| While many states have embraced new health care | | | | The state government has changed several insurance |
| policies, Mississippi, however, is one of the states that | | | | regulations in the states, which include the limits on |
| have been left behind due to socioeconomic problems. | | | | pre-existing condition exclusions and portability of |
| Poverty affects Mississippi's economic and health | | | | insurance. This led to the changes in the Health |
| policies mainly because private and public payers were | | | | Insurance Portability and Accountability Act of 1996. |
| less involved or concerned in reducing the health care | | | | The state pursued a high-risk insurance pool to about |
| spending, and believed that the state has insufficient | | | | 1,500 people with serious health conditions, who were |
| budget for health and long term care services. | | | | not eligible for any health insurance. The risk pool was |
| In fact, Mississippi was voted the worst state in terms | | | | funded by the insurance companies and member |
| of health care system in 1999. Mississippians have poor | | | | premiums. |
| health status compared to residents of other states, | | | | Long Term Care |
| and Mississippi is the 50th state with premature | | | | Mississippi has somewhat stringent policies in terms of |
| mortality rate. Several factors influence these trembling | | | | long term care. The state issued the |
| health concerns such as heart disease, smoking, | | | | "certificate-of-a-need-system" that diminished the |
| cancer, infant mortality, and motor vehicle deaths. | | | | number of nursing home beds and creation of new |
| However, Mississippi prides of having the highest child | | | | home health agencies. The restrictions on nursing |
| immunization rates in the country. The low quality of | | | | home expansion as well as limiting the average stay in |
| health care can be blamed on demographic factors | | | | nursing home facilities resulted to low occupancy rate |
| such as poverty, high unemployment and illiteracy rate. | | | | of 99 percent. Although Mississippi receives the largest |
| From 1994 - 1995, 20 percent of non-elderly | | | | share in Medicaid, the budget that should have been |
| Mississippians were uninsured, which is 4% higher than | | | | used for long-term care was, otherwise, used on |
| the national rate. The high rate of uninsurance in | | | | institutional care. Even though home and |
| Mississippi is caused by low level of | | | | community-based services have flourished within the |
| employer-sponsored insurance. Although Medicaid limits | | | | state, these programs are dominated by Medicare and |
| the number of eligible policyholders, many impoverished | | | | remain unpopular that the institutional care. Half of |
| residents (about 16 percent of the state population) | | | | elderly and disabled Medicaid enrolees in Mississippi |
| participate and rely in Medicaid. | | | | need long term care services. |
| Medicaid Expenditures | | | | Given those underlying health care problems, the |
| Medicaid provides the second largest state budget for | | | | Mississippi government enacted the reform bill in 1997. |
| health care. This budget comes from the federal | | | | The bill carried few changes on the state's financial |
| government and revenue contributed by health care | | | | system, but it did not make necessary reforms for |
| providers. Mississippi has the highest federal Medicaid | | | | Medicaid. Lawmakers became worried that recipients |
| reliance in the country that rose to about 77.2 percent | | | | would lose cash assistance might lose Medicaid |
| in fiscal year 1997. | | | | benefits as well. |
| Mississippi's Medicaid expenditure has been higher the | | | | Meanwhile, the state adopted the long term care |
| national average since 1990s. The large expenditures | | | | partnership program that has been running previously in |
| were triggered by the growth of DSH spending and | | | | other states. The Mississippi Long Term Care |
| higher spending per enrolee. Unfortunately, less | | | | Partnership program contains the same vision of other |
| Medicaid budget is appropriated for long term care | | | | states: to help residents protect their assets against |
| services compared to other services, primarily | | | | the spend down requirements of Medicaid. This |
| because of the restrictions on nursing home and home | | | | program will lessen the burden of getting long term |
| health capacity. With at least 30 percent Medicaid | | | | care insurance in Mississippi. The partnership policies |
| spending that goes on long term care services, the | | | | have the following features: long term care insurance |
| state receives relatively lower than the national rate of | | | | inflation protection, asset protection, and tax deductions. |
| 40 percent. | | | | |