Under the new law, the federal government will kick in an estimated $9.9 billion over the next ten years to expand the Medicaid program, “enough to allow the state to cut in half the number of poor adults without insurance.” But as Levey discovered, the state government isn’t interested in implementing these measures:
For every dollar the state spends to expand healthcare for the poor, it stands to get as much as $20 from Washington. But state officials have been making it harder, not easier, to enroll in government-backed healthcare programs.
Republican Gov. Haley Barbour campaigned on a promise to cut the healthcare safety net to balance the state budget. Shortly afterward, Mississippi began requiring Medicaid recipients to submit to in-person interviews once a year, making it the only state with such a sweeping rule. In Tutwiler, the closest registration office is in nearby Sumner. It’s open one day a week, on Tuesdays, from 9 a.m. to noon and 1 p.m. to 3 p.m., as well as the third Wednesday of the month.
Barbour, who said recently that the healthcare overhaul “would prove disastrous” for Mississippi, has joined a lawsuit filed by GOP officials in several states seeking to overturn the law. For the little clinic near the banks of Hobson Bayou, that could mean more challenging days ahead.
The clinic that Levey profiles in his story treats so many uninsured patients it has to rely on donations and grants to keep its doors open. Its director, a Roman Catholic nun named Anne Brooks, is excited about the additional funding in the new law, but remains “doubtful the state’s leaders will take advantage of the federal help.” “I just know I have to see my patients,” Brooks said, as she reminisced about those she has treated, including the town’s former physician who rode through the bayous to see patients with a rifle on his saddle to fend off panthers. “It would be nice if someone could figure out a way to pay us for doing it.”
To be clear, the law does require states to spend extra dollars on Medicaid, but the additional spending is small compared to “increases in coverage and federal revenues and relative to what states would have spent if reform had not been enacted.” The federal government picks up the entire tab of Medicaid expansion until 2016 and will pay for 95% of the expansion in 2017, 94% in 2018, and 93% in 2019. Beginning in 2020, the federal government will fund 90% of the expansion. A recent Kaiser Family Foundation study found that Mississippi would have to spend $429 million on Medicaid between 2014 and 2019 (a 4.8% increase) to cover 320,748 thousands residents. The federal government would pick up the rest of the tab, financing 95.8% of the expansion.