Wednesday, May 1, 2013

Cecil Brown touts Medicaid expansion

Representative Cecil Brown (D-parts unknown) submitted the following column to JJ supporting expansion of the Medicaid program.

May 1, 2013

The Mississippi Legislature recently voted to give $70 million to a Japanese company to build a tire manufacturing company in Clay County. The company projects 500 new jobs at the plant and a company investment of $300 million. Long-term plans call for a total state investment of $130 million, a company investment of $1.2 billion and a total of 2,000 new jobs. The University Research Center of Mississippi estimates the state will recover its investment within 9-10 years through increased economic activity. The state Senate adopted the legislation unanimously. In the House there were two “no” votes, both from Republicans.

The math is pretty simple. In the short run, the state will spend $70 million to create 500 jobs, a cost of $140,000 per job. Over time, the state will spend $130 million for 2,000 jobs, $65,000 per job. Not cheap, but in line with similar projects. This project is the latest in a long line of “economic development” projects that the state has helped fund with taxpayer dollars. Other states do the same.
Now comes an even larger economic development project at a much lower cost to the state – the expansion of the state Medicaid program. Here’s how it works. Mississippi will agree to add about 300,000 working Mississippians who currently have no health insurance to its Medicaid program. In exchange, the federal government will pay 100% of the medical costs of the expansion for the first 3 years. After that, the federal reimbursement rate will slowly decrease to 90% where it will remain. According to the same Mississippi economists who vetted the Clay County project, over the next 10 years Mississippi will receive new federal monies of nearly $10 billion at a net cost to the state of $368 million. The economists also project the creation of nearly 9,000 new jobs. These numbers alone argue for expansion.

But there is more. Under the new Affordable Care Act, companies with more than 50 employees must provide health insurance to their employees or pay penalties of $2,000 to $3,000 per employee. Employees covered by Medicaid are not subject to the penalty. Jackson Hewitt, a respected nationwide tax preparation service, estimates that if Mississippi does not expand Medicaid, Mississippi employers could be subject to penalties ranging from $21.7 million to $32.6 million. Another argument for expansion.

If that is not enough, failure to expand Medicaid will have a devastating impact on Mississippi hospitals. Beginning in October of this year, Mississippi’s hospitals, including the University Medical Center, will lose up to $200 million per year in federal health care dollars they use to pay for health care for folks who are uninsured. Medicaid expansion will replace most, if not all, these dollars. If we reject the expansion, UMC will lose $100 million, and the state’s other hospitals will share in the loss of the other $100 million. The loss of these dollars will result in the loss of hundreds of health care jobs across the state, and, perhaps, the closure of local hospitals.

The math is pretty simple.
1)Reject Medicaid expansion and subject small employers to substantial penalties, forego 9,000 new jobs , face the closure of local hospitals and the resulting loss of hundreds of jobs and reject $10 billion of new federal funds over the next 10 years, or
2)Expand Medicaid, provide 300,000 working Mississippians with health insurance, and create 9,000 new jobs all across our state at a fraction of the cost per job that the Legislature just spent in the single county of Clay.

You don’t have to be an economist or a mathematician to figure this one out.

Cecil Brown, CPA/PFS
Mississippi House of Representatives
Jackson, MS
601-362-8383 (h)
601-573-8777 (c)

31 comments:

Darryl Hamilton said...

Rep. Brown states that "...Mississippi will agree to add about 300,000 working Mississippians who currently have no health insurance..." How many non-working Mississippians will be added to the program? How does subjecting small businesses with >50 employees to penalties encourage growth and entrepreneurship? Because, Rep. Brown, rest assured that the insurance purchased independently or through the exchange as a collective is going to be extravagantly priced. Whatever profits they generate are going to be wholly shit-canned.

And if he thinks the math is simple on this, he should turn in his CPA/PFS designation.

Anonymous said...

The economists also project the creation of nearly 9,000 new jobs. These numbers alone argue for expansion.

Show us the jobs from CHIPs Brown.

