Friday, July 5, 2013

From MDES to Medicaid, legislators no strangers to reauthorization fights

*First appeared in the Laurel Chronicle on July 4, 2013


The recent debate in Jackson on whether the state should expand its taxpayer-funded Medicaid program in accordance with the Affordable Care Act (ACA; also known as “Obamacare”) brought back certain legislative memories.

Call me crazy, but there seems to be a trend – both in the way D.C. promotes adoption of its policies under the current president and the way in which Mississippi legislators use repealers to their political advantage.

Consider the way in which Medicaid expansion is pitched to the states by President Obama. States can expand Medicaid eligibility and add thousands of beneficiaries to the rolls, but it won’t cost one cent…at least not yet. It’s the “expand now, pay later” scenario so popular with this administration. More on that later.

In the special session which ended this weekend, the Legislature reauthorized Medicaid so that it legally exists to provide health insurance to the state’s poor. (Sidebar: Generally speaking, state agencies and other programs have repeal dates, much like expiration dates, which must be acted on by the Legislature lest the programs shutdown.)

The reauthorization process didn’t come without controversy, however, as Democrats and Republicans fought over whether Mississippi should expand its Medicaid program. Ultimately, Republicans got their way, and the Legislature reauthorized the program without expanding it. Expansion may happen in the future, of course, but Republicans took the prudent approach in delaying major changes until more information about the ACA is known.

A look at yesteryear may shed light on why the most recent Medicaid reauthorization debate – and the threats about the program being shutdown - shouldn’t surprise anyone who follows the Obama Administration and Mississippi politics in general.

I’m reminded of another initiative the Administration and its allies tried to implement in Mississippi. A lesser known part of Obama’s famous stimulus package, the Unemployment Insurance Modernization Act gave states “free” money to expand unemployment programs. If states adopted certain policies, such as paying unemployment compensation to individuals who worked part-time, the federal government would pay for any additional costs– at least, temporarily. Sound familiar?

Since unemployment insurance was part of my policy portfolio, I spent a great deal of time working on this issue for former Gov. Barbour. His opposition to expanding the state’s unemployment program was shared by Republicans in the Legislature who recognized this regulation change would have created additional taxes on businesses once the stimulus money ran out.

Democrats disagreed and refused to reauthorize the Mississippi Department of Employment Security. While Democrats toted the water for the President’s liberal unemployment programs, the future of MDES, its employees, and others – such as unemployment insurance recipients and workforce trainees – was in jeopardy.

Ultimately, Gov. Barbour was able to negotiate a compromise to reauthorize the agency without expanding eligibility to part-time workers.

But, that wasn’t the first time Democrats used MDES as a pawn in legislative games. In fact, when MDES’s repealer came up in the 2008 session, Democrats refused to approve its reauthorization until Republicans agreed to increase the state’s unemployment benefits. The agency was eventually reauthorized in a special session Gov. Barbour called to deal with the issue.

In recent history, we’ve seen Democrats threaten the very existence of state agencies as a negotiation tactic to push the agenda they share with President Obama – even if it results in tax increases or additional costs to the state.
But to solely blame Democrats is a bit misleading, as both parties are guilty of using Machiavellian legislative tactics to achieve their goals, whether that’s actually making a policy change or simply raising the public’s awareness of an issue.

So, I guess my real point is this: The recent fight over Medicaid expansion is just one more example of current political trends in D.C. and Jackson.

The trend coming out of D.C. is Obama’s fondness for the “no money up front” pitch in which states can opt into expanded programs without additional costs…until a few years down the road, when the expanded programs (Medicaid, unemployment insurance, etc.) are simply too established to repeal. It’s actually a clever strategy, when it works.

The trend coming out of Jackson is one that’s been going on since before I joined the motley crue of Magnolia State politicos, and it is simple: The Mississippi Legislature loves a repealer. Seriously, check nearly any law that establishes an agency or a new program, and there will be a section that calls for the abolishment of the program on a date certain…unless the Legislature acts.

In theory, this provides a strategic advantage for legislators who threaten to shut down the agency unless certain conditions are met. But in practice, as I’ve witnessed, shutting down a government program is the exception, not the rule…even if the headlines scream differently.

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