Conceptually, Medicaid was created to provide humanitarian health care to those unable to pay for the cost of care by virtue of age or disability – but “conceptually” was a long time ago and very far away from the reality of today.
Between then and now, risk has transferred from private sector coverage causing the publicly funded Medicaid program to function as a form of reinsurance in the increasingly high-cost health care market.
Understanding the relationship between Medicaid, private sector coverage, and health care providers is important now that the biggest testosterone war ever on this side of Texas is taking place here over funding for Mississippi’s Medicaid program.
In March, we suggested it was time for someone at the Capitol to blink and agree to a compromise over how to fill a $90 million gap in funding for the state’s Medicaid program…What’s changed between now and March, though, is that [Governor ] Barbour has upped the ante by threatening to cut Medicaid services if his hospital tax plan is not approved. [Speaker] McCoy has flatly refused to consider the plan, preferring instead to raise the tax on tobacco as well as tapping the state’s Rainy Day Fund if needed.
What hasn’t changed since March – or ever, for that matter – is why related federal law gives states the authority for assessments such as that proposed by the Governor – and that matters a lot.
The Medicaid program design makes those who profit from Medicaid services subject to related assessments (taxes). Within the limitations established in the law, the authority to do so rests with the states.
Opposition to the Governor’s proposal ignores the fundamental justice of taxing those who profit from taxpayer investment in the Medicaid program.
The governor’s steadfast opposition to a tobacco tax increase makes some question his motives, but McCoy has been equally as stubborn – if not more so – in challenging Barbour to force an increase.
The speaker’s calling the governor’s plan a “sick tax” reeks of politics designed to curry favor and support among those who rely on Medicaid for their health care. And his idea for dipping into the Rainy Day Fund suggests some head-in-the-sand fiscal irresponsibility – for such an idea simply postpones the problem while draining financial reserves.
Frankly, it would also be head-in-the-sand, to ignore what some of those affected by the Governor’s proposal are saying.
Most hospitals across the state are supporting the governor’s tax plan because it will mean more revenue for them in the form of Medicaid reimbursements…
Many hospital administrators, though, add a caveat “in the current political environment” to their support calls. They say they would like to see a cigarette tax increase, but also realize that is not under consideration by Barbour.
If the hospitals will earn more by paying the assessment of the Governor’s plan, it seems obvious they’d earn even more from the from the cigarette tax – and that has everything to do with their budget, not ours.
How can it make sense on any level to not expand Medicaid at this point in time when by not doing so keeps the working poor from seeking basic healthcare or impoverishes them further when they do? Who benefits from keeping people in ill health?