Governor Barbour declared an end to the Medicaid crisis yesterday and announced that he has decided on a plan to bridge the $90 Million Medicaid gap. As a result, the Senate voted 30 to 19 along party lines to adjourn sine die today, and later a frustrated House of Representatives followed suit. This means that the long and expensive special session to resolve the Medicaid “crisis” has ended -- for the time being. Interestingly, the special session ends without the legislature having passed any legislation to address the problem that gave rise to it.

The Mississippi Hospital Association (“MHA”) had previously agreed to the governor’s bed tax plan as a mechanism to fund the Medicaid shortfall, but did so under duress. That plan would have imposed a tax on all hospitals of $167.00 per non-medicaid bed. The Senate passed the original plan by a 41-7 vote over a month ago, but I did not vote in favor of the bill. The governor’s original plan did not make it through the House and hospital support eroded over time. In the time since Barbour’s original plan passed the Senate, a lawsuit filed by the MHA against the governor over his attempt to impose a gross hospital assessment was decided with Judge William Singletary ruling in favor of the hospitals. Judge Singletary’s decision held that Governor Barbour did not have the authority to assess hospitals without legislative approval.

Undaunted, Governor Barbour has now proposed in his new plan to assess hospitals, but under a different statutory provision than his previous attempt. Barbour’s new plan essentially creates a shortfall in the Upper Payment Limits (“UPL”) program which he uses to justify imposing a gross assessment on hospitals in the amount of $375 Million. Put another way, the governor takes money from hospitals and gives it back to them and in doing so creates the illusion that there is a deficit in the UPL program. Under his new plan, because there is a deficit, however illusory, the governor believes he is empowered to assess hospitals to make up the difference. According to Governor Barbour, he has had the authority all along to implement his current plan without legislative approval the Judge’s ruling notwithstanding,. This is despite the fact that the federal agency charged with approving the program, Center for Medicaid Services, has not given final approval and despite the fact that the legislature has no data concerning how individual hospitals will be affected.

Ironically, two House committees passed a compromise bill today to fund Medicaid and the bill was scheduled for floor action tomorrow. The House bill reportedly raised the cigarette tax by $.44 per pack and incorporated the governor’s original bed tax plan to raise the balance of the $90 Million needed. Mississippi Hospital Association representatives testified before the House committees that they did not agree with the logic of Governor Barbour’s new plan and did not support it. In fact, the MHA officials said that they support the approach the House is taking. However, before the bill could be sent over to the Senate, we adjourned.

The hospitals and Barbour may be headed back to Court as it appears from discussions I have been privy to that MHA is of the opinion that the governor’s new plan violates Judge Singletary’s order. It looks like a court will ultimately have to decide the parameters of the governor’s authority as there has been no legislative resolution of the issue. It is likely that we will be called back in yet another special session to resolve the Medicaid problem. This is truly an unfortunate development and wasteful of important and scant resources.

As almost an aside, the Senate passed a bill creating a public health laboratory today with no dissent. In an effort to hold the Senate in town until we could receive the House Medicaid bill, I asked that the laboratory bill be held on a motion to reconsider. This is a common maneuver used to afford extra time to consider legislation and is the right of any Senator. However, because of the vote to adjourn sine die before lunch the laboratory bill died. I have already been blamed for the death of this bill despite the fact that an identical laboratory bill was passed by the House and headed to the Senate. If the Senate had only worked a little longer, we could have passed both the laboratory bill and a compromise Medicaid bill tomorrow. The Senate adjourning sine die killed the laboratory bill as well as any hope of a compromise on Medicaid.