You conveniently fail to mention that the Yokohama deal has contractual “clawbacks” of $35,000 per job should they fail to provide in each of the four 500-job phases.

Will you and your fellow Donkeys agree to penalties for your failures? Of course not. LOSER.

Anonymous said...

This expansion is far too logical. Seriously, how could thinking people reject this? If you know Cecil Brown, you know that he is the brighest bulb in the legislature. He will be sorely missed after he completes this term.

KaptKangaroo said...

Cecil,

Seriously,

9,000 new jobs = 9,000 new bureaucrats?

Anonymous said...

Since news cycles are tight in Donner Harpy's world right now with her election apoplexy (and raging hatred for Kingfish) Representative Brown must have meant for his column to be read by the low information types who regularly stray, er, read here from the JFP.

The Obamatollah promised the country that his plan to redistribute wealth through the guise of socialized healthcare would cost the country $938 billion over the first decade. But the CBO's Feb 2013 estimate now pegs the first decade price tag at more than double or $1.88 trillion dollars.

Representative Brown can't defend any of his Medicaid numbers.

Kingfish said...

Be nice. Mr. Brown was nice enough to submit his column to JJ so I expect the same courtesy in return.

Anonymous said...

Which other media outlet has carried the column KF?

Anonymous said...

Mr. Brown, the money that we would get from the expansion is National Debt money. We will all be paying for it in federal taxes.

Anonymous said...

I have a good memory. This isn't the first time Kingfish has admonished his readers to be kind to Cecil Brown and watch your mouth. As if Brown did us all a favor by passing his column on to Jambalaya. Everything he does has a personal motive. Don't doubt it.

In the alternative, Kingfish could always run Brown's stuff as a 'paid advertisement', leaving no room for comment or exposure.

KaptKangaroo said...

My point was serious, not contentious. Mr. Brown has been good enough to present his ideas here to those who have genuine questions. He normally responds.

My point is the fuzzy math, do it and lose 9,000 jobs; don't do it and gain 9,000 jobs. That is an 18,000 job swing.

Anonymous said...

You 'job swing' is an elusive concept, a theory, meaningless. Like an average.

But, seriously (and non-contentious), whether Mr. Brown responds on here to the common man is of little importance. He can seclude himself and draw speculation or he can respond here and reveal his colors. There is really nothing at all magical or special aboout Cecil Brown and I don't know why you two think there is.

Anonymous said...

I can't cry for UMMC and their potential loss of Federal dollars. I can't use UMMC since my company's healthcare insurance is not in-network. My insurer is CIGNA, one of the largest insurers in the U.S. UMMC must prefer uninsured clientele, Medicaid patients and/or undocumented aliens over those of us with CIGNA insurance

Mississippi Cheeseburger Trustees said...

A randomized-controlled study published this week in the New England Journal of Medicine by a group of nation's top health policy scholars has found that Medicaid has no measurable effect on any of the objectively measured physical health outcomes the study examined.

Though it is likely too complicated for Cecil Brown, Brandon Jones and Bobby Moak (D-Annandale) to understand.

KaptKangaroo said...

May 2, 2013 at 4:02 AM

Your comment clearly demonstrates your continued need to start your own blog replete with those public figures in life you find most relevant - perhaps you can do an exclusive expose' on the Easter Bunny or Tooth Fairy.

Anonymous said...

Cheeseburger, you must not have read the study you cite or else didn't understand it or have a hidden agenda.

The study you cite was a two year study of Oregon's expanded health care.

While there was no improvement in certain health measures like reducing blood pressure or blood sugar levels, there was an improvement in preventive care and a reduction in depression. There was also a positive financial impact on the poor/working poor ( which we have many in MS).

Those conducting the study were indeed brilliant and pointed to the long benefit of preventive care ( increased mammograms , for example) in reducing costs with early diagnosis and treatment.

They also pointed out that treatments to preserve health in the form of medications had increased.

You should actually read a study rather than have someone else tell you what is says unless your reading comprehension is poor. Then get someone who doesn't have a agenda to explain it to you.

