Citing anonymous sources in the state health care industry, Mississippi Today reported recently that Gov. Phil Bryant, a longtime opponent of Medicaid expansion, is now exploring the possibility. It’s based on an Indiana program started in 2015 by then-governor and now-Vice President Mike Pence. Called “Healthy Indiana,” it was made politically palatable to conservatives by avoiding mentioning “Medicaid expansion” whenever possible and including a work requirement, where beneficiaries must either work, go to school or volunteer for 20 hours a week to be eligible, with exceptions.
Such a plan might work in Mississippi, which is one of 14 states holding out on expanding the health insurance plan for the working poor.
But it’s unclear yet how serious the state’s leadership is about the idea. Anonymous sources can be suspect, and the governor’s spokesman downplayed Bryant’s interest. Also, others parts of Obamacare are being dismantled, leaving the future of any part of it in question, and the Legislature would seem loathe to take up something that controversial during an election year in 2019. However, the Mississippi Today report said the governor might be able to do it through executive order, and the political cost of not acting might be greater if Democrats like Attorney General Jim Hood, who is running for governor, pound Republicans about an issue that has growing popular support.
That’s in part because five hospitals have closed in Mississippi since 2010 and four have declared bankruptcy in the past four months, according to Mississippi Today. The expansion needs to be done before more rural hospitals, which are so vital both in terms of health care and good-paying jobs in small communities, close their doors. Before Obamacare, they received much more in federal payments to compensate for treating indigent patients. That was fair because the government requires hospitals to give care even when they know the patient will never be able to pay for it.
Yet the Affordable Care Act significantly reduced those payments in exchange for expanding Medicaid. The idea was the working poor would have health insurance through the program and, thus, hospitals would not have to treat them for free.
But Mississippi and other states like it undermined the plan by refusing to expand Medicaid. The official argument was that the state couldn’t afford to give its 10 percent match required to get the estimated $1 billion annually from the federal government and that it couldn’t rely on the feds to continue to fund their obligation in the future, possibly leaving the state responsible for the full program once people became accustomed to receiving it.
In truth, there was always only one real reason Republican politicians opposed Medicaid expansion: to score political points with conservatives by blindly fighting anything associated with Obamacare and its namesake.
That’s been proven by the fact that now that the former president has faded from the scene, multiple Republican-dominated states have expanded Medicaid or are considering it. Idaho, Utah, Maine, Nebraska and Virginia have already recently decided to take the jump. Mississippi would be late to the party, but the idea would still make sense for improving health care and sparking the economy.
— Charlie Smith
