House Democrats propose Medicaid expansionPublished 12:08am Thursday, March 7, 2013
NATCHEZ — Mississippi House Democrats have proposed a compromise measure that would expand Medicaid in the state only if federal funding they consider critical to hospitals is cut.
The proposal was announced Wednesday, but has not yet been formally introduced. Rep. Robert Johnson (D-Natchez) is one of the co-authors of the resolution, which would expand Medicaid in Mississippi proportionally to cover any reduction in Disproportionate Share Hospital Funds. DSH funds are federal dollars directed to local hospitals to reimburse them for services rendered to uninsured patients. The funds will be reduced under the Affordable Care Act because everyone will ostensibly be insured.
Johnson said the issue is particularly personal for him because local hospitals serve a needy population, and that population would be affected if Medicaid is not expanded but the mandated $19 billion reduction DSH program goes through with the Affordable Care Act.
Representatives of both Natchez Regional Medical Center and Natchez Community Hospital have previously said that a loss of DSH funding would present a serious financial void for them.
In the Natchez area, 40 percent of health care consumers are Medicaid and Medicare patients, Johnson said.
“Of the people who are left from that in the private-pay system, approximately 25-30 percent are people who don’t have insurance at all,” Johnson said.
“We need to be prepared with a trigger. If expansion is not possible for us right now, we need to have it set up where it is in place when the time comes.
“When we look at our rural hospitals, we can’t afford to have only four or five hospitals across the state, but these (rural hospitals) cannot provide if we do not do something.”
“I served seven years on the Medicaid committee, five of those years as vice-chair; I know what I am talking about.”
But Rep. Sam Mims (R-McComb), who serves as the chairman of the house public health and human services committee, and who represents a portion of Adams County, said he believes such a proposal would be hasty at this time.
“At this point, we are still going to get the DSH money back from the federal government — in 2013 everything will come,” Mims said. “If we come to a point in 2014 and the DSH money from the federal government is changed or (has) gone away, then at that point we will have to make some decisions.”
Mims said he also feels some frustration that the federal health authorities have not given any indication of what the future reduction in Mississippi’s DSH funding might be.
“They do not feel the need to give us an answer, so that is very discouraging,” he said. “I think it is premature to expand Medicaid at this point.”
More primary than the focus on a potential DSH reduction is the fact that the state cannot afford to expand the Medicaid program at this point, Mims said.
“If (DSH funding) goes away, then we, of course, have to have a discussion in order to take care of our hospitals and our citizens,” he said.