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Reeves vetoes health insurance bills that experts, watchdogs say would help consumers

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Reeves vetoes health insurance bills that experts, watchdogs say would help consumers

Gov. Tate Reeves last week axed two health care bills that passed the Legislature with bipartisan support and that health experts say could improve health care.

Senate Bill 2622 would have sped up the prior authorization process, which insurance companies use to tell providers whether a drug or procedure is covered for certain patients. Reeves said while the bill itself was a “good idea,” he referred vaguely to mistakes in its language, including that administrative hearings were in “an incorrect place in the bill” and what he said would be increased costs for Medicaid as his reasons for vetoing.

Senate Bill 2224 would have given State Insurance Commissioner Mike Chaney the authority to study and address inequalities in insurance reimbursement rates, which Reeves said was a “bad idea.” The commissioner would be able to fine insurance companies up to $10,000 per violation if they’re unable to justify unequal reimbursement rates for different hospitals for the same procedures.

“It allows us to put some sunshine and open transparency on Blue Cross Blue Shield,” Chaney said. “We’re trying to figure out where all the money goes. They say, ‘We don’t have to tell you that.’”

This became a major issue last year when the University of Mississippi Medical Center, the state’s largest hospital and only children’s hospital and organ transplant center, went out of network with Blue Cross, the state’s largest private insurer. The dispute between the two stemmed from the insurance company’s reimbursement rates.

State Insurance Commissioner Mike Chaney addresses the audience in the pavilion at Founders Square at the Neshoba County Fair. on July 27, 2016, in Philadelphia, Miss.

Blue Cross did not respond to multiple requests for comment.

In his veto messages, Reeves said he believes the bills would increase the cost of health care.

When asked whether the governor had data to back up his claims, Reeves’ press secretary Shelby Wilcher said his understanding that the bills would increase health care costs is rooted in “basic economics.”

“If the cost to provide the service increases, such increases (sic) will be passed along to the consumer,” she said. “The bills contained numerous costly additional burdens, heavy fines, and mechanisms for forced rate increases that would all have an inflationary effect on health insurance.”

It is unclear how the bill that would speed up the prior authorization process would increase costs.

Tim Moore, executive director of the Mississippi Hospital Association, is still confused about Reeves’ claim.

“Where is the data that supports the claim of higher health care costs? I do not see that,” he said. “Interesting that it is two health care related bills that are the first to be vetoed.”

Chaney last year advocated on behalf of consumers when UMMC went out of network with Blue Cross. He said it’s always been his job to monitor the equity of reimbursement rates to providers and its effect on consumers, and this bill would’ve given the commissioner’s office more teeth in its ability to regulate companies.

“I should say that the governor’s veto is a very bad idea because it hurts consumers and health care providers,” he said.

This bill would have allowed Chaney to enact rules and regulations and gather data about how insurance companies reimburse different providers for different services, which is currently not easily accessible or equitable, and study how consumers are treated based on their plans.

Chaney said Blue Cross reimburses providers in Tennessee at higher rates, despite consumers in Mississippi paying comparable premiums.

“BCBS administers those premiums and those policies in Mississippi at lower reimbursement rates,” he said. “Blue Cross won’t give us that information. It’s that simple.”

A study by consulting group Milliman estimates that Mississippi is reimbursed on average at the lowest rate in the country by commercial insurers compared to Medicare.

In addition, consumer experts say Blue Cross in Mississippi has the financial means to pass savings on to consumers but has not. A Mississippi Today investigation last year found that the company has accumulated far more than what regulators require, and perhaps the largest such surplus by percentage of any Blue Cross company in the country at about $750 million.

As for mistakes in SB 2622, Reeves’ inability to name more than one specific error concerns Angela Ladner, executive director of the Mississippi Psychiatric Association and Mississippi Oncology Society.

“When you say there’s a mistake, you need to be really specific about what you’re talking about,” she said. “As far as content, I’m not sure that there were a lot of mistakes. I think the Department of Insurance worked significantly hard to make sure that the bill was in a format that everybody agreed upon, and that’s why they passed it.”

And despite being passed overwhelmingly by the House and Senate, it is unclear if the Legislature will attempt to override the vetoes, which would take two-thirds majorities in both chambers.

Sen. Hob Bryan, a Democrat who represents Amory and chairs the public health committee, said he was not aware of any override attempts and that he could not understand why the governor vetoed the bills.

Leah Smith, a spokesperson for Lt. Gov. Delbert Hosemann, who leads the Senate, said Monday that his office continues to review the veto messages.

A spokesperson for House Speaker Philip Gunn did not answer questions for this story.

Wilcher said via email that the governor’s office is hopeful that the Legislature can come up with an improved version of the prior authorization bill.

“This is unfortunately the victim of a strong lobby by health plans and insurance companies that are saving money on the backs of the patients that they’re supposed to be serving,” Ladner said.

In 2022, the most recent year for which data is available, Blue Cross spent a total of $82,000 on lobbying.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

On this day in 1997

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mississippitoday.org – Jerry Mitchell – 2024-12-22 07:00:00

Dec. 22, 1997

Myrlie Evers and Reena Evers-Everette cheer the jury verdict of Feb. 5, 1994, when Byron De La Beckwith was found guilty of the 1963 murder of Mississippi NAACP leader Medgar Evers. Credit: AP/Rogelio Solis

The Mississippi Supreme Court upheld the conviction of white supremacist Byron De La Beckwith for the 1963 murder of Medgar Evers. 

In the court’s 4–2 decision, Justice Mike Mills praised efforts “to squeeze justice out of the harm caused by a furtive explosion which erupted from dark bushes on a June night in Jackson, Mississippi.” 