Which are you, Cheeseburger...intellectually lazy, unable to comprehend what you read or do you have another motive?

Anonymous said...

The issue is not whether Medicaid expansion will benefit Mississippi and a failure to expand will be disadvantage Mississippi.

Our state is heavily dependent on federal aid and we benefit in the private sector from that aid.

Conversely, if that aid is decreased, we will feel it in the private sector. In this case, it will be in the medical industry.

And, one can argue some businesses will have increased costs and therefore reduced profit.

You can argue that we should sacrifice our state's best interest to reduce federal spending. That is a legitimate argument.

Then we might have a rational debate about what types of federal spending, if any, will have a long term benefit that warrants the short term spending.

We could debate whether or not the reduced profits for some will be mitigated in the long term by increased worker productivity and long term reduction of health care costs.

But, attacking Mr. Brown personally , when his figures are accurate and inaccurately citing The New England Journal study is ,at best, counterproductive and politics at its worst.

Being an informed citizen is an individual responsibility and to some of us, a patriotic duty.

By the way, do you know the number one leading cause of death in children in the U.S. these days? It's cancer ( source CDC). The incidence of autism continues to increase.

Do we really want to limit our discussion to dollar figures? Or might not the declining health care statistics in every category compared to other industrialized nations be more important to our discussion of healthcare?

There is more than a little evidence out there that education and superior health care once played more than a small role in our prosperity as a Nation.

Take off your political blinders and start thinking of our Nation FIRST!



Anonymous said...

Don't get bent, Captn. We all have an opinion. Nothing special about yours except you always get a pass from the moderator for your stupidity. You don't have any more of a corner on lucidity or valid concepts than the next guy. It's really all in your mind. Cecil has no more grasp of educational needs and issues in this state than Ben Allen has on the realities of downtown Jackburg.

Anonymous said...

But, attacking Mr. Brown personally , when his figures are accurate ...

Do you have proof of his accuracy? The job creation numbers he cites are only a projection. How many actual jobs were created by CHIPs?

You can't defend his accuracy nor your own self-delusions of being an informed citizen.

Anonymous said...

7:40 am, pray tell share with us your educational and professional background since you purport to be so much better informed and intellectually superior to Allen and Brown.

While I don't agree with either man on everything, it seems to me they 1) have a basis upon which they make their arguments rather than name call and 2) are in the arena rather than throwing spitballs on a blog 3) have good educational credentials and 4) actually have been successful.

So , what gives you the chutzpah to think YOU know more about any issue and your judgement is more sound?

Prove them wrong on facts. Personal attacks are for those with the intellectual and emotional maturity of a toddler!

Anonymous said...


May 2, 2013 at 7:36 AM = YAWN, SNNOOORRRREEEEE

Anonymous said...

8:25; Correct me if you find me wrong, but, I don't see anyone (even 7:40) claiming knowledge superior to that of Brown or Allen. What has been pointed out, for those of us who can read, is that neither of those guys has knowledge or theories that are (or have proven to be) superior to those of others. Being on a legislative committee simply equals being on a committee. Brown can't defend his numbers and Allen can't defend his vision. Both exist (read: muddle around) in a world of speculation and projections.

KaptKangaroo said...

I get moderated just as much as anyone else, I just don't whine about it.

Kingfish said...

All right, you clowns have had your fun taking shots at each other. Argue the merits and facts of the column back and forth. The sniping at each other. Stop.

And if you're mad because I won't allow you to start insulting Mr. Brown, sorry. My policy has always been to give public officials who submit columns to this website a certain amount of respect. No one gets censored for viewpoint. However, Just getting on here and calling the author names is going to get zapped. Don't like it? Not my problem. Parham Bridges park playground is open right now if you want to go act like a 12 year old.

Anonymous said...

If the debate of facts is your goal you might want to fact check Mr. Brown's columns in advance of publication because the only facts he's presented are those regarding the Yokohama deal.

Anonymous said...

