Mississippi State Economist Admits ‘Timber Effect’ Higher Taxes Risk of Medicaid Expansion | Mississippi Politics and News

The case for Medicaid expansion is much less watertight than the media, Democrats say based on an interview with the state economist.

Earlier this week, Mississippi State Economist Corey Miller released a report titled “A Fiscal and Economic Analysis of Medicaid’s Expansion in Mississippi Under the Affordable Care Act. “The report (below), at first glance, seems to show that if Mississippi lawmakers decided to expand Medicaid, it would pay for itself.

MS State Economist Report on Medicaid Expansion by yallpolitics on Scribd

Predictably, Democrats and members of the mainstream Mississippi media have attempted to use it to feature Governor Tate Reeves and Republican legislative leaders. They falsely labeled the report as the state economist calling “BS“on those who oppose the expansion of Medicaid.

To seek to clarify the technical aspects of the report and to dig a little deeper into the numbers and political arguments, Y’all Politics sat down with state economist Corey Miller in a video interview (below).

Miller said this new Medicaid expansion report was not prompted by lawmakers or other entities, but rather believed it was time to revisit the matter given the recent movement. as part of the American rescue plan. The last time the state economist looked at the matter was in 2012, and Miller said the estimates needed updating.

“I’m not trying to start anything with anyone,” Miller said of his report, comparing his efforts to the Congressional Budget Office’s analysis.

He said his office was non-partisan and had no agenda, and that as a state economist he did not make policy recommendations.

“I hope the report did not come out as being pro[Medicaid] expansion. It certainly wasn’t our intentions, to be pro or anti, ”Miller said.

The state economist’s report found that the expansion of Medicaid in Mississippi would increase Medicaid enrollments in the state from about 228,000 to 233,000 people between 2022 and 2027. This additional population , according to Miller, consists of individuals between the ages of 19 and 64 whose household income is below 138% of the federal poverty level.

In other states, these estimates have tended to be low. In neighboring Louisiana, their estimated initial expansion population was around 400,000. It currently exceeds 600,000, 50% more than the amount on which policymakers based their decision. Such a disparity of estimate is one of the pillars on which President Philip Gunn based his objection to the expansion, as well as the long-term budgetary impacts of more people on the program with less support. federal government resulting in increased state budget costs.

Miller acknowledged that there can be a “wood effect” – those who haven’t applied traditional Medicaid do so when the expansion occurs. This dynamic has been seen in other states, but Miller says he doesn’t think there would be much of this effect in Mississippi.

However, the state economist says he is not exactly sure of the fiscal impact if this “wood effect” were to occur.

“Obviously the costs will increase if that were to happen. How much would this affect savings, I’m not sure what impact it would have on savings, ”Miller said.

When asked if there were any potential drops for the state if it expanded Medicaid or if the expansion was a good deal overall, Miller said there were always factors that could come into play. involved and which hypotheses cannot explain.

“I think of the ‘wood effect’ we talked about. Other states have seen it. As you mentioned, Louisiana. Kentucky had it when they got bigger a few years ago. They got a lot more registrations than they thought they would, ”Miller said. “Of course, there is always political uncertainty. You don’t know if the funding will continue in the future. This is still a possibility depending on political developments in Washington and the preference for the Affordable Care Act in general. We have had 38 states that have adopted it so far, so I think that probably makes it less likely that it will be drastically changed at this point, but yes it is a possibility.

Miller said his estimates included the assumption that people on Medicaid would stay while projecting a 79% enrollment rate for people without current insurance coverage and a 15% enrollment rate for those currently on. employer coverage but would then be eligible to switch to Medicaid as part of the extension.

This shift from private insurers to government roles is another concern Republicans have voiced in their opposition to the expansion of Medicaid.

Currently, the federal government will cover 90 percent of population expansion spending from 2022, while Mississippi would be responsible for the remaining 10 percent. The report estimates that the state’s annual costs of expanding Medicaid range from approximately $ 186 million to $ 207 million from 2022 to 2027.

The report describes what Miller believes are savings the state would see by moving traditional groups (current Medicaid recipients) to the expansion group as well as cuts in unmatched care costs for healthcare facilities and hospitals. . Miller estimates that the annual savings range from about $ 206 million to $ 227 million between 2022 and 2027, “roughly offsetting the annual costs to the state of expanding Medicaid over the same period.”

“We think the biggest area of ​​economics would probably be unpaid care for hospitals,” Miller said.

The current costs of uncompensated care are paid by hospitals through a state assessment. Miller says the state not having to pay these costs is a benefit to taxpayers and says taxpayers are already paying for expansion into other states to some extent.

But Miller says a tax hike, or an assessment on hospitals, remains a real possibility if costs were to exceed savings if Medicaid were extended.

Miller also presents that state revenues and the economy would benefit, estimating an increase of $ 44 million in annual revenues and an average increase of 11,300 jobs per year, mostly in the health care sector and the ‘welfare.

Mississippi is currently struggling to fill vacancies. However, Miller says that if there is a sustainable group of patients added to the rollers through the expansion, it could attract more workers to the state.

“It’s not a certainty, far from it, it’s a possibility,” Miller said of his estimates.

The report estimates that the Medicaid expansion would result in a 0.7% increase in personal income while pushing the state’s population to between 3,300 and 11,500 people in the first 5 years of the expansion period until. ‘in 2027.



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