Jackson Free Press

JACKSON, Miss. (AP) — Democrats in the Mississippi Legislature say they're trying to preserve the option of expanding Medicaid in the state, even though Gov. Phil Bryant and other Republican leaders oppose adding hundreds of thousands more people to the government health insurance for the poor.

The Democrats' votes helped kill a bill Thursday that would keep the existing Medicaid program in business beyond July 1. Lawmakers say there are other bills to keep the program alive.

Bryant said Democrats are playing "shameful" politics. House Speaker Philip Gunn, R-Clinton, called the Democrats' effort "misguided."

House Bill 560 needed 68 votes to pass. There were 61 for and 52 against, divided largely along party lines — Republicans for and Democrats against.

Many state programs, including Medicaid, must be reauthorized every few years. That gives lawmakers a chance to review the programs and to make changes, large or small.

The House Democratic leader, Rep. Bobby Moak of Bogue Chitto, urged party members to vote against the Medicaid reauthorization bill Thursday because it could not be changed to add Medicaid expansion. He said a Senate bill could be amended later. There's a technical reason the House bill couldn't be amended: It doesn't contain the right sections of state law, and House rules prohibit adding sections that aren't in the original draft.

Under the federal health overhaul that President Barack Obama signed into law in 2010, states have the option to expand Medicaid to people making up to 138 percent of the federal poverty level. The federal government would pay 100 percent of medical expenses for the newly qualified enrollees from 2014 to 2017, then the federal share would be reduced to 90 percent by 2020, with each state paying the balance.

The poverty level is about $11,000 for one person, so the expansion could cover a person making up to about $15,000. Each state sets its own upper income limit for Medicaid enrollment, and Mississippi has one of the lowest in the country, at about 50 percent of the poverty level.

Moak said Medicaid expansion could support about 9,000 health care jobs in the state.

"Today was the first effort to make sure those jobs come to this state, and the voices of 300,000 Mississippi souls and their options for health care are heard," Moak said in a news release after the House voted.

Bryant has said expanding Medicaid would force officials to increase taxes or cut services such as education or public safety.

"I am certainly prepared to run Medicaid by executive order to prevent nursing home patients and aged, blind and disabled adults from losing services," Bryant said in a news release Thursday. "I believe the Democratic leadership's threatening the care of vulnerable citizens to advance a political agenda is shameful."

The Division of Medicaid says 641,378 were enrolled in the program in December, in a state with a population of just under 3 million.

A recent study conducted by the Urban Institute for the nonpartisan Kaiser Commission on Medicaid and the Uninsured estimates about 288,000 newly eligible people could be expected to enroll in Medicaid if Mississippi does an expansion. The study says another 57,000 who are eligible for Medicaid under current standards could be expected to sign up.

The study estimates that with expansion, Mississippi would pay about $1.2 billion more for Medicaid, stretched over 10 years, and would collect more than $15 billion in federal money.

Bryant relies on research from the Milliman firm, which shows larger potential enrollment and substantially larger state expenses.