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Medicaid expansion on Mississippi's mind

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July 15, 2012


By: Stephan Burklin
JACKSON, Mississippi: While the national media have largely seized on the political implications of the Supreme Court’s upholding of the Affordable Care Act, policymakers in Mississippi are grappling with the practical consequences of the Court’s decision to allow states to choose whether to expand their Medicaid programs.[1]

The nation’s highest court struck down the portion of the health care bill that would give the federal government the right to withhold Medicaid funding to states who refused to comply with the new income thresholds pegged by the Affordable Care Act.[1]

Some governors have indicated that they would seek to opt out of the Medicaid expansion, citing high costs.[1]

According to the DeSoto Times Tribune, Republican leaders have predicted that the expansion coupled with Mississippi’s estimated 618,000 uninsured residents could cost state taxpayers an additional $200 million.[1]

Currently, Medicaid serves Mississippians with an income of up to 100 percent of the poverty level or $23,050 for a family of four. The health care law would have required the state to offer Medicaid to all citizens whose income is below 133 percent of the poverty level, or $30,650 for a family of four. Estimates suggest that 250,000 to 400,000 new Medicaid recipients would be added to the state’s rolls given the federal law’s parameters.[1]

Skeptical governors contend that the costs to states would be irresponsible in times of fiscal austerity, despite the fact that the federal government would pick up the entire tab for the expansion until 2017 before scaling back to 90 percent of the costs in 2020 and thereafter.[1]

According to the DeSoto Times Tribune, former Gov. Haley Barbour told Congress in 2011, “The federal act would require us to increase the Medicaid rolls by about two-thirds, or about 600,000 to a million – a third of our population – because the costs are back-loaded, it would be $1.3 to $1.7 billion over 10 years. We are going to have to raise taxes or cut spending, and more likely, we will have to do both.”[1]

Mississippi’s Medicaid program is one of the most heavily subsidized Medicaid program in the nation. According to the DeSoto Times Tribune, in the fiscal year that ended June 30, 2011, for every $1 the state spent on medical care for the poor, the federal government spent $5.61. In the fiscal year that ended June 30, 2012, the ratio dropped to $3 in federal funds for every $1.[1]

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