Sunday, June 23, 2013

ObamaCare for Mississippians II

But how do we all get health coverage?

Most Americans and Mississippians have health coverage. Most get it through their employers, seniors have Medicare, many of the very poor have Medicaid, and veterans have the VA. Some buy it themselves at outrageous prices.
However, more than a third of Mississippians under 65 are uninsured. Almost half of African Americans are uninsured. Contrary to what you might think, almost three fourths of the uninsured are employed. These numbers are a few years old and are probably worse now.
So what will ObamaCare do for these Mississippians? Unfortunately, Mississippians will not have the same benefits other Americans will have, because our Republican Governor and State Legislature have fought ObamaCare every step of the way. But let's look at how ObamaCare is supposed to work, and then how it will be in Mississippi.
Health care in America is very complicated. ObamaCare was not the easiest or best solution, but it was what could be passed by Congress. It kept the employer based system that we've had for many years and tried to correct its drawbacks. There are several layers to these corrections, and we'll look at them one at a time. 

The Working Poor

There are working people who don't qualify for Medicaid, either because they have no children or they earn too much. But they don't earn enough to afford to buy insurance. Under ObamaCare,  Medicaid would be expanded to cover ALL people with incomes at or below 135% of the poverty level. In Mississippi, this would give health coverage to around 300,000 Mississippians who have none now. The Federal government would pay 100% for the first 3 years, gradually decreasing to 90% by 2020.
The Supreme Court decision last year that upheld ObamaCare did say that states could not be required to expand Medicaid. To no one's surprise, our Republican Governor immediately said Mississippi would not expand Medicaid - before he had even studied it or looked at the numbers. The Republican leadership in the State Legislature was on board.
Only one problem: Democrats demanded that the expansion be brought to a vote before funding the current program. Democrats are NOT saying they won't vote for the current Medicaid program. All they want is for the expansion to be debated and voted on. If it loses, they'll vote for the current program. Republicans refuse to even debate or vote on it. Why? Who knows? Maybe they don't have the votes to kill it. Maybe some Republicans don't want to go on the record as opposed to a bill that will bring $1 billion to Mississippi, create 9,000 jobs, provide 300,000 Mississippians health care, and save many small, rural hospitals*.
As of right now, the entire Medicaid program is set to end on June 30th. Although the Republicans have a majority in the State Legislature, they need Democratic votes to pass funding bills, which require more than a majority. Since the Legislature is not in session, the Governor must call them into special session next week.
If the Republicans get their way, there will be 300,000 working Mississippians who will NOT have health coverage, whereas Americans in states that expand Medicaid will have coverage. Guess Mississippi Republicans just don't care about those families. There will also be several small hospitals that will be forced to close. Guess Republicans don't care about those communities.
We'll know in a week, and I'll post an update here.
*Hospitals will be adversely affected if Medicaid is not expanded because of a federal funding formula that is beyond the scope of this post. Consequently, Mississippi hospitals are very supportive of expansion.
Coming next: ObamaCare for Mississippians III: What about those uninsured middle class families that don't qualify for Medicaid?

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