Friday, May 3, 2019

Wyatt Emmerich: Expand Medicaid

Northside Sun publisher Wyatt Emmerich recently pushed for the expansion of Medicaid in Mississippi in an editorial:

With state Elections coming up, one of the hottest issues is expansion of Medicaid....

As a result, Mississippi has passed up about 10 billion dollars in federal money over the past decade.

This federal money would have given up to 300,000 working, low income Mississippi families health care coverage....

I believe turning down this money is hurting our state. I’m conservative, but if the feds want to pour money into our state, so be it.

Mississippi is a poor state for two main reasons: We lack a major urban area and we are still suffering from the vestiges of slavery, including the devastation of the Civil War.

As a result, our state has traditionally been a big beneficiary of federal dollars, getting two and three dollars back from every dollar we pay in federal taxes. It’s a good deal.

When the Democrats were in power, we took every advantage of federal largesse. But since the Republicans took over, we turn up our noses at this money, because Republicans don’t like welfare, even when it is beneficial to our state.

This could be one reason our state quit growing for the first time in 50 years. States that haven’t expanded Medicaid have much lower levels of job growth.

In rural areas, hospitals that were once the biggest employers in their communities are now going bankrupt and closing. Experts have identified the cause: Failure to expand Medicaid.

The Brookings Institute, one of the largest and oldest think tanks in the country, recently did a report titled “Do States Regret Expanding Medicaid?” Their conclusion: No.

The study found that states did not encounter increased costs. Instead, Medicaid expansion caused the feds to pay for many services formerly paid for by the states. The study concludes: “The strong balance of objective evidence indicates that actual costs to states so far from expanding Medicaid are negligible or minor, and that states across the political spectrum do not regret their decisions to expand Medicaid.”

Meanwhile in Mississippi, the portion of Medicaid that Mississippi has to pay has skyrocketed from $258 million in 2010 (when Medicaid was expanded) to $840 million in the 2019 budget.

So by refusing to expand Medicaid not only has Mississippi turned down a billion dollars a year in federal manna, but our in-state cost has increased by $582 million a year...

Meanwhile, the current Republican leadership falls all over themselves to hand out billions in tax breaks to huge corporations with billions in net income, not to mention the hundreds of millions that went down the drain subsidizing cockamamie start-up companies now bankrupt.

So billions in public welfare for rich corporations is just fine but federally-subsidized health care for the working poor is socialism?.... Rest of column.
Will it be an issue in the elections? 


Anonymous said...

It was my understanding that the expansion dollars was "seed" revenue that would phase out starting at some point in the future, leaving states to either pick up the dole or cut the roles back down to pre-obama levels at some point in the future. MS couldn't survive without reducing the roles, which would be hard to do.

Anonymous said...

And in today's WSJ:

Anonymous said...

Why would state populations increase due to medicaid expansion ? Who are the people who move in and where do they come from ?

Anonymous said...

Medicaid expansion via Obamacare has always been a time delayed bomb to trap red-state politicians into either cutting rolls or increasing taxes.

Anonymous said...

You lost me at Wyatt Emmerich.

Anonymous said...

It's not cost of Medicare that we should be looking at. It's the cost of not expanding it.

Anonymous said...

This Northside Sun editorial simply contains a ton of false conclusions. Medicaid expansion is only offered to people who fall in a gap between qualifying for Medicaid under current rules, roughly 100% of the federal poverty rate, and 138% of the federal poverty rate, where they would qualify for Obamacare subsidies. The govt was going to pick up 100% of the costs from 2014-2017 and 90% after that. The match from the feds on regular Medicaid is about 65%. MS picks up the other 35%, which the editorial says has risen from $258 million to $840 million. Those figures are completely unaffected by a Medicaid expansion; people who are in the old program stay in the old program. Only people between the 100% and 138% are in the "expansion", and if the $10 billion of "lost dollars" figure is correct, Mississippi would have had to come up with 10% of that number, or 1 billion dollars over the last 5 years, or 200 million more per year on top of the $840 million we are already out. Plus, once someone falls out of the "working poverty gap" between 100% and 138% (example, they become unemployed), then they go into the old system and the state picks up 35% of the future costs.

Obama knew this was a time bomb waiting to explode, the previously mentioned WSJ article about Rhode Island is accurate. That is why he proposed in his budgets for FY 2016-FY2018 that the Medicaid expansion be reimbursed at a "blended" rate, something between the 65% old program and 90% expanded program> He knew it couldn't be sustained. Congress knows it also.

Our state cannot even find 52 billion to fund the teacher pay raises they have just passed. I don't know where they would find the 200 billion minimum in extra payments for Medicaid on top of the $840 billion dollar commitment they already have.

