- - Monday, October 1, 2012

When the Supreme Court ruled on the Obama administration’s health care reform law a few months ago, the court upheld the right of the states to decline Medicaid expansion.

States throughout the nation are now looking at the enormous and growing percentage of their budgets already consumed by Medicaid expenses, and many simply cannot fathom shouldering the additional burden of even more Medicaid spending. Mississippi is certainly among those states opposed to expanding the program.

Beyond differences in philosophies on the role of government, beyond Obamacare’s superficial approach to righting the issues in America’s health care system and beyond this law’s inability to put Americans to work in jobs with decent wages and health care benefits, one fact is certain: Government programs come with a price.

People tend to forget that government has no dollar that it has not gained through taxation or borrowing. Even the Obama administration cannot pay for its massive health care law without raiding funding from other programs and levying taxes against the American people. After all, the bills for these expansions will come due, and the money has to come from somewhere.

Mississippi, too, must decide where it would get the money to pay for more and more Medicaid. Do we drain money from public safety and education? Do we tax money out of private revenues and family checking accounts? As governor, I say we reject the expansion and find a better solution.

During fiscal 2012, the Mississippi Division of Medicaid — just one of several state agencies responsible for paying Medicaid costs — required $3.62 billion in federal funds and $763 million in state funds to directly administer the Medicaid program, with a conservative total operating cost of more than $4.38 billion as of the Supreme Court ruling. This is without assuming the bill for Medicaid expansion that the Obama administration is attempting to lull taxpayers into accepting.

In fiscal 2012, Mississippi spent more than seven times as much money on the existing Medicaid program as we did on economic development and most of our state public safety efforts combined.

Furthermore, Medicaid spending is requiring an ever-increasing portion of resources while spending gaps in education continue to grow.

As governor, I cannot imagine directing money away from our children’s education, our ability to keep our citizens safe and our ability to provide for ourselves through job creation in favor of funneling more money into a program that addresses none of these other critical needs.

Building a budget from the dollars entrusted to Mississippi by its taxpayers requires choices, and a Medicaid expansion clearly does not present good options for our state.

According to a Milliman report requested by the Mississippi Division of Medicaid, an estimated 400,000 people could be added to the Mississippi Medicaid rolls if we accepted the Obamacare expansion. Such an expansion could result in 1 in 3 Mississippians being on Medicaid and would balloon the state’s associated cost burden.

Our budget then would show additional costs of more than $1.6 billion over seven years, including an estimated $427 million in 2020 alone. This is all on top of what we already spend on the current Medicaid program in our state.

I would personally rather see those 1 in 3 earn health care coverage through good-paying jobs in Mississippi’s energy sector or our cutting-edge, advanced manufacturing operations.

Nonetheless, such cost increases would obliterate Mississippi’s budget and force us into the position of choosing which other services to kill or maim in favor of funding Medicaid.

Tack on the additional $81 million that the state would have to pay in the first three years of the expansion just to cover the increased administrative costs, and the situation becomes even more grim.

There is no doubt that quality health care is of utmost importance, but signing on for an enormous, expensive Medicaid expansion will not serve Mississippi well.

How much better off are we really if 1 in 3 can charge health care expenses to Medicaid but we cannot afford to fund our schools or make the infrastructure improvements that attract businesses and jobs?

Mississippi deserves more, and there are real solutions to improving health care without sacrificing our other core needs.

To start, each of us must assume personal responsibility for our own health and our own choices. Living a healthy lifestyle that includes regular exercise and a proper diet can help shrink Mississippi’s obesity rate and the chronic diseases such as diabetes that accompany it. Hazardous activities such as smoking erode our health, and as governor, I am leading the fight to end the multiconsequential epidemic of teen pregnancy in Mississippi.

At the core is job creation. We must continue working, as we did during the 2012 legislative session, to create an environment where businesses flourish so Mississippians can secure sound employment and fund their own health insurance.

Mississippi can and will do better. As governor, I will fight to protect our future — our education, our safety and our jobs — and that means that I will resist any effort to expand Medicaid in this state.

Gov. Phil Bryant is a Mississippi Republican.

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