Bryant: Medicaid special session starts Thursday

Emily Wagster Pettus
JACKSON, Miss. (AP) — Mississippi Gov. Phil Bryant is calling lawmakers into special session at 10 a.m. Thursday and asking them to do in less than four days what they didn’t do in three months. He wants them to adopt a Medicaid budget and keep the program alive once the new fiscal year begins July 1 — all without adding people to the plan.

Health coverage for more than 1 in 5 Mississippi residents is at stake.

During the three-month regular session that ended in early April, lawmakers didn’t fund or reauthorize Medicaid because of a partisan dispute over whether to expand the program as allowed under the federal health care law signed by President Barack Obama.

“It is unfortunate that Mississippi taxpayers must bear the expense of a special session because some lawmakers chose to make a political point during the regular session instead of acting responsibly to conduct state business at the appropriate time,”Republican Bryant said in a news release Monday. “I urge the Legislature to act immediately upon convening to authorize and fund the Division of Medicaid. Taxpayers should not have to pay for days of political showmanship, and Medicaid beneficiaries deserve to be freed from the uncertainty that has been thrust upon them.”

Bryant is taking steps to block lawmakers from trying to expand Medicaid. Only a governor can call a special session, and he sets the agenda. Bryant is limiting the sections of law that may be considered, and this stops Democrats from trying to redefine who can be covered by the federal-state health insurance program for the needy, aged, blind or disabled and for low-income families with children.

However, it’s not clear whether Bryant’s narrowly focused proposal will keep Medicaid on good financial footing because he’s not asking legislators to extend a hospital tax that helps pay for the program in its current form.

Under the 2010 federal health overhaul, states have the option to expand Medicaid coverage to people earning up to 138 percent of the federal poverty level, or about $15,000 a year. The cutoff in Mississippi now is about $5,500 a year, but Medicaid still does not cover many able-bodied adults at or below that income level.

Mississippi is one of the poorest states in the nation, and more than 644,000 of its nearly 3 million residents are already enrolled in Medicaid. Expansion could add an estimated 300,000 people.

Democrats, who are in the minority in the state House and Senate, have been pushing to expand Medicaid or to allow low-income working Mississippians to use federal subsidies to buy insurance on the private market. Republican leaders say they don’t want to increase people’s dependence on government.

Linda Rigsby, health director for the liberal-leaning Mississippi Center for Justice, criticized Bryant. “With his decision to leave debate over Medicaid expansion out of this special session, Gov. Bryant decided against the clear, no-brainer choice for Mississippi,” Rigsby said in a news release Monday. “The 300,000 Mississippians who would be eligible need access to quality, affordable health care to lead productive lives. Without it, they will continue to suffer from preventable illnesses and resort to costly emergency room visits that drain taxpayer dollars.”

Republican Lt. Gov. Tate Reeves said in his own statement that he had spoken with Bryant and House Speaker Philip Gunn, R-Clinton, and all agreed the House would be the first to consider Medicaid reauthorization.

“I support extending the agency for one year to study ways to reform the program, improve care and find efficiencies to save money,” Reeves said. “Earlier this year, the Senate reauthorized and funded Medicaid without expansion in a bipartisan vote. Unfortunately, the bill died in the House. I stand ready to pass similar bills in the special session.”

The governor appoints the Medicaid director, and Bryant had said in recent weeks that he believes he could run Medicaid by executive order if lawmakers fail to reauthorize the program. However, Attorney General Jim Hood, a Democrat, issued a nonbinding legal opinion last week saying the governor would not have the power to do that.

Without the hospital tax, it’s unclear how the state will come up with enough money to fund Medicaid. Passing a tax bill takes a 60 percent majority in both chambers. That would be at least 74 votes in the 122-member House and at least 32 votes in the 52-member Senate. In the normal course of events, the tax provisions would be part of a bill to reauthorize Medicaid. Without the tax provisions, it would take only a simple majority in each chamber to keep the program alive.

A budget bill, which delineates how money would be spent, would be handled separately. Adopting a budget requires simple majority of elected members. That’s 62 votes in the House and 27 in the Senate.

The 2010 federal law says that if Medicaid is expanded, the federal government would pay 100 percent of medical expenses for the newly qualified enrollees from 2014 to 2017. The federal share would be reduced to 90 percent by 2020, with each state paying the balance. Bryant and other Republicans say they don’t trust the federal government to fulfill its funding promises and they don’t want state government to be left with large obligations it can’t afford.