Protect Medicaid to help Mississippi children

An Open Letter to Mississippi Senators Thad Cochran and Roger Wicker

Dear Senators,

You and your fellow Senators are no doubt very busy working on the new federal health care legislation. As you do so, please take time to consider Mississippi children and their access to health care coverage. Consider that:

· Mississippi Medicaid provides health insurance for 328,000 low- income children in Mississippi. 31% of our state’s children live in poverty.

· Children make up 59.7 percent of Mississippi’s Medicaid population, but account for only 19% of Medicaid expenses.

· Each Medicaid-eligible child costs Mississippi just $2,791 per year, on average, compared to average costs per adult Medicaid enrollee of $5,864. Children insured through Medicaid are less costly to treat than children insured through private insurance. Overall, the program has been very successful, cost effective and has ensured that the children of Mississippi get the health care they need.

· Twenty percent (20%) of MS children have special healthcare needs and of these, 44% rely on Medicaid to pay for needed health care service.

· We now have the lowest rate of uninsured children in our state’s history because of Medicaid and the Children’s Health Insurance Program.

· Blair E. Batson Hospital for Children is the only children’s hospital in Mississippi and relies heavily on Medicaid payments. Without our generous federal Medicaid matching dollars, we are at risk endangering the essential services it provides to our most vulnerable children.

· Our local community hospitals serve many working and low-income families. Even without the cuts to Medicaid passed by the House, many smaller hospitals, which already have unstable finances, will struggle to stay open. These Mississippi community hospitals rely on Medicaid and Medicare payments to remain solvent. Further cuts to their revenue may force the closure of hospitals statewide.

· Mississippi now receives $2.94 in federal matching funds for every $1.00 in state money allocated to Medicaid.

Change is imminent, and many Mississippi pediatricians are deeply concerned with potential threats to the Medicaid program! Although the public has not been given the details, it is clear that federal health care legislation now before the Senate could result in drastic cuts to the Medicaid program over time. Medicaid is a flexible federal-state partnership.

Changes to this formula would inevitably shift cost to the states, and, as you well know, Mississippi cannot afford to shoulder those cost shifts.

We know that if Medicaid funding is capped, it will mean a drastic reduction in federal support for Mississippi’s Medicaid program. Mississippi’s current revenue outlook will not allow for reallocation of current state dollars to make up for lost federal dollars, given that the federal government pays at least 74.6 percent of the total cost of Mississippi’s Medicaid program. The repercussions of altering that federal match will be devastating to the health of our state, especially for our children.

State pediatricians have been working since 2013 with our state’s Division of Medicaid to stabilize and reduce Medicaid costs by emphasizing preventive health care for Mississippi children. We are very concerned that, under the changes in the House bill, Mississippi children may longer have access to needed preventive care visits and that children who are the most vulnerable will not receive the specialty care that they need. The backbone of the Medicaid program is EPSDT (early periodic screening, diagnosis and treatment). This means during their first two years of life children have approximately 10 well-child visits and are guaranteed health benefits that cover a variety of medically necessary services.

All children, even those with commercial private insurance, are healthier if their teammates, playmates and classmates have good access to preventative health services.

Already, this year’s reductions to our MS State Department of Health’s budget will make preventive services for children harder to access. Potential Medicaid funding caps and/or block grants will place these essential services further from reach for Mississippi children.

We are very concerned that the newest pediatricians, in whom Mississippi has invested so heavily, are likely to pick up and move to another state with a more lucrative payer mix, reversing the progress made over the last several decades to lessen the physician shortage in our state.

Treating early-identified problems helps children grow up to be healthy, productive and tax-paying adults. We will do well to remember the truth shared by Frederick Douglass: “It is easier to build strong children than to repair broken men”.

Mississippi children and families, in addition to our state’s health status and economy have so much to lose if federal legislation is passed to cap Medicaid expenses. Help keep us from going backward in caring for our kids! Please protect children’s health care coverage and oppose any caps to Medicaid in the health care bill presented to the Senate. We encourage any readers of this open letter to contact their Representative and Senators to oppose caps to Mississippi’s Medicaid growth.

Sincerely,

Nikki Ivancic Currey, MD, FAAP Tupelo, MS

John Gaudet, MD, FAAP Hattiesburg, MS