Fact Check:
Barbour Medicaid claim off base

[April 15, 2011]  JACKSON, Miss. (AP) -- Gov. Haley Barbour, a potential 2012 Republican presidential candidate, played fast and loose with his state's Medicaid enrollment numbers this week as he spoke in Washington and chatted up voters in the early primary state of New Hampshire.

"Our rolls dropped from 750,000 to 580,000 in the first couple of years," Barbour said Tuesday on Capitol Hill, referring to Medicaid enrollment trends after he took office in January 2004. That would be a 22.7 percent decline.

The problem is, Barbour's numbers are misleading, according to statistics provided by his own administration.

The Mississippi Governor's Office Division of Medicaid had a different way of counting Medicaid enrollment under Barbour's predecessor, Democrat Ronnie Musgrove. The program changed its counting method in 2006, about midway through Barbour's first term.

Barbour's numbers come close to working only if he uses a beginning figure from the old counting method and an end figure from the new method -- an apples-to-oranges comparison.

Mississippi Medicaid spokesman Francis Rullan said Thursday the old and new methods of counting enrollment can't be compared or mixed and matched.

Under the old method, some Medicaid recipients were counted more than once in a single reporting period. If a person dropped off the Medicaid rolls, for whatever reason, and re-enrolled during the same month, that counted as two enrollments rather than one.

The new counting method, adopted by the Barbour administration, eliminates the duplicate statistics for enrollment. So a person who drops off the rolls and signs back up in the same month counts as one enrollment rather than two.

Using the old method of counting, Rullan said Mississippi's average monthly Medicaid enrollment during fiscal 2004 was 768,004. Barbour took office midway through that year. Applying the old method to today's numbers, the March 2011 enrollment was 741,000, Rullan said. That's a drop of 27,004, or 3.5 percent, in Medicaid enrollment since Barbour took office.

Using the new method of counting, Rullan said Mississippi's Medicaid enrollment in January 2004, when Barbour took office, was 574,852. After fluctuating up, down and then back up, enrollment hit 633,543 in January 2011. That's an increase of 58,691, or 10.2 percent, during Barbour's first seven years in office.

Rullan, who has worked for Medicaid since the Musgrove administration, said he doesn't know why the program changed its method of counting enrollment under Barbour.

"Why do they have different ways of looking at it? I don't know," Rullan told The Associated Press on Thursday. "All I know is that they do and they have."

Barbour spokeswoman Laura Hipp did not say Thursday where the governor got the numbers he has been citing.

"Medicaid reforms under Gov. Barbour have had a significant impact on the cost of the program while ensuring that those who are eligible for Medicaid receive it regardless of which counting method you use," Hipp said.

Soon after Barbour became governor, he persuaded legislators to change Medicaid's re-enrollment procedures, and he said the change helps keep ineligible people off the rolls. Rather than handling annual re-enrollment by mail, Medicaid recipients are required to go to a local or regional office to sign up again in person.

Critics say this "face-to-face" re-enrollment creates hardships for poor people in rural areas who might not have ready access to transportation.

Barbour said the re-enrollment process is reasonable and makes exceptions for patients who are homebound or in nursing homes. In New Hampshire on Thursday, he defended the face-to-face re-enrollment.

"It's not too much to ask for someone to drive to the county seat and say, 'I exist. Here are my children, here are their birth certificates, they live with me,'" Barbour said over breakfast at a restaurant in Manchester.

The Mississippi Division of Medicaid is part of the governor's office, and each governor appoints the executive director. The position generally changes when a new governor takes office.

[Associated Press; By EMILY WAGSTER PETTUS]

Associated Press writers Ken Thomas in Washington and Holly Ramer in Manchester, N.H., contributed to this report.

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