Read this much of the New England Journal paper yourselved:

"Results
We found no significant effect of Medicaid coverage on the prevalence or diagnosis of hypertension or high cholesterol levels or on the use of medication for these conditions. Medicaid coverage significantly increased the probability of a diagnosis of diabetes and the use of diabetes medication, but we observed no significant effect on average glycated hemoglobin levels or on the percentage of participants with levels of 6.5% or higher. Medicaid coverage decreased the probability of a positive screening for depression (−9.15 percentage points; 95% confidence interval, −16.70 to −1.60; P=0.02), increased the use of many preventive services, and nearly eliminated catastrophic out-of-pocket medical expenditures.

Full Text of Results...

Conclusions
This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain."

That doesn't sound like a resounding success to me, but that is why these things are debated by legislators before throwing tax money at them.

Anonymous said...

2:35 pm that is not different from what I wrote.

What is it about lower rates of depression, diabetes detection and management and reduced financial strain" that you don't understand?

The first sentence debunked the fears that the expansion would result in an increase in prescription medical costs for treatment of hypertension and cholesterol. The second sentence debunked the notion that all these poor folks would be diabetics.

What is it about "increased use of preventive services" and " nearly eliminating catastrophic out of pocket medical expenses" sounds negative to you?!

What results did you expect for preventive care in TWO years?

What , pray tell, did you expect in terms of results? Do you have any concept of what the typical person picked up in expansion would be like in terms of health and income? They , by and large, are the relatively healthy working poor.



Anonymous said...

"The first sentence debunked the fears that the expansion would result in an increase in prescription medical costs for treatment of hypertension and cholesterol. " [i.e., "We found no significant effect of Medicaid coverage on the prevalence or diagnosis of hypertension or high cholesterol levels or on the use of medication for these conditions."]

In other words, every new person who was enrolled when the program was extended, and was hypertensive or had elevated cholesterol, already knew they had hypertension or hyperlipidemia, and was already being adequately treated for it.

So where is the additional benefit that justifies the cost?

This is reminiscent of health fairs and drug store screenings for blood pressure and cholesterol. The results seen almost universally are that people checking their blood pressure or cholesterol already know they have a problem, and are checking how well it is controlled. Very few new, untreated participants get tested and find something unexpected.

Anonymous said...

10:26 pm
However did you come up with THAT interpretation?

They didn't find new costs for drug prescriptions associated with new people included in the expansion as the fear mongers predicted.

The fear mongers assumed massive findings of hypertension and diabetes in the working poor or that doctors would prescribe just to prescribe.

If you go to the doctor, what is the first thing that happens? You are weighed,your temperature is taken and a nurse checks your blood pressure.

So, yes, the rational always understood that the fears were unjustified as being overweight and diabetes are related and blood pressure is checked when you show up for any problem.

The " few" for whom something unexpected is found get treatment that will reduce the chance of a catastrophic event like a stroke that ends up costing the rest of us a fortune as we pay in our health care costs for those receiving uninsured emergency treatment and hospital care.

What is it about the fact that the insured were covering the hospital costs of the uninsured that you can't understand?

Why can't you understand that finding one person with high blood pressure and treating them will save you money when it prevents an early stroke or heart attack?

Have you not understood that those who work for large corporations with large coverage pools pay less for health insurance and have more benefits for their money than a single payer?

Don't you understand how insurance works? Those who don't need it pay for those who do for the security of knowing IF they need coverage they won't be financially decimated.

A healthy, young minimum wage worker who is not covered by employment would have to pay $360 a month for $1000 deductible insurance in Mississippi. Try making that possible. But, pool all those people and the costs go down.

Obamacare is trying to change Medicaid to insurance pools. What about that did you miss?




Anonymous said...

So the last 1/2 of May 3, 2013 at 6:28 AM is not an attack nor sniping KF?

Anonymous said...

Meanwhile, the 65 year old needing L4-5 surgery can't find a surgeon who accepts new medicare patients.

Shutterbug said...

Kingfish is being kind to The Frown, in hopes The Frown will buy him a new Canon camera. He's busted after the trip abroad.



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