Put Medicaid revamp plan on the table

By By Sid Salter
April 17, 2002
Gov. Ronnie Musgrove told the Capitol press corps and various newspaper editorial boards last week that he and his appointees could run the state's Medicaid program $100 million cheaper than it is being operated today under the strict oversight of the Legislature.
He didn't mumble, stumble or prevaricate when he said it, either. Musgrove said if the Legislature would give him and Medicaid executive director Rica Lewis-Payton the "flexibility" to run the program, the savings would be about $100 million. Get to it, Gomer, I say. Show us. But he said the program would still need additional funding of some $75 million whether or not the Legislature granted him the "flexibility" he sought.
Last week, the House was willing to hand Musgrove that "flexibility." The Senate was not. Clearly, the House leadership was smart enough to give Musgrove the chance to help them or hang himself on a rope of his own design.
Mired in melodrama
The Senate mired in petty politics and controlled in great measure by lobbyists for the big ticket Medicaid vendors was not. Hence, the Senate is now the whipping boy for the state's Medicaid troubles.
In the midst of all this melodrama in which our elderly, our disabled and our children are being shamelessly used as political pawns a little political clarity might be in order:
Mississippi has had budget woes in prior years that threatened the Medicaid program's funding. There have never, repeat never, been mass expulsions from the state's nursing homes. Hasn't happened. Won't this time, either, unless it's done as a political stunt.
Musgrove's cries for the Legislature to surrender their authority to manage the Medicaid program to him and his appointees sounds a little less credible when one considers that during his 12-year legislative tenure, he uttered not a word about the need to give the governor control of the Medicaid program.
Huge spending increase
Despite all the wailing from the Musgrove administration about the Legislature abdicating its responsibility to pay for Medicaid, lawmakers authorized more spending for Medicaid in FY02 and FY03 than has ever been spent on the program in state history.
Musgrove says flatly he can operate the Medicaid program $100 million cheaper, but has yet to offer any concrete plan to the public or the Legislature as to how he intends to accomplish that feat.
The Legislature as an institution has been muttering about fraud and corruption in the operation of the Medicaid program as one cause of the free flow of red ink in the program. Lt. Gov. Amy Tuck says she hears "flexibility" from the Governor's Mansion, but that her interests lie in "accountability." Why, then, isn't the Legislative Performance Evaluation and Expenditure Review Committee actively probing the Medicaid program?
Medicaid is in the ditch because of legislatively-mandated expansions of the Medicaid program and a Musgrove-led recruiting drive to sign up more children for the Childrens Health Insurance Program. Both share blame.
Now that the programs have been expanded and new beneficiaries identified, neither Musgrove nor the Legislature has the courage to take responsibility for either increasing taxes to pay for services at existing levels or to cut services and reduce the number of eligible recipients. It's a political nightmare.
Mississippians can't afford a Medicaid program with a blank check. Musgrove says he can envision one operating $100 million cheaper. Does anyone think it might be time the governor shared that detailed plan with the Legislature or are they to continue to buy a pig in a poke?