March 6, 2009
JACKSON -- A handful of Republican senators broke ranks and joined Democrats against two Medicaid measures pushed by GOP Gov. Haley Barbour to save money and generate revenue for the financially strained health care program for the poor.
The Senate voted 30-17 Thursday for legislation to use federal economic stimulus funds in place of a state tax Barbour wants to impose on hospitals.
The bill would also eliminate the current requirement that parents with children covered by Medicaid must visit a state office once a year to be screened by administrators. This is to determine if their children should remain eligible for coverage. Barbour says the meetings help keep incidents of fraud low by requiring beneficiaries to disclose their annual income.
The Senate went against its leaders Thursday to adopt a provision saying the state won''t impose the Barbour-proposed hospital tax if federal funds are available to offset the need for extra money.
The American Recovery and Reinvestment Act that President Obama enacted last month provides about $770 million for Mississippi''s Medicaid program, according to estimates provided to the state Legislature.
However, Senate Appropriations Chairman Alan Nunnelee, R-Tupelo, noted the federal funds run out next year and that Medicaid needs additional funds for the duration.
"It puts the entire budget in a serious budget hole," Nunnelee said of the Senate''s action Thursday. "We need a long-term sustainable revenue source for Medicaid, and I think the Senate is not willing to accept the responsibility for coming up with that."
Sufficiently funding Medicaid has been among the most vexing budget issues bedeviling the Legislature as it copes with the state''s economic downturn. Legislators have been arguing for the past couple of years over whether to help fund Medicaid with Barbour''s proposed $90 million tax increase on hospitals.
The Mississippi Hospital Association, the MHAP and other groups have waged strong opposition to the hospital tax and urged the Legislature to opt for a cigarette tax increase instead.
House-Senate negotiators have been trying to iron out a final version of cigarette-tax increase bills passed earlier this year by the two legislative bodies.
The Republican-led Senate allied with Barbour had been pushing for the tax on hospitals to help fund Medicaid, but the Democratic-controlled House has only agreed to a smaller hospital tax combined with a higher levy on cigarettes.
The infusion of federal Medicaid funds to help states with their economic recovery has provided a much-needed windfall for Mississippi''s budget shortage.
About $2.8 billion is earmarked for Mississippi to help fund various government services and assist people struggling through the economic recession, according to legislative estimates.
The state in 2005 began the in-person Medicaid recertification process, which Barbour says has successfully kept bogus recipients out of the program and saved money.
"Requiring face-to-face meetings to check a recipient''s eligibility has reduced fraud and improved the efficiency of Mississippi''s Medicaid program," Barbour said Thursday in a statement issued by his office.
"Medicaid employees are working diligently to ensure that every Mississippian who needs health care is receiving health care."
However, critics of the face-to-face recertification process have persuaded the House and Senate to vote for ending this requirement. They say it has been used to deprive eligible recipients of health care.
Mississippi is the only state that requires all families to recertify their eligibility at a state Medicaid office to maintain health coverage for their children, according to the Mississippi Health Advocacy Program.
"The only results of this in-person interview requirement have been millions in new administrative costs and thousands of children being left without health care," the MHAP said in a report issued Wednesday.
Complaints abound that it''s hard for Medicaid recipients to find time to travel to the Medicaid offices, many of which aren''t open full-time.
Five of the Senate''s 25 Republicans joined 25 Democrats to pass the Medicaid bill. The 17 senators voting against it are all Republicans.
Sen. Gary Jackson, R-Kilmichael, was one of those Republicans voting for the bill. He said he''s against imposing a tax on hospitals suffering financial problems.
"I don''t want to do anything to hurt the hospitals in my district. They''re already in a pinch on several fronts," said Jackson, whose multicounty district includes part of Oktibbeha.
House Bill 105 to revise the state Medicaid program, including a provision to not impose a hospital tax and to eliminate the requirement that families with children on Medicaid make annual visits to state offices to be screened for eligibility.
--Terry Brown, R-Columbus: Not voting
--Bennie Turner, D-West Point: For
--Hob Bryan, D-Amory: For
--Gary Jackson, R-Kilmichael: For
--Sampson Jackson, D-Preston: For