There have been quite a few columns and articles in local media promoting Medicaid expansion in Mississippi. Russ Latino published a column opposing said expansion over at the Magnolia Tribune website. Mr. Latino opined:
In every state that has expanded Medicaid, enrollment and costs have been woefully underestimated. A big reason for this miscalculation is that Medicaid expansion ends up covering not just the uninsured, but ends up forcing people off of private health insurance plans onto the welfare program. A study by actuary Milliman in Florida found that a whopping 65 percent of the Sunshine State’s expansion population would come from people who presently have private insurance. The two pockets of privately insured that end up on Medicaid post-expansion are: (1) people who are currently getting individual private plans through the ACA exchange; and (2) people who receive voluntary coverage through small business employers. In non-expansion states like Mississippi, people with incomes between 100-150 percent of federal poverty level are eligible for fully-subsidized private health plans on the ACA exchange. Under the law, eligibility for this benefit is limited to people who do not have other affordable coverage options. In expansion states, however, eligibility for the ACA exchange starts at 138 percent of federal poverty level. Someone earning between 100-138 percent of FPL level with a private exchange plan literally cannot stay on that plan if expansion occurs. Absent some unique waiver from CMS, the state of Mississippi cannot simply override ACA eligibility standards. Take Louisiana as a case study. In 2016, the year it expanded Medicaid, there were an estimated 100,000 Louisianans earning between 100-150 percent of the federal poverty level with private plans on the ACA exchange. Fast forward to 2019, and the number of people in this income range on the ACA exchange has dropped by 80 percent to 20,000. They moved to Medicaid. Louisiana now has the second lowest incidence of private health insurance plans in the nation....
Read the rest of the column over at the Magnolia Tribune.
38 comments:
Grand bargain: Substantial reforms to (or abolish) Certificate of Need in exchange for expansion of eligiblity of medicaid.
If you want to reduce the cost of healthcare services, you must increase supply. CON's restrict supply of healthcare services to what the government (and incumbent providers) think appropriate.
Expanding medicaid maybe is not perfect policy, but it's already been done in 40 other states and is inevitably going to happen in Mississippi.
It's no longer "creeping socialism," it's here now.
"Medicaid expansion" = a vote getting scheme.
9:08 healthcare is not a product - it is a service. The only increased "supply" with expanded Medicaid is the number of people who will be enrolled and showing up expecting healthcare services at no cost to them. You can ditch CON and put a hospital in every town but a hospital must operate as a business or it will close. Even hospitals have to account for salaries, equipment and supplies, and all sorts of other overhead expenses...and at the same time, they must write off millions of dollars they deliver in care that they cannot collect. Because while private pay and insurance pays a provider a dollar for every dollar of service, programs like Medicaid pay maybe half, or sometimes even less for every dollar of care provided. People supporting expanded Medicaid think that sending many more people to hospitals with this money-losing formula will somehow be a good thing. In reality, it only makes it more difficult for any hospital to stay open.
I'm not a health insurance expert but from a cost basis if the goverment is fully subsidizing their private health insurance plan through the marketplace what is the real difference if they then go from Ambetter to Medicaid. The government (taxpayers) are still paying for everything. Is this a true expansion of cost or just a shift to a different program?
This article makes too much sense: shame the lawmakers will not consider it.
Many specialist physicians do not accept Medicaid because its reimbursement rate sucks. Medicaid taking a bigger share of medical services can mean fewer specialists, hence a reduction of quality of care.
MS should pass a Parental Choice law that will greatly improve the quality of schools, thereby enabling better incomes to afford better healthcare without Medicaid expansion.
is healthcare a right or a commodity to purchase?
Lease we forget Missippi is already getting much more than paid in for the federal taxes paid. If Medicare expands nobody in the state is paying a .000000001 fraction of the $ the federal government picks up. I assume no one wants to hear about the cost/ benefit ratio as it relates to the states contribution . Yet the state freely gives tax incentive packages to business with math that is questionable on the front end. How many people are working in a Data Center across the country?
