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Medicaid in Mississippi: Part 1: What is Medicaid?

By Jeffrey Hess | Published 16 Apr 2013 05:31am | comments

The clock is ticking on Mississippi's Medicaid program. The existing program is set to expire at the end of June. Lawmakers ended their three month legislative session grid locked over the program and its future. In the first of a three part series, we take a closer look at Medicaid in Mississippi and what expansion means.

 What is Medicaid?

 Medicaid is often generically called the “health insurance program for the poor,” but that is only partly accurate.

 Medicaid does provide health insurance for close to 700,000 Mississippians and nationwide, Medicaid currently covers about 60 million people currently, or 1 in 5 Americans, but those people must be both poor and in a certain category.

 Rachel Garfield is a senior researcher with the Kaiser Family Foundation, a non-partisan health policy institute.

 “So you need to be very low income and in addition fit in a category. So those categories are children, pregnant women, and some parents. The eligibility levels for adults are quite low,” says Garfield.

 For example, a single mom in Mississippi with just one child can only earn about $5,500 dollars a year in order for her to receive Medicaid.

 To break it down, a little less than half of the people on the program are kids, another quarter are elderly and another 20% or so are disabled, the rest are pregnant women and very low income parents.

Garfield says other than kids, Medicaid plays a huge roll supporting the elderly or disabled.

“It also provides supplemental coverage for very low income Medicare beneficiaries who otherwise might face significant gaps in their coverage. It is also the primary payer for long term care services in this state. So people who need nursing home care or ongoing care in the community,”

 

The program is expected to cost the state around $800 million dollars in the next fiscal year to provide nursing home and ongoing, long term health care, but, it also brings in roughly three times that figure in matching funds from the federal government.

That means Medicaid pays $800 million dollars a year to nursing homes in the state and $1.6 billion to Mississippi hospitals.

House Medicaid Committee chair Bobby Howell of Kilmichael, a Republican who is skeptical of expanding Medicaid, says the program covers all a person's health needs like doctors’ visits, prescriptions, eye glasses and more.

“Medicaid provides very broad coverage. For those beneficiaries, basically you cannot buy a policy that is as comprehensive as Medicaid is.”

Able-bodied Mississippians without children are not eligible for Medicaid at all, regardless of how little they earn.

What could expansion mean for Mississippi?

The federal health care reform law, Garfield says, is attempting to wipe away those distinctions on category.

“The expansion will get rid of those categories. So it will only be based on income and it will cover everyone up to 138% of the federal poverty level. So about 12 to $15,000 dollars a year depending on how large their family

That's about 300,000 people mostly parents and childless adults, that is the Medicaid expansion, and it is optional for the state.

Cost figures vary, but most estimates expect that expanding Medicaid will cost the state around $1 billion dollars over 10 years, while the federal government adds about $12 billion to the pool to help pay for care.

There was no agreement to re-new or fund the existing Medicaid program, putting the health care of the nearly 700,000 MIssissippians who rely on it at risk and the potential for 300,000 more Mississippians to access health care also in question.

 

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