's talk about that issue," said Democrat rep. Bobby Moak.


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