All of this "free" stuff will have to be paid for eventually. Either taxes will have to go up dramatically, or so much money will be printed that the inflation we saw in the 70's will seem benign to what we will experience in the future.

Anonymous said...

What has the world come to when Republicans are arguing for more welfare? Is there no refuge for fiscal conservatives and people who don't like to steal from their fellow citizens?

Anonymous said...

It's the cost of not expanding it.

Nice sound bite Clara.

Anonymous said...

Expanding Medicaid, as Wyatt proposes, ignores the long term cost to the state while covering it up with the supposed short term benefits. Along with the claim that the expanded Medicaid is needed to "save" our rural hospitals ignores the real problem that they are facing, which isn't touched by the increased business that an expanded Medicaid might provide.

Rural hospitals face financial difficulties because the accounting rules 'change' that has made it virtually impossible for them to obtain long term financing, among other things. Most rural hospitals survive today only as a funnel to a larger facility down the road where specialty care is available. Medicaid expansion isn't going to change any of that.

(And, of course, there is the now additional cost of the hospital's PERS contributions which are driving their financial peril, just as it will do to local school districts and small towns.)

Anonymous said...

Medicaid expansion is absolutely a good idea for Mississippi. We have already missed out on billions of dollars of federal support for the program. That billions of dollars would have gone to prop up hospitals and that especially includes our rural hospitals, many of which are closing.

Would Medicaid expansion improve the health or outcomes of the recipients? Marginally if at all. The studies done in Oregon have shown that it does not improve health outcomes.

But the commenters (above) fail to realize is that (without Medicaid expansion), the majority of babies born in Mississippi (now) are on Medicaid.

What Medicaid expansion would do is support many hospitals, especially rural ones, that face bankruptcy without it. And ditto the Medicaid recipients: Medicaid expansion prevents the recipients from declaring bankruptcy.

Anonymous said...

But it would be with those "free" Federal dollars !

Anonymous said...

It's obvious that Emmerich has no clue about long term costs to the state.

While I admire the man for what he's done with the little "Northside Sun",
. . . it ain't a really strong outlet for "in depth" news.

Wyatt should stick with what he's good at . . . taking photos of who was at the latest Jackson Country Club social events and such.

I'll give him credit, he managed to have the North Side Sun placed in every medical waiting room in north of Capitol Street.

Anonymous said...

I am 100% for Medicaid expansion and 100% for Medicare For All which will take place in the next 3 to 4 years. I would rather see my tax dollars go to help the poor and elderly than have them pay for the lifestyles of the corrupt good old boy system we have in this state.

Anonymous said...

Simple solution: bus tickets for everyone who wants to move somewhere where it's easier to get on Medicaid. Everyone wins!

Anonymous said...

This is sad. How is it that people choose to believe that a state which is among the unhealthiest and poorest would not benefit for money that would help it not be the unhealthiest and poorest? Those people who would have been covered under any Medicaid expansion didn't simply go away. They still have healthcare costs. Who do you all think pays for those costs currently? Insurance itself is a form of socialism. Corporate welfare is nothing more than government redistributing money to assist corporations. Based on the article discussing Mississippi's lagging "GDP" above and our dwindling population we could definitely use the jobs, tax dollars, and income.

Anonymous said...

How many rural community hospitals in the state have close due to a lack of expansion?

Anonymous said...

to 1:17... you post reads like a combination of calculus, easter philosophy and chinese checkers.

Anonymous said...

1:17 pnm - you lost me at $52 billion to fund the recent Mississipp teacher pay raise. Are you a spoof poster?

Anonymous said...

To refuse Medicaid expansion, Phil Bryant had to be smarter than the leaders of 47 other states. Not likely. His racially motivated decision has cost MS billions of dollars and quality health care to scores of poor people.

Anonymous said...

Remember when Bill Clinton provided federal funds for states and municipalities to 'hire' a hundred thousand law enforcement officer? That, too, was simply attractive 'seed money' which was phased out after two years. Any who remained employed had to be 'funded' by the host agency.

Anonymous said...

Northside Sun is the only paper covering Madison County with any depth. Prince constantly moans that he and his lieutenant are stretched too thin to cover the news...yet he, in his brilliance, won't pony up and hire any staff.

Rod Knox said...

Damn the actual costs, Mississippians are determined to do anything to spite "those people" and starve them into submission or starve them out of the state. We are such a grand, Christian bunch here in Mississippi dontchaknow.

Anonymous said...

8:56 PM Most hospitals outside of the large urban areas will be closing.

Anonymous said...

Then we have folks like Rod Knocker and Bernie Sanders and assorted anonymous posters who are all for increasing free this and free that but not a word about how it will be funded. Not one word.

Oh, wait! California 'expanded' coverage four years ago and they've got funding under contro.....Wait!

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