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Lawmakers getting last shot at Medicaid fix
By: ADAM NORTHAM, DAILY LEADER Staff Writer
08/04/2008
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With the resumption of a special session Monday morning, the Legislature will likely be facing its final opportunity to resolve Medicaid's $90 million funding gap before Gov. Haley Barbour moves forward with a revised set of program cuts that he says require no legislative input.

The governor's new plan will allow him to decrease hospitals' reimbursement rates, institute a lesser round of Medicaid service cuts that he claims will affect less than 1 percent of the health care community and raise hospital taxes as a way to make up the program's deficit. The money will later be made up by increased federal UPL (Upper Payment Limit) payments to hospitals.

Barbour has been working with the federal Centers for Medicare and Medicaid Services to craft the new plan.

Local legislators are under the impression the governor will allow them one last shot at passing Senate Bill 2013 - the legislation containing a $167 per day hospital bed assessment as a means of funding Medicaid that the governor, Mississippi Hospital Association and Senate prefer - before he proceeds with the new plan.

"If we don't pass it, the governor is gonna dissolve the session, because he doesn't have to have us anymore," said District 92 Rep. Becky Currie, R-Brookhaven. "Then, we'll go home and what the governor has planned will take effect. That's the only choice he has."

Currie said the governor's new proposal is very similar to one of the first such hospital assessment plans proposed early in the regular session. The proposal, even though supposedly less harmful to health care providers than a series of cuts abandoned by the governor last week, is still not a good thing for Mississippi's hospitals, she said.

"No, I don't like it," Currie said. "But before one person loses a job or has their hours decreased, or we have health care services decreased, I'd rather have this plan. This is better than any of the above in that respect."

The new plan is not better than SB 2013, Currie said. She said SB 2013 was originally written as a better alternative than the proposal now being presented by the governor, and believes the House should have passed it along with the Senate.

"Then we wouldn't be in this mess," Currie said. "The House leadership wanted to play politics, and they played it. Now, they've gotten cut off at the knees, and they can either vote to save their hospitals or they can vote against it. They can take their pick."

District 53 Rep. Bobby Moak, D-Bogue Chitto, said the House would be in a race Monday morning to produce a new Medicaid funding plan, most likely a tobacco/assessment hybrid bill, and send it to the Senate quickly. He believes the Senate plans to take up new items expected to be added to the session's agenda and adjourn quickly, leaving the House to make the choice as outline by Currie.

If the Senate beats the House out the door, however, Moak said the House would just follow suit and let the state's hospitals play out their legal options.

"I don't believe there's enough support in the House to pass the bed tax," Moak said. "When the governor finally brings [the new cuts] forward, I think the hospitals will sue him again, and in my opinion they will be successful again."

District 91 Rep. Bob Evans, D-Monticello, believes Moak's predictions are likely. He said the Democrat-led House is unlikely to institute SB 2013 as a last-ditch effort.

"If it's going to be take it or leave it, I cannot imagine it will be anything but a leave it," he said. "I think SB 2013 has been dead in the water for months."

Evans said he suspects the House will use its last-minute opportunity to present another form of tobacco tax, either in conjunction with smaller pieces of SB 2013 or a stand-alone tobacco tax increase. He said an increased tobacco tax of $1 per pack would provide the state with more than twice the $90 million required to locally fund Medicaid. And with economic times like they are, the state cannot afford to "leave that money on the table."

Evans admitted that any tobacco taxes sent to the Senate will probably be turned away as they have been throughout the special session. He said, though, the House would not be to blame if the governor moves forward.

"If he does something unilaterally without the approval of the Legislature, that's his baby," Evans said.

Whatever the House does with its time Monday will have a direct effect on the options available to the Senate, said District 39 Sen. Cindy Hyde-Smith, D-Brookhaven.

"We're just seeing what the House is going to do," she said. "We're just going to have to wait and look at what surfaces."

Amid rumors of adjournment in the Senate and tobacco tax bills in the House, Hyde-Smith said she would not surprised if both chambers were sent home and the issue taken up again in January during the 2009 regular session.


©The Daily Leader 2010

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