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Where are education advocates on Medicaid debate?
They're awfully quiet
by Alan Lange
We've been spending a lot of time talking about the Medicaid debate and how to this point the Republicans in the Mississippi Legislature have remained generally on the right side of the issue. In continued tough economic times, it's hard to swallow another major entitlement expansion in Mississippi that could costs tens of millions of dollars per year every year . . . forever. Medicaid is expensive enough and as it stands one in every five Mississippians is a beneficiary of that program.

First, let's look at the latest numbers. Medicaid came out on Monday with updated guidance on DSH payments, which is really at the core of the issue. I have been shocked that the numbers haven't been reported. In today's Daily Journal, Bobby Harrison seemed to bury the lede without any real deference to the actual numbers that are in print. According to Medicaid's own numbers, in 2013-2014, Mississippi's DSH payments are projected (not guaranteed) to go down only $4.4 million. On page 31 of the linked document, DSH payments go from $162.3 million to $157.9 million. Not that $4.4 million isn't real money, but in the confines of a state budget, $4.4 million is a rounding error.

Speaker Pro Tem Greg Snowden made an interesting point in the debate recently. Predictably, you're not seeing that getting any press coverage at all. Basically, Mississippi's general fund is the source of funds for both education and Mississippi's Medicaid match. So who are you going to choose, education funding or Medicaid expansion? Can't have both. Snowden's point is that folks who are ostensiby pro-education seemed to be ignoring the political and economic reality that says that you can't in the long term spend tens of millions of dollars a year more for Medicaid, which even on the current path we may be doing, without it significantly hurting education. Yet education advocates remain quiet as church mice on this bourgening money grab.

Phil Bryant has got to wrestle control of this debate back by putting House Democrats on the actual vote. He's right on policy, politics and morals on this issue. Lucien Smith, Chief Counsel to Governor Bryant, was on Paul Gallo's show yesterday saying that essentially Bryant would not call legislators back until a deal in principle had been reached. He doesn't want to subject voters to a $30,000/day fruitless special session. But that gives the Democrats the luxury of publicly holding an impossible position (not voting to refund Medicaid) without actually having to vote against it. It's a bluff. They know it and everyone else does to. And even if the special session met every day from here to the end of June and spent $1 million, it pales in comparison to the long term cost of getting this wrong.

It's time for Bryant to call the special session on a straight up vote to reauthorize. If he keeps the call narrow, the Senate will likely pass the bill quickly and adjourn. The House will likely wrangle with it procedurally for a day or two. However, if there's no debate on expansion, and an up or down vote is all that's left, there's really not much more to do than vote. If Democrats vote to not reauthorize Medicaid, it will be the worst political move they've made in decades and Republicans will be set up for 2015 in ways they can't even imagine.

Politics is about making choices. Democrats face an impossible one. It's time for the posturing to end and the voting to commence.

Editors note: We will be welcoming back Frank Corder to the site in the coming weeks!

Posted May 15, 2013 - 11:50 am

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