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Legislators expect extension, not expansion of Medicaid


Sen. Terry Burton

Sen. Terry Burton



Sarah Fowler and Nathan Gregory



Hours after Governor Phil Bryant announced a Thursday special session of the state legislature to address Medicaid concerns, Senator Terry Burton, R-Newton, spoke with future nurse practitioners on the Mississippi University for Women campus. 


Burton, a seasoned politician who currently chairs the senate energy committee and serves as vice chairman of the senate appropriations committee, spoke to the students about the challenges they would face as future health care providers given the upcoming changes in insurance and, potentially, the expansion of Medicaid, a measure that is being fought by the state's Republican leadership. Burton also serves on the public health committee and handles all senate bills relating to Medicaid and public health. 


"Medicaid has been a big part of what I do for the last 23 years in the state senate," he said. 


Speaking to a group of about 30 students, Burton said the uncertainty revolving around The Affordable Care Act, commonly known as Obamacare, will have a direct effect on the state's Medicaid costs and benefits. 


Under federal Medicaid guidelines issued in 2010, states are granted the option of expanding Medicaid coverage to those earning up to 138 percent of the federal poverty level -- approximately $15,000 annually. According to the Associated Press, the cutoff for Medicaid in Mississippi is now at about $5,500 a year. The Affordable Care Act says if Medicaid is expanded, the federal government would pay 100 percent of medical expenses for newly qualified participants from 2014 to 2017. That amount would be reduced to 90 percent by 2020, with each state fronting the remaining 10 percent. 


Lawmakers in the Senate voted earlier this year in favor of funding Medicaid without expanding it to an additional 300,000 people as prescribed under the Affordable Care Act. The Senate's proposed legislation died in the House's Rules Committee. 


If lawmakers do not reach an agreement before July 1, the medical services of more than 644,000 state residents will be jeopardized as a result. 


"Healthcare reform is going to change the way health care is approached in this country," Burton said. "Some say in a very positive way, some say in a very negative way. Whoever is right is not important. What is important is it's going to change." 


"So the Republicans killed the program and the Democrats killed the budget," he said. "I like to joke and say that was truly a bi-partisan effort." 


Burton said he and fellow Republican legislators want to reject the federal funds attached to expanding Medicaid because they question how long it will be before the government well runs dry and the state is left holding the bag. 


When reached Monday afternoon, Rep. Tyrone Ellis, D-Starkville, agreed the matter should have been resolved during regular session, but said he and fellow Democrats have tried to find common ground with Republicans and use that as a foundation for expanding Medicaid. 


"People are hurt with the fact of being put in this position because we did not have to be here," Ellis said. "We could have resolved this during the regular session. Now here we are wasting time, energy, resources, funding and it was unnecessary. All it would have taken would have been our being able to communicate with one another.  


"Therein lies the problem -- lack of communication From the Democratic standpoint, we want to expand Medicaid. We've been very clear about that. We even came closer to the middle in terms of reaching out and trying to assist the Republican administration. We went and met with (state insurance commissioner) Mike Chaney. We put everything together with his blessings for the healthcare insurance exchange. He signed off on it. We have a viable, doable, workable program as an option to the rubber stamp, cookie cutter Affordable Care Act. We presented that option. The only thing left now is for them to take a good, serious look at it." 


Sen. Terry Brown, R-Columbus, said the state already struggles to fund the recipients it already has and cannot afford to add 300,000 more. 


"We absolutely cannot afford it," Brown said. "There's no way. I know my friends on the Democrat side want to expand and there are a lot of healthcare folks that want to expand, but we've got 700,000 people on Medicaid right now, and we're having trouble funding them. To put another 300,000 on, I don't know how in the world we could do it.  


"We just need to re-enact and give certainty to the 700,000 that are already on it. It's hard to take away something from someone that's already got something. We can argue the next session on if we want to expand and how we want to expand. Right now, we need to go down there, extend what we've got and get out of there." 


Burton shared a similar sentiment. "We will pass a bill: There's no way Medicaid is going to go away, we will have a Medicaid program. My belief is that we will have a program exactly as it is right now with the same criteria for participation for the next year, until June 30 of next year funded with $840 million in state money." 


Ellis said while he does not expect his colleagues to reach an agreement that would include expansion of the program, he likes "to be proven wrong." 


"I'm not saying they won't do that," Ellis said. "They may surprise us and do that. I hope so. That way, you have more working poor on Medicaid with the state paying $10 and the feds paying $90 per hundred. I think that's a good deal all day long." 


Lawmakers convene at 10 a.m. Thursday. They have until Sunday night to approve a Medicaid program. Passage of a budget bill requires 62 votes in the House and 27 in the Senate. Republicans hold majorities in each branch. 


Bryant previously said he believed he could run Medicaid in the event that lawmakers fail to reauthorize the program. Attorney General Jim Hood issued an opinion last week saying Bryant did not have that authority.




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