There are strong arguments for using the cigarette tax to fund the Medicaid deficit. Cigarettes contribute greatly to Medicaid costs. It makes sense to connect funding for health care with the greatest single risk to personal health.
But there’s also logic to Barbour’s argument that hospitals have been paying into the system to draw down the 3-1 federal-state dollar match in Medicaid for a long time and should continue to do it as a reliable, sustainable means of funding for the health care program for the poor and elderly.
Yes, the governor has one solution he insists upon. Yes, the House leadership has offered a compromise mixing the two solutions. But the fact is, the governor has drawn a line in the political sand and has the votes -at least in the Senate -to back him up.
In short, a cigarette tax to fund Medicaid is politically untenable at this point. There are two alternatives for the House, in spite of periodic talk of other options: 1) Accept Barbour’s position and the plan prepared, if reluctantly, by the state Hospital Association, or 2) Continue the stalemate and watch Barbour put major Medicaid cuts into effect.
The House leadership has taken what it considers a principled stand on the tobacco tax and says Barbour doesn’t have to cut Medicaid. But the fact remains that he will. It’s simply not worth the impact on people needing health care to push that position any farther -in spite of perceptions that Barbour is being stubborn and inflexible, and perhaps a desire by some to see him ensure some self-inflicted political damage.
Is yielding to the governor’s position political surrender? Only in the short term, and anyway, politics can’t rule the day on this one. Sure, Barbour has his own political axes to grind, but the House could end this mess by agreeing to the Hospital Association plan and calling the governor’s hand on his promise about the cigarette tax.
A deal that funded Medicaid with the hospital tax and received more specific assurances from the governor on his future cooperation with tobacco tax efforts could be a win-win for both sides. More important, it would keep Medicaid solvent, remove the threat of interrupted services and – with a cigarette tax increase assured -discourage smoking.
The cigarette tax proponents have won the war. Now all that remains is the last mop-up battle. That fact has been lost in all the controversy over Medicaid, and it needs illumination.
Shine the light – and end the stalemate.
NE MS Daily Journal