How Will Health Care Ruling Affect Mississippi?By Jeffrey Hess | Published 28 Jun 2012 04:15pm |
Now that the US Supreme Court has ruled the majority of the Health Care Reform Law constitutional, what is the next step for Mississippians and state lawmakers? MPB's Jeffrey Hess reports that ruling could mean access to health insurance for hundreds of thousands of Mississippians, but the poorest in the state could be left out.
The high profile ruling Thursday left most of President Obama's health care reform law intact....including the most controversial element....the requirement that all Americans have health insurance or pay a tax penalty.
That means many of the policies that are attempting to bring insurance to the half a million Mississippians who currently do not have it remain in place.
Including tax credits for moderate income Mississippians to help pay for the health insurance they are now required to have.
Theresa Hannah with the Mississippi Center for Health Policy says those people will purchase that insurance and receive the credits through a health insurance marketplace called an exchange.
“We are expecting around 275-thousand people. And about 229-thousand of those would be eligible for subsidies under the exchange,” Hannah said.
The law requires the exchange to be ready for use in 2014.
If it functions as expected could lower the rate of people without insurance by 10-percent or more.
Mississippi is actually ahead of the national curve in setting up an exchange.
Efforts have been underway for months to build that on-line market place where consumers can shop and compare policies.
Insurance Commissioner Mike Chaney says moving forward with the exchange in Mississippi will prevent the federal government from entering the state to set up and run one.
“It is important to us that we take care of the citizens of this state that we have an exchange designed by Mississippians for Mississippians and operated by Mississippians and not by the Federal Government. We do not think that one size fits all is the way to go. What will work in New York State or California may not work in Mississippi,” Chaney said.
Chaney believes the exchange will comply with the federal law.
The court ruling did leave a big question mark for the poorest Mississippians.
The law sought to bring more uninsured adults into the Medicaid system, by expanding eligibility to roughly 300-thousand low income Mississippi adults.
Mississippi College School of Law Professor Matt Steffey says the court ruled that the federal government cannot threaten Mississippi's whole Medicaid funding if they decline to expand their eligible population.
“It is essentially a contract theory. We have an existing contract between the federal government and the state on Medicaid. The government offered a new contract. The Supreme Court ruled you cannot hold contract one to contract two,” Steffey said.
The ruling puts the decision about the health care of hundreds of thousands of Mississippians at the feet of the state legislature.
The federal government is offeringto start out paying 100-percent of the initial cost of the new population...that match would drop to a 90-percent match by 2020.
Leading state budget writers have worried that the estimated 400-million-to1-billion dollar price tag over the next ten years is too much to bear.
Governor Phil Bryant says the state should consider opting out of the Medicaid expansion.
“Before I will make deep draconian cuts in education and in transportation and workforce development, we will certainly seek opportunities that the state will have to reduce the welfare cost to Mississippians. If you look at adding 400-thousand (people) that certainly will damage this budget beyond repair," Bryant said.
Lt. Governor Tate Reeves released a statement saying quote-Mississippi taxpayers simply cannot afford the cost, so our state is not inclined to drastically expand Medicaid.
Mississippi is one of the poorest states in the nation with 640-thousand people currently on Medicaid.
Supporters of the expansion argue that the matching funds are very generous and would bring much needed health care to some of the poorest Mississippians.
Many of the newly eligible people are working but cannot afford health insurance says Corey Wiggins with the Mississippi Health Advocacy program...
“If you look at the amount of money that we spend on the uninsured here in the state of Mississippi, which is a large number, that cost already gets passed off. If you look at the doctors who are here who will now have people that will have health insurance who can actually pay for that coverage through their insurance plans. I think that benefits providers. So I think there is a lot of cost that when you look past that initial budget cost, there are a lot of cost that benefit Mississippians and benefit the state as a whole,” Wiggins said.
Whether or not to expand eligibility and accept the federal money might be the biggest spending fight for law makers when they head back into session to craft the 20-14 budget this January.
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