Heaven forbid that Mississippi actually do something to help the working poor. The article in this post is nothing more than propaganda-filled lies. It is nothing less than hateful. I guess the author didn't think about people just quitting work altogether so they can qualify for Medicaid as opposed to keeping a low-paying job with no benefits. Moron!
Agreed! Medicaid broke eldercare so it left the elderly no choice but to sign up and that did nothing but cause the care to decline due to the heavy burden of the crazy regulations. The more u expand a broken system, the worse the outcome. Leaders are working on the next system to reform - healthcare. No matter the political party, they all want to own it and control it.
10:57am
Rights are as specified in the Constitution: if one pays an insurance premium, he is entitled to what he paid for. Nevertheless, doctors and hospitals are often willing to negotiate payments, even reduced payments.
BTW, NHS, the British mandatory socialist medical system, provides healthcare if one is willing to wait months to get a procedure. In some cases, patients are lined up in hallways, laying on gurneys, waiting for their turn after first waiting at home for months.
Vast majority of Doctors are very deserving of their elevated pay and status, I am happy to sacrifice to qualify for their lifesaving services which are a bought privilege, not a right.
If someone gets sick and goes to the ER, the ER must treat them regardless of whether they can pay. The hospital gets $0.
However, if this person is covered by medicaid, the hospital's loss is much much less as they will be paid something for the treatment.
Further, if this person is covered by medicaid, they may have further options to get treatment prior to an emergency, which overall should cost less and help the patient stay healthy.
Insurance through the Affordable Care Act is a joke. It is hard to find a provider that accepts it. Also reimbursement is very low. Medicaid would be a better option!
Imagine if the government forced the housing or auto industry to operate under the rules they put on hospitals.
Anyone who contacts a realtor/seller is given a house regardless of their ability to pay for it. Anyone who shows up at a car dealer gets to own a vehicle, whether they have money or not.
Now imagine if the government offered programs allowing realtors/home sellers and auto dealers to get reimbursed. Ah, but the guvment dictates that realtors and car dealers can only get back a fraction of the money they have lost.
Then imagine a movement to expand this so that a lot more people qualify to go get themselves a free car and a free house.
That's how our healthcare system works for hospitals, and that's what would happen if you expand Medicaid.
Geez, I wonder why all the other red states are embracing expansion that initially refused for political purpose? Did all those GOP states sell out to the commies and socialists? Or did they just learn math?
So what’s the Magnolia Tribune? Is this a legitimate news source and who is it owned by?
How about everyone pay for their own shit like in the old days....
Latino is nothing more than a political hack.
@2:21 PM. Well, lets take a look at one of the first states to sign up. Indiana.
Indiana was one of the first states to expand Medicaid following the passage of Obamacare. It now faces a billion dollar shortfall in the program and is slashing benefits to disabled families.
A lot of states had included previously-approved Section 1115 work requirements that have since been withdrawn by CMS under the Biden Administration.
Some of the Ms legislators are touting the work requirement. Its already been shot down so that's no good.
2:21 learn about payor mix, not math. If you live in a state where there is a favorable payor mix, you can integrate a certain level of uncompensated care into your system (but even then you will make your financial situation worse). But if you live in a relatively rural, or low-income region, especially an area like the Delta, expanding Medicaid won't do a thing but close down what few hospitals are left. With few private pay or insurance patients, almost all in these areas rely on some Government program that the hospital loses money on. Tell me, would you trade me a $20 bill if I gave you a $5 bill in return, even trade? Of course not. Mississippi has been at the very edge of its limit (and even past it) for years now. There's nowhere else to go for many Mississippi hospitals except broke.
11:49. thank you for the accurate answer to my question of right vs commodity. health care is a business from which we are free to choose to purchase services. it’s not a right.
it’s not the government’s responsibility to pay for anyone’s long term medical care, cancer treatment, heart surgeries or even cold medicines. it’s yours! and you are free to either pay for the service or not.
our nation is in debt up to its eyeballs because we think we are being heartless when the government doesn’t step in to save people from their own bad choices, or lack of want to work.
