Medicaid in Mississippi: Part 3: Medicaid and HospitalsBy Jeffrey Hess | Published 18 Apr 2013 11:37am |
Expanding Mississippi's Medicaid program to cover 300,000 more residents is one of the most hotly debated political battles in that state. Democratic lawmakers are putting a lot on the line in an attempt to expand the program, while Republicans decry the expense. While legislators have argued this issue of what expansion would look like for the state, so have policy experts.
Delta Regional Medical Center in Greenville serves nearly 150,000 Mississippians in the heart of the Mississippi Delta.
Standing at a white board with the details of his hospital's budget, CEO Stansel Harvey says he is worried about the future.
"We won't close. But what we will happen is Delta Regional as you see it right now is going to have to change," says Harvey.
Harvey is looking at the bottom line for his hospital if the federal government decreases the money the hospital gets to offset uncompensated care.
The federal health care reform law orders the reduction because it assumed that an expansion of Medicaid would eliminate the need for those funds.
That reduction is terrifying some hospital administrators like Harvey.
"It doesn't take a genius to figure out that if you made $2.9 million and you take a $5.6 million cut you are in the hole, and you are going to have to make some substantial operating changes to be able to manage that,” says Harvey.
When Harvey says 'operating changes' what he means is potentially firing doctors and nurses, or dropping the services that his hospital provides such as implanting pacemakers.
"What we are going to have to do is fundamentally change the way we do things and that is going to be the best I can see is reducing services, continues Harvey. “When you look at our number one cost, which is labor, what we will have to do is reduce services and reduce costs and reduce labor costs."
Amy Walker is a nurse in the emergency room.
She says she is very concerned about the future of the hospital and for the Delta patients that rely on the services they provide.
"I work in the emergency department and I see patients all the time that have walked up here or have had to wait until their neighbor got home from work to be able to come to the hospital because they don't have a car. They don't have family that can take them places. Where are these people going to go for health care?" says Walker.
The United States Supreme Court's ruling on the health care reform law now makes Medicaid expansion optional.
(Watch the latest episode of MPB's Southern Remedy on Medicaid)
Most of the people who would be brought into an expanded Medicaid program are parents or childless adults.
People like Rene Trevillion an uninsured mother of three with chronic back problems.
"I would love to see that I am able to get health care insurance. Something that I am able to afford first of all,”says Trevillion.
While the first three years’ cost of Medicaid expansion will be paid completely by the federal government, the state will gradually be asked to contribute more.
Ultimately, Mississippi will be required to put up 10% of the medical costs of the new people on the program. Most estimates put that figure around $100 million dollars a year.
Republicans, like Governor Phil Bryant, have repeatedly insisted that the increase is too much for the state to bear.
"The thing that I do not believe, I do not believe that the federal government has the revenue to fully fund Medicaid across the United States of America. I am not going to fall into this trap and leave the taxes payers of the state of Mississippi holding the bills," Bryant said.
But Democrats, along side public health advocates and the health care industry, are keeping up the pressure to take the money and expand the program.
David Blount is a Democratic Senator from Jackson.
"Not only would it improve health care, but the economic benefit of 90-95% of the money coming from the federal government into this state. It is a good deal for the state of Mississippi. And regardless of who people voted for, for president, I hope they will look at the numbers and make the decision that is right for the state," Blount said.
Democrats attempted to force a vote on expansion, which ultimately resulted in the session ending without an expansion agreement or even a plan to continue the existing Medicaid program.
That is a huge looming problem for the state.
And while lawmakers do not have to decide about Medicaid expansion this year, they need to approve a bill to renew and fund the existing program before it expires at the end of June.
When, how or if that deal can be reached before this summer remains an open question.
The entire MPB News "Medicaid in Mississippi" series is below:
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