He wrote that Beckwith’s constitutional right to a speedy trial had not been denied. His “complicity with the Sovereignty Commission’s involvement in the prior trials contributed to the delay.” 

The decision did more than ensure that Beckwith would stay behind bars. The conviction helped clear the way for other prosecutions of unpunished killings from the Civil Rights Era.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

Medicaid expansion tracker approaches $1 billion loss for Mississippi

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mississippitoday.org – Bobby Harrison – 2024-12-22 06:00:00

About the time people ring in the new year next week, the digital tracker on Mississippi Today’s homepage tabulating the amount of money the state is losing by not expanding Medicaid will hit $1 billion.

The state has lost $1 billion not since the start of the quickly departing 2024 but since the beginning of the state’s fiscal year on July 1.

Some who oppose Medicaid expansion say the digital tracker is flawed.

During an October news conference, when state Auditor Shad White unveiled details of his $2 million study seeking ways to cut state government spending, he said he did not look at Medicaid expansion as a method to save money or grow state revenue.

“I think that (Mississippi Today) calculator is wrong,” White said. “… I don’t think that takes into account how many people are going to be moved off the federal health care exchange where their health care is paid for fully by the federal government and moved onto Medicaid.”

White is not the only Mississippi politician who has expressed concern that if Medicaid expansion were enacted, thousands of people would lose their insurance on the exchange and be forced to enroll in Medicaid for health care coverage.

Mississippi Today’s projections used for the tracker are based on studies conducted by the Institutions of Higher Learning University Research Center. Granted, there are a lot of variables in the study that are inexact. It is impossible to say, for example, how many people will get sick and need health care, thus increasing the cost of Medicaid expansion. But is reasonable that the projections of the University Research Center are in the ballpark of being accurate and close to other studies conducted by health care experts.

White and others are correct that Mississippi Today’s calculator does not take into account money flowing into the state for people covered on the health care exchange. But that money does not go to the state; it goes to insurance companies that, granted, use that money to reimburse Mississippians for providing health care. But at least a portion of the money goes to out-of-state insurance companies as profits.

Both Medicaid expansion and the health care exchange are part of the Affordable Care Act. Under Medicaid expansion people earning up to $20,120 annually can sign up for Medicaid and the federal government will pay the bulk of the cost. Mississippi is one of 10 states that have not opted into Medicaid expansion.

People making more than $14,580 annually can garner private insurance through the health insurance exchanges, and people below certain income levels can receive help from the federal government in paying for that coverage.

During the COVID-19 pandemic, legislation championed and signed into law by President Joe Biden significantly increased the federal subsidies provided to people receiving insurance on the exchange. Those increased subsidies led to many Mississippians — desperate for health care — turning to the exchange for help.

White, state Insurance Commissioner Mike Chaney, Gov. Tate Reeves and others have expressed concern that those people would lose their private health insurance and be forced to sign up for Medicaid if lawmakers vote to expand Medicaid.

They are correct.

But they do not mention that the enhanced benefits authored by the Biden administration are scheduled to expire in December 2025 unless they are reenacted by Congress. The incoming Donald Trump administration has given no indication it will continue the enhanced subsidies.

As a matter of fact, the Trump administration, led by billionaire Elon Musk, is looking for ways to cut federal spending.

Some have speculated that Medicaid expansion also could be on Musk’s chopping block.

That is possible. But remember congressional action is required to continue the enhanced subsidies. On the flip side, congressional action would most likely be required to end or cut Medicaid expansion.

Would the multiple U.S. senators and House members in the red states that have expanded Medicaid vote to end a program that is providing health care to thousands of their constituents?

If Congress does not continue Biden’s enhanced subsidies, the rates for Mississippians on the exchange will increase on average about $500 per year, according to a study by KFF, a national health advocacy nonprofit. If that occurs, it is likely that many of the 280,000 Mississippians on the exchange will drop their coverage.

The result will be that Mississippi’s rate of uninsured — already one of the highest in the nation – will rise further, putting additional pressure on hospitals and other providers who will be treating patients who have no ability to pay.

In the meantime, the Mississippi Today counter that tracks the amount of money Mississippi is losing by not expanding Medicaid keeps ticking up.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

On this day in 1911

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mississippitoday.org – Jerry Mitchell – 2024-12-21 07:00:00

Dec. 21, 1911

A colorized photograph of Josh Gibson, who was playing with the Homestead Grays Credit: Wikipedia

Josh Gibson, the Negro League’s “Home Run King,” was born in Buena Vista, Georgia. 

When the family’s farm suffered, they moved to Pittsburgh, and Gibson tried baseball at age 16. He eventually played for a semi-pro team in Pittsburgh and became known for his towering home runs. 

He was watching the Homestead Grays play on July 25, 1930, when the catcher injured his hand. Team members called for Gibson, sitting in the stands, to join them. He was such a talented catcher that base runners were more reluctant to steal. He hit the baseball so hard and so far (580 feet once at Yankee Stadium) that he became the second-highest paid player in the Negro Leagues behind Satchel Paige, with both of them entering the National Baseball Hame of Fame. 

The Hall estimated that Gibson hit nearly 800 homers in his 17-year career and had a lifetime batting average of .359. Gibson was portrayed in the 1996 TV movie, “Soul of the Game,” by Mykelti Williamson. Blair Underwood played Jackie Robinson, Delroy Lindo portrayed Satchel Paige, and Harvey Williams played “Cat” Mays, the father of the legendary Willie Mays. 

Gibson has now been honored with a statue outside the Washington Nationals’ ballpark.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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