Mississippi’s vast Medicaid-eligible population makes it among the costliest items in the overall state budget, but even though its bill to the state is projected to exceed $1 billion for the first time this year, nearly 74 percent of its total $4 billion-plus program is paid by the federal government.

Elected officials in both parties often lament the escalating costs of Medicaid, but it pays the bills for nearly 786,000 Mississippians, including eligible children in the Children’s Health Insurance Program.

As the Journal’s own Bobby Harrison reported, Medicaid is a “state-federal health care program. In Mississippi, the program covers primarily the disabled, certain segments of the elderly, poor pregnant women and poor children. Despite the rising costs of the program, the Mississippi Medicaid program is more restrictive in terms of  the income levels covered than programs in many other states. For instance, segments of the working poor who are covered in other states are not covered in Mississippi.”

Mississippi gets the best federal match because we are the poorest state by Medicaid calculations.

It’s expected that the Mississippi Division of Medicaid will request $71 million in deficit appropriation for the current budget year in the 2016 legislative session. It is virtually unthinkable that Mississippi would refuse any of its Medicaid share because of the consequences to client/patients and to the state’s economy. A 2013 analysis showed that Medicaid helped create more than 136,000 jobs in Mississippi, including 900 directly employed in administration of the program.

Rep. Steve Holland, D-Plantersville, said in Harrison’s reporting the focus should not be on how much Medicaid costs the state, but how much it saves the state. Without the program, Holland said the state’s health indicators – already the worst in the nation on most measures – would be even more dismal.

“Plus, it might be the biggest economic engine in Mississippi,” he said. “It certainly is in many rural areas.  And even in Tupelo, take Medicaid away from North Mississippi Medical Center, and they are in serious trouble.”

Harrison reported there is evidence growth in the program might be slowing, though leading legislators doubt growth will be completely stopped or reversed in the foreseeable future. That same opinion was expressed more than 20 years ago by then-Speaker Tim Ford of Tupelo, the son of a physician and a strong advocate of Medicaid.

The Legislature has approved allowing the agency to place most of its recipients in managed care programs, in which Medicaid pays a specific amount of money for a private company to provide health care. As managed care is ramped up, the hope is that the cost of the program will be more predictable.

Most political and health leaders agree that holding down costs in the long-term will help in improving the health of Mississippians so that they are using the program less.

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