MM Curator summary
The Medicaid Director is not making any friends by pointing out that 2/3rds of potential expansion enrollees already have insurance coverage.
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Drew Snyder, the executive director of the Mississippi Division of Medicaid, said that based on a study conducted by University Research Center economists, most of the people who would gain health care coverage if Mississippi expands Medicaid already have coverage.
Referring to the study conducted by State Economist Corey Miller and Senior Economist Sondra Collins, Snyder recently said, “What really jumped out to me was that 65% (of the people who would be covered under Medicaid expansion) already had some form of insurance… What it looked to be was this was primarily not providing individuals with a new affordable coverage, but shifting insurance coverage for people already covered.”
The report, as Snyder correctly pointed out, does conclude that a significant majority of the people who would sign up for Medicaid expansion if the state provided it already have health care coverage. Gov. Tate Reeves and others have argued that enacting Medicaid expansion would allow people to drop private coverage they are at least partially paying for and enroll in a program — Medicaid expansion — paid by the federal and state governments. But the study pointed out nuances.
The study estimates that 233,489 people would be added to the Medicaid rolls if the state expands Medicaid as is allowed under federal law.
Of those 233,489:
- 82,204 would be people who currently have no insurance.
- 11,623 would be people with employer-based coverage.
- 28,910 would be people with private insurance through the federal Healthcare Exchange where they currently receive federal subsides to help pay for the coverage.
- 110,752 would be people currently covered by the state Medicaid program.
But Snyder did not mention the fact that if the state had Medicaid expansion like 38 other states and the District of Columbia, those 110,752 could be diverted from the current Medicaid program, where the state must pay a greater share of the match than the state would if the people were covered through Medicaid expansion.
Put simply, under Medicaid expansion, the state would be paying less for the health care for those 100,000-plus.
Mississippi has the best matching rate for its traditional Medicaid program with the federal government paying 84.5% of the costs during the COVID-19 pandemic. But the federal matching rate for those covered through Medicaid expansion is 90%.
There are currently about 780,000 people covered by Medicaid in Mississippi. Those people include the disabled, poor pregnant women, poor children and a segment of the elderly population. Most healthy adults who are not pregnant cannot garner coverage through the current program except for in certain caregivers of those on the Medicaid program living in extreme poverty.
Under Medicaid expansion, coverage is provided to those making up to 138% of the federal poverty level or $17,774 annually for an individual.
The study estimated that the total state population that would be eligible to enroll in any potential Medicaid expansion is 330,000, though a significant number of that group would not enroll in the Medicaid expansion program.
Reeves, who opposes Medicaid expansion, and others have argued that more people would sign up for Medicaid expansion than projected in many studies. During his successful 2019 gubernatorial campaign, he also said that in neighboring Louisiana when that state began Medicaid expansion, many people with insurance through other means dropped that coverage and enrolled in Medicaid expansion.
The study by the Mississippi Institutions of Higher Learning University Research Center surmises that Medicaid expansion would produce an average of 11,000 jobs per year between 2022 and 2027 and provide an additional $44 million per year for the state general fund.
The positive results, the study concludes, are the result of several factors, including the economic boost from the infusion of the federal money into the state, the savings from moving certain groups from the traditional Medicaid program to the expansion program and from other incentives provided by the federal government to expand Medicaid.
Snyder questioned the validity of the study.
“We recognize these are big decisions,” Snyder recently told legislative leaders of the possibility of expanding Medicaid. “…This is not a free or add-on to the state. It will cost money. The question now comes is this the money we want to spend.”
After making his comments, Snyder conceded he is not an economist.
Snyder first was appointed as executive director of the Medicaid Division by former Gov. Phil Bryant and re-appointed by Reeves. Both Reeves and Bryant have been adamant opponents of Medicaid expansion.