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franklin county times

Mississippi Medicaid a test of wills

By Staff
October 17, 2004
By Buddy Bynum / editor
Warning: Trying to fix Medicaid may have serious consequences to your political health.
Political red flags are flying across Mississippi these days over how to control Medicaid spending without punishing needy recipients.
By every fiscal standard, Medicaid is a hungry monster whose belly is about $100 million light. That's an estimate of the program's projected deficit, the magic money lawmakers will have to find if they want to fully fund it. Absent some legislative action, the spending will continue to grow at a rate many in state government believe to be unsustainable.
You can blame current conditions on liberalization of Medicaid eligibility standards in the 1990s, which opened the program to more people; the sky-high cost of prescription drugs; lawsuit abuse; and even, if you wish, on the fact that the sun rises in the east. The real question isn't blame; it's what can and should be done, and the upcoming debate should focus on substance not hot political rhetoric.
Success story
In many ways, Mississippi Medicaid is a success story. It is a godsend for many people.
But in other ways, Medicaid is a victim of its own success because there is a high price to pay for medical care, and I mean for anyone just just poverty-level, aged or disabled people. Private companies are budgeting for shocking increases in their part of health insurance premiums paid for their employees.
It will not be uncommon next year for such premiums to go up by as much as 40 percent. Blue Cross/Blue Shield, which handles health insurance for most state employees, is one of the few exceptions.
Medicaid isn't private health insurance. Medicaid is a state-federal program that covers an astounding 768,000 Mississippians, nearly 30 percent of the state's population. State tax dollars serve as a match for federal money and, generally, the more the state puts in, the more the federal government puts in.
With the events of last week, with Gov. Haley Barbour bowing to a federal court challenge to Medicaid reforms passed by the Legislature earlier this year and Mississippi's own elected attorney general siding with the plaintiffs, a serious test of wills is shaping up a serious test of not only political philosophy but also moral responsibility.
Is it the state's job that is, the taxpayers' job to care for its neediest people no matter what the cost? Should Medicaid be fully funded at the expense of education? And, if so, to what extent? Cut institutions of higher learning again? Cut community colleges again? Reduce the amount going to K-12? Make public school teachers give back their pay raises? Earmark gambling revenues to Medicaid? Raise taxes?
Barbour has already challenged lawmakers to "show me the money" he's talking about the $100 million of new money but has taken a sacred oath against raising taxes. The governor would likely veto any tax increase to sustain Medicaid and whether the Legislature could muster enough votes to override is still an open question.
While he awaits legislative action in January, Barbour says he will turn to ways of eliminating fraud in Medicaid; that most certainly will account for an extra mil or two. But not even eliminating every smidgen of fraud will solve funding problems over the long term.
Sen. John Kerry said in the debate the other night he wants the federal government to take over states' Medicaid programs; he didn't say how much it would cost or how he proposes to fund it. About the last thing Mississippi needs now is another unfunded federal mandate, that's something the federal government tells states to do but doesn't provide any of the green stuff that makes it happen.
Mississippi needs Medicaid. Mississippi also needs legislators with the backbone to solve the problems and stick with their solutions.
Buddy Bynum is editor of The Meridian Star. Call him at
693-1551, ext. 3213, or e-mail bbynum@themeridianstar.com.

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