3:56, Just to clarify for the uninformed and uneducated, Payor Mix = Working taxpayers pay for everyone else who get their shit for free from the gubmint
All kidding aside, it seems pretty simple to me: Medicaid is a government program. Do any of you know of ANY government program that has made its intended purpose BETTER?
I didn't think so.
If Medicaid expansion is for the purpose of allowing the 'working poor', who can't afford insurance, to HAVE insurance....how is it that 65% of the cases to which Latino refers (Florida) were those who had private insurance?
So, is it a lie that expansion in Mississippi would throw a life jacket to parents with low wage jobs who can't buy insurance...When they have insurance all along?
I've always trusted Latino equally as much as I trust Delbert.
Why not just put everybody on Medicaid, call it something else, force hospitals (doctors) to provide slow, lazy service and accept whatever the government reimburses and move along?
No reason they can't re-use needles, syringes, blood bags, bedpans, pillow cases, ace bandages, plastic cups and sponges.
12:03 PM, I used to think what you posted is true. I thought a hospital had to treat anyone who arrived at their emergence room. When I worked at a hospital in Jackson I found out that is not true. The hospital where I worked would sometimes not allow the ambulance to bring a patient to them. In one case a man died when they told the driver to take him to another hospital because they would not treat him.
I am a pretty conservative person but I think Medicaid should be expanded. I was involved in the health insurance business for 50 years so I have some understanding of the issue. It would be great if all employers offered affordable health coverage to their employees but not so. It’s not going to happen but our country could afford to lower taxes, provide needed services, etc, if we didn’t sent billions of dollars to the rest of the world. My time left is possibly just over single digits but I pray the leadership of our state and country becomes more responsible to its citizens.
@8:26 - if the hospital is a public hospital, by law it's emergency room has to treat anyone who shows up at the door; if it is a private hospital, this is not the case.
10:50 that is incorrect. That law is called the Emergency Medical Treatment and Labor Act and it applies to ALL hospital emergency rooms - both public and private.
One victim of the refusal to expand Medicaid is the special-needs population of the state. It's embarrassing how many more resources neighboring states that expanded Medicaid have for adults with autism or other issues.
As usual, the GOP is tap-dancing on the backs of the most vulnerable. They had best be wrong about the existence of an afterlife.
8:44, adults w real ‘special needs’ already have Medicaid bc they are disabled and qualify for Medicaid through a multitude of programs that give them eligibility.
Are you suggesting that one’s salvation is dependent on one’s opinions on Medicaid expansion? I missed that lesson in Sunday School.
I missed that Sunday School lesson too.
@4:20 Health care is most certainly a right. I cannot imagine the depravity of human beings who do not want the working poor of Mississippi to have access to health care.
In order to qualify for Medicaid IN MISSISSIPPI, you must be low income AND have a child or be handicapped. Childless low-income workers are SOL. Is the writer trying to make us believe that an employer out of the kindness of his heart paid the premiums of those ACA clients and now the tax payer does? What difference does it make if the poor person gets health care via ACA or Medicaid???? The tax payer is paying for the coverage either way.
9:28 that's true, but the government is already up to its eyeballs in record debt. The money it spends is borrowed to the limit, and more money is borrowed when it raised the limit...again and again. Government programs, including Medicaid, already put a tremendous strain on the public budget. And now folks are wanting to expand the number of people who can qualify for Medicaid. Meanwhile, the number of taxpaying entities (businesses and individual taxpayers) is shrinking. How is this going to end well?
I’m looking forward to the day when everyone has Medicaid, nobody works or pays taxes. We are close.
"Health care is most certainly a right."
February 28, 2024 at 8:26 PM
"Most Certainly"? How can you back that up? The Bible? The Constitution? Executive Order? Supreme Court Ruling?
Why not just say, "In my opinion...", or "It would be nice if...".
Why should I have to pay for others health care? No one pays my health care. I’m not going to sugar coated but it’s not my problem. The poor need to help themselves and not expect me to pay for there free stuff.
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