JACKSON • Even as the COVID-19 pandemic continues to shine a harsh light on state’s long-standing health disparities, the prospects appear dim for any expansion of Medicaid access to the state’s working poor.
Both Gov. Tate Reeves and Speaker of the House Philip Gunn oppose expansion of the Medicaid program, but Lt. Gov. Delbert Hosemann continues to voice a willingness to consider some version of the idea.
Reeves, Gunn and Hosemann are all Republicans.
In a recent editorial board interview with the Daily Journal, Hosemann said he has looked at how Arkansas expanded Medicaid by using a modified version of the Affordable Care Act provisions.
However, Hosemann was frank that the politics of the issue present a steep climb in the Legislature.
“There’s some built-in resistance to anything that starts with an O,” Hosemann said, referring to the “Obamacare” nickname often used as a shorthand for the ACA.
But Hosemann has also suggested that a Northeast Mississippi lawmