A “sweeping series of Medicaid reimbursement reforms” could bring Mississippi’s hospitals an extra $689 million yearly, Gov. Tate Reeves announced at a Thursday press conference in Jackson, Miss. His plan to help rescue dozens of struggling hospitals comes 47 days ahead of the statewide elections where the Republican incumbent will face Democratic challenger Brandon Presley, who has long accused him of doing too little.
The governor’s proposal involves two plans that use federal funds to reimburse hospitals in the Medicaid system at a higher rate. Hospitals would have to pay more in taxes to receive more federal dollars, though.
“The Medicaid system was built and designed to support those most in need across America— eligible seniors in need, pregnant mothers, children, people with disabilities—that is who Medicaid was designed to serve,” Reeves said at the press conference. “This increase in the reimbursement rate will help expand the opportunities for care across the state for those beneficiaries.”
The governor has long opposed and continues to oppose accepting over $1 billion in annual federal funds to expand Medicaid, which supporters say could give more than 200,000 uninsured working Mississippians access to health care and help hospitals stay afloat with little cost to the state.
Under Reeves’ plan, the Mississippi Hospital Access Program would directly pay hospitals that have patients in the Mississippi Medicaid managed care program, offering a higher reimbursement rate that is closer to the average commercial rate, he said. Another part of the plan will help supplement hospitals’ Medicaid base payment rates “by reimbursing inpatient and outpatient hospital services in the fee-for-service system up to the Medicare upper payment limit,” Reeves’s press release explained.
“This funding will have a profound impact on the bottom line of state hospitals, both large and small,” Reeves said at the press conference.
He said the extra money for hospitals would also help improve the quality of care for people on Medicaid and would come “at almost no cost to Mississippi taxpayers.”
“Ultimately, those who receive care through these particular institutions are going to bear some of that cost, so it is going to be some on the taxpayers,” Reeves said.
Reeves said he submitted the proposals on Sept. 21 to the federal Centers for Medicare and Medicaid Services, who must approve them before they are enacted. If the programs pass, they would go into effect on July 1, 2023.
The Medicaid Disproportionate Share Hospital program gives financial help to hospitals that care for children, uninsured people, people with low incomes, people with disabilities and older people. Mississippi Division of Medicaid Executive Director Drew Snyder said DSH will not need to fund most Mississippi hospitals if the U.S. Centers for Medicare and Medicaid Services approves Reeves’ plan.
“What we’re going to see is hospitals that were receiving DSH before are not going to receive DSH because they’re getting more money in more pools, other revenue sources. So, you will still have some, but the net impact will be felt in other places, the other supplemental payment programs,” Snyder said at the press conference.
‘Too Little, Too Late’
Some Mississippians say Gov. Tate Reeves’ proposals would do little to help the state’s struggling hospitals, like Greenwood Leflore Hospital, which has shut down several departments to save money. Greenwood Mayor Carolyn McAdams, in an Aug. 25 interview with the Mississippi Free Press, said the hospital is “on the chopping block” partly due to no Medicaid expansion.
Reeves’ plan estimates that Greenwood Leflore would get over $10 million annually at a 138% increase rate. But the hospital would not receive the money until next year when it might be too late, Mississippi Rep. John Hines warned in a Sept. 21 press release.
“Today’s announcement is too little, too late for hospitals who have already cut jobs and services, for KPC Promise Hospital that already shut down and for Greenwood-Leflore that could close down by the end of the month,” Hines said.
Kimberly Hughes is the co-chair of the Care4Mississippi Coalition Steering Committee, a nonpartisan health care and advocacy organization. She said the extra funding for the hospitals is helpful, but it is not the only solution.
“This issue is much larger than just our hospitals—it impacts our health care providers in small towns and clinics across our state, it weighs on our economy, and it damages the health of hard-working Mississippians,” she said in a Sept. 21 press release. “It is time that Mississippi has a real conversation on closing the coverage gap by expanding our Medicaid program.”
Mississippi House Rep. Cheikh Taylor, the chairman of the Mississippi Democratic Party, said Reeves’ plan has not been vetted to show that “this program works in Mississippi.”
“It’s my estimation that it takes $800 million to really get this program to work; $700 million is another Band-Aid,” Taylor told reporters after Reeves’ press conference.
Democratic candidate for governor Brandon Presley has put Medicaid expansion at the center of his campaign, estimating that 220,000 Mississippians could be added to the Medicaid roster. Expansion would cover residents who make between 100% and 400% of the federal poverty level.
Mississippi and nine other Republican-led states have not expanded Medicaid, even though the federal government would pay for almost the entire cost. Reeves has long invoked the name of former President Barack Obama (who made Medicaid expansion possible when he signed the Patient Protection and Affordable Care Act into law in 2010) when explaining his opposition to expansion.
“While Obamacare expansion is a solution that some have proposed in our state and obviously 35 or 40 other states, I don’t believe it would have nearly the financial impact to the bottom lines of these institutions … both public and private, than what this is going to have when CMS approves it,” the governor said Thursday.
Reeves said the state needs “more people in the workforce,” not on Medicaid. Supporters of Medicaid expansion “tend to forget the cost” of adding thousands of Mississippians to the rolls, he said.
“Adding 300,000 able-bodied Mississippians to the welfare rolls, I would argue, is a bad idea,” the governor continued.
Presley criticized Reeves for revealing his plan so close to the election, accusing the Republican governor of pulling an “election-year stunt.”
“If Tate Reeves really cared about ending the hospital closure crisis he created, he would call a special session and expand Medicaid so working families can get the healthcare they need,” Presley said in Sept. 21 press release. “Tate Reeves has had 12 long years to do something about Mississippi’s hospital crisis and 47 days before an election is too little, too late for the hospitals that have cut essential services, lost jobs, or are on the brink of closing altogether.”
Nick Judin contributed to this report.