With a sluggish economy and an ever-tightening state budget, Mississippi is cutting Medicaid eligibility back to 100% of poverty level amid protests from some lawmakers who say the changes from the current 135% of poverty level are cruel and heartless.
Using current federal poverty guidelines, that means the income cutoff is $9,310 for one person instead of $12,569.
Warren Jones, M.D., executive director of Mississippi Medicaid since January and past president of the American Academy of Family Physicians from 2001 and 2002, acknowledged the changes will be difficult for many people but said they're necessary to keep the program financially solvent.
"When we used to have a $150 million surplus in the Medicaid program, we could say we want to expand that population, give them additional services," Jones, who was appointed by Republican Gov. Haley Barbour, said in an interview with the Associated Press last week. "Now we're running a $200 million-per-year deficit. So we've got to find a way to really continue to provide those essential services and still make this program available," Jones said.
The changes are set to take effect July 1, and 65,000 Medicaid recipients have been sent letters saying they're being removed from the program. About 60,000 of those people will be covered by Medicare, which is paid completely by federal funds, but there are widespread concerns that the Medicare prescription coverage will leave some with burdensome out-of-pocket expenses.
Barbour says he's seeking federal waivers to let Medicaid keep covering the other 5,000 people. But the state won't know until after July 1 whether the waivers are approved.
Barbour also is asking federal permission to guarantee continued Medicaid coverage for four groups of patients: those who have undergone organ transplants, those with end-stage kidney disease who need dialysis, cancer patients who are taking chemotherapy or radiation and people on anti-psychotic drugs.
The bill passed by lawmakers and signed by Barbour specifies the need to continue coverage for transplant, dialysis and cancer patients. Jones said Medicaid officials made an administrative decision to continue coverage for those on antipsychotic drugs.