NRMC supports Medicaid expansion

Published 12:15 am Thursday, February 14, 2013

NATCHEZ — The Natchez Regional Medical Center board of trustees has sent a resolution to the state legislature supporting the expansion of Mississippi’s Medicaid program. A failure to expand Medicaid could have a serious negative impact on the hospital in coming years, the board said.

That’s because in part, with the implementation of the Affordable Health Care Act, commonly known as Obamacare, hospitals expect to see a reduction or even elimination of Medicaid Disproportionate Share Hospital payment programs, said Charles Mock, chief financial officer for NRMC.

“In a nutshell, the DSH programs are programs set aside by congress years ago to compensate hospitals for care they rendered for people who are not covered by insurance,” Mock said. “It gives you an estimated portion of the cost of those services to you, but not 100 percent. Without those funds over the years, a lot of hospitals would have bit the dust.”

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Under the Affordable Care Act, Mock said those funds will go away because in theory everyone will be insured, either by private insurance or Medicaid. The CFO said from 1994 to 2012, NRMC received $30 million from the DSH program.

“In this particular state or in any state, if in fact you don’t have the expansion of insurance coverage and the DSH funds go away, that leaves a critical void in hospital finance,” he said.

Not only both area hospitals, but hospitals around the state, would take a significant hit if the DSH program was eliminated, but Medicaid was not expanded, Natchez Community Hospital Chief Executive Officer Eric Robinson said.

“I think the need (for DSH) is present in any market, particularly in Mississippi,” Robinson said. “There is a share of the population that health care services can be a financial burden for, and the DSH program has been put in place to meet that need. With the expansion, it makes sense that the DSH program would go away at that point, because the people the DSH program is set to serve would be served through another vehicle.”

Rep. Sam Mims (R-McComb), is a health care marketing representative and serves as the chair of the House Public Health and Human Services Committee. But Mims said he believes an expansion of Medicaid at this time would be a premature decision.

“The federal government is still going through the process of trying to determine our DSH money, and it is my understanding we will receive our DSH payments for 2012,” Mims said. “The governor’s office has contacted (U.S. Secretary of Health and Human Services Kathleen Sebelius) to ask her what the intentions are for the DSH payments as we go forward, and the answer we received was they will get back to us. We don’t know if that means we will have an answer in February or March or late 2013.”

When the U.S. Supreme Court ruled the Affordable Health Care Act constitutional, the court declared that states could not be punished for not expanding Medicaid.

“If we don’t receive the DSH money, there is an argument to be made that is punishing Mississippi,” Mims said.

“If we don’t expand, our Medicaid population will stay the same and I believe we will still be entitled to that DSH money. If they come back at the end of the year and say your DSH money will continue, I don’t see any reason to expand Medicaid.”

And Mims said he doesn’t believe the expansion will happen this session. The representative, who also serves on the House appropriations committee, said the state’s budget is currently too tight to further fund Medicaid.

“It is true the first three years the federal government will pay 100 percent of Obamacare, but after that the state will have to pick up a percentage of that, and I don’t see how we can afford it.”

Robinson said that while hospitals wait, they have to be ready for any outcome.

“Our job here, regardless of funding sources, is to provide the best care possible,” he said.