- Governor Reeves said the proposed expansion in the legislation unwisely comes at a time when federal funding of existing Medicaid services is in question.
Governor Tate Reeves (R) has vetoed a Medicaid Technical Amendment bill that he says would result in expansion of the program, a change he adamently opposes.
Prior to sine die, Governor Reeves vetoed SB 2687, citing what he viewed as efforts to expand the program. Reeves said that Medical Technical Amendments Bill would have potentially increased the state’s total Medicaid budget by $40 million. The state would pay 24 percent while the remainder would come from federal funding, which Governor Reeves noted was in a state of flux under the current administration.
On Thursday, Reeves vetoed what he called the previous bill’s sister, SB 2386. Again, he stated in his veto message that if he signed off on the bill, those same additional costs would be put on the program as a whole, leaving the state of Mississippi to pick up 24 percent.
“Specifically, the provisions in Senate Bill 2386, when aggregated, are estimated to add total recuring (sic) costs of more than $40,000,000 to the annual budget of the Division of Medicaid (“Division”) (of which the state share would be approximately 24%). Such proposed expansion unwisely comes at a time when federal funding of existing Medicaid services is in question,” Reeves wrote in his veto message.
While presenting SB 2386 on the floor of the House of Representatives on April 1, State Rep. Missy McGee (R) said the updated version of the Medicaid Tech Bill aimed to address the issues Governor Reeves had with SB 2687 by removing language that dealt with physician upper payment limits that could potentially affect the University of Mississippi Medical Center.
McGee clarified that the bill could not be described as Medicaid expansion.
“I will tell you that there is nothing in this bill that is Medicaid expansion,” McGee said while on the floor. “There is nothing in this bill that expands Medicaid eligibility to any groups or individuals that are not already in the Medicaid program.”
Governor Reeves acknowledged in his veto message that Senate Bill 2386 addressed his issue with the Medicare Upper Payment Limits program language in the previous bill, noting that if it had passed, it would lead to a budget deficit at UMMC the Legislature would have to address.
Reeves also took issue with the bill’s intent to remove the broad discretion afforded to the Division of Medicaid under federal law to find creative ways to increase supplemental payments to hospitals under the Mississippi Hospital Access Program, or MHAP, by freezing the current methodology.
“Such broad discretion allowed the Division to increase recurring supplemental payments to hospitals by a number greater than $700,000,000 annually, effective July 1, 2023,” Reeves wrote. “Thus, the effect of Senate Bill 2386 would be to unwisely place the Division in a straitjacket, preventing it from finding more creative and innovative ways to increase supplemental payments to hospitals.”
He said it would be “nonsensical” for such a bill to freeze the MHAP, while also forcing the Division to open the program to another hospital and creating a “legal impossibility.”
“In short, because Senate Bill 2386 unwisely expands Medicaid at a time when federal funding is in question, needlessly ties the hands of the Division with respect to finding new and inventive ways to increase supplemental payments to hospitals, and continues to have the potential to threatened UMMC’s annual operating budget in the near future, I am left with no choice but to veto the bill at this time,” Reeves stated.
When reached for comment Friday, Rep. McGee told Magnolia Tribune that SB 2386 included federal compliance requests from the Division of Medicaid.
“Furthermore, the provisions in the bill addressing the Mississippi Hospital Access Program (MHAP) supplemental payments would not have ‘frozen’ the amount of federal dollars Mississippi could draw down. The state would have still been able to draw down the maximum amount allowed by law,” McGee said. “The bill said that the ‘formula’ by which hospitals would receive such funding could not be changed so that our hospitals, particularly our rural hospitals, could adequately budget these critical dollars and know precisely the amount of funding they would receive.”
McGee contends that the measure gave hospitals certainty as they budget and provide services to Mississippians, instead of having the criteria changed from year to year.
“SB 2386 was not divisive legislation, and I was glad to see the House and Senate working together to make our Medicaid program as efficient as possible for providers, beneficiaries and the taxpayers of Mississippi,” Rep. McGee added.
