Today Mississippi senators face a deadline to reauthorize the state’s Medicaid program.
The House of Representatives initially failed to pass the measure last week as Democrats challenged the exclusion of a Medicaid expansion included as part of the Affordable Care Act.
Similar arguments continue in the Senate, with Democrats asserting that the expansion makes fiscal sense for the state as the federal government assumes the majority of the costs (over 90 percent), while state Republicans find the state’s 10-year, $1 billion expenditure too great.
Alabama recently rejected the federal government’s proposed expansion, and Mississippi appears headed in a similar direction.
What are the consequences of the state’s denial of federal funding, and what would the expansion mean for Mississippians?
To receive Medicaid in Mississippi, one must not only be low-income but also meet specific eligibility requirements.
The program currently provides for children, pregnant mothers and parents living at more than 200 percent of the poverty line.
It also provides long-term care for elderly persons living in poverty within the state.
The ACA expansion changes these restrictions and removes some eligibility requirements, setting the income standard at 138 percent of the poverty line and allowing for participants without children.
In numerical terms, it will bring about 300,000 new participants into the program and cost the state around $1 billion from 2013-2022.
This sum represents around 1 percent of the state’s budget.
Recall from last week’s discussion of potential unionization at Nissan that the state spent nearly $380 million recruiting the company to the Canton plant, almost four times as much as the yearly increase mandated by the Medicaid expansion.
This expansion will provide jobs much like the Nissan investment, as federal funds primarily go to health care providers who will see increases in patient numbers.
Along with this increase in patient numbers comes a decrease in uncompensated costs, which arise from uninsured patients and must be partially funded by state and local governments.
The reduction of these costs will offset the funds provided by the state in part as residents receive insurance benefits and cost the state less money for uncompensated visits and illness reduced by preventive care.
Regardless of whether or not the state decides to accept federal expansion of Medicaid, the program will see increased participation by those already eligible for coverage as a result of other changes mandated by the Affordable Care Act.
Without the expansion, the state will see around 57,000 more Medicaid participants and will not receive the percentage of matching federal funds guaranteed within the new health care law.
While the federal government already assumes a larger portion of Medicaid expense than the state government, the ACA increases this percentage to additionally offset enrollment, and as the state denies the federal expansion, it also denies this increased funding match for persons whom they will be forced to cover, regardless of whether or not they accept the expansion.
Republican lawmakers describe the Democratic defeat of Medicaid legislation this week as “short-sighted,” yet their own position against Medicaid expansion fails to account for the long-term benefits of the program, just as it fails to offer any solution for residents left uninsured and facing impending fines when the government fully implements the ACA.
The law requires Americans to purchase insurance, and those living at or near the poverty line will have difficulty doing this without state or federal assistance.
The state’s government can recognize this now and implement the proposed expansion (which is primarily federally financed) or face future complications as the state’s poor residents remain uninsured and face federal fines and tax liens.
Insuring more residents makes long-term economic sense for everyone, and maintaining an ideological position in the face of compelling research does nothing to advance the state.
The numbers in this article come from a report on Medicaid recently commissioned by the Kaiser Family Foundation.
Meghan Holmes is a second-year graduate Southern studies student from Arab, Ala. You can follow her @styrofoamcup.