With state elections coming up, one of the hottest issues is expansion of Medicaid. When Congress passed the Affordable Care Act nine years ago, it included the expansion of Medicaid to cover families and individuals making 138 percent of the poverty level.
Congress agreed to pay states for 100 percent of the expansion. Two-thirds of the states quickly jumped on the opportunity.
Seventeen states, all conservative, most in the South, declined the expansion after the U.S. Supreme Court ruled that the feds couldn’t force states to expand the program.
Mississippi did not expand. Our conservative leadership cited two main reasons: First, it was part of Obamacare. Second, they believed the feds would end up forcing the states to foot more of the bill, which would bust the state budget.
Both of these arguments were somewhat questionable. First, although the expansion of Medicaid was passed at the same time as Obamacare, it is a separate program, one which has a 55-year history. Second, after nine years, the feds are still paying almost all the cost of the expansion.
As a result, Mississippi has passed up about $10 billion in federal money over the past decade. This federal money would have given up to 300,000 working, low income Mississippi families health care coverage.
Of the current major candidates for governor and lieutenant governor, only Tate Reeves is dead set against expansion. And boy is he dead set. When asked his reasons for not expanding Medicaid, Reeves simply repeated this line three times in a row: “I am opposed to Obamacare expansion in Mississippi.”
I believe turning down this money is hurting our state. I’m conservative, but if the feds want to pour money into our state, so be it.
Mississippi is a poor state for two main reasons: We lack a major urban area, and we are still suffering from the vestiges of slavery, including the devastation of the Civil War.
As a result, our state has traditionally been a big beneficiary of federal dollars, getting two and three dollars back from every dollar we pay in federal taxes. It’s a good deal.
When the Democrats were in power, we took every advantage of federal largesse. But since the Republicans took over, we turn up our noses at this money, because Republicans don’t like welfare, even when it is beneficial to our state.
This could be one reason our state quit growing for the first time in 50 years. States that haven’t expanded Medicaid have much lower levels of job growth. In rural areas, hospitals that were once the biggest employers in their communities are now going bankrupt and closing. Experts have identified the cause: Failure to expand Medicaid.
The Brookings Institute, one of the largest and oldest think tanks in the country, recently did a report titled “Do States Regret Expanding Medicaid?” Their conclusion: No.
The study found that states did not encounter increased costs. Instead, Medicaid expansion caused the feds to pay for many services formerly paid for by the states. The study concludes: “The strong balance of objective evidence indicates that actual costs to states so far from expanding Medicaid are negligible or minor, and that states across the political spectrum do not regret their decisions to expand Medicaid.”
Wyatt Emmerich is president of Emmerich Newspapers. Reach him at wyatt@northsidesun.com.
