The top drawer political reaction to the Supreme Court’s decision upholding the health care reforms known as “Obamacare” is one founded deeply in the 2012 federal election cycle and the inexorable grind of partisan politics.
But in Mississippi, the central focus of the decision for state policymakers in both the executive and legislative branches of government is what the majority of the Supreme Court said about how the federal government can enforce the expansion of the Medicaid program dictated by the Obama health care reforms.
On Medicaid, the court said that the federal government can’t threaten or withhold funding for the state’s existing Medicaid program simply because the state fails to expand Medicaid as dictated by the Obama health care reform act. That part of the ruling raised the Mississippi Legislature’s attention.
Medicaid in Mississippi is nearly a $5 billion annual proposition utilizing both federal and state dollars that serves some 641,454 Mississippians. Currently, the state offers Medicaid to citizens with an income up to 100 percent of the federal poverty level or $23,050 for a family of four.
It is also the most heavily subsidized Medicaid program in the nation. In the fiscal year that ended June 30, 2011, for every $1 the state spent on medical care for the poor, the federal government spent $5.61. In the fiscal year that ended June 30, 2012, the ratio dropped to $3 in federal funds for every $1.
For Mississippi, the court’s ruling mitigates what many Mississippi legislative leaders have predicted was the most expensive and difficult portion of the reforms for state government to finance – the expansion of the Medicaid program in the poorest state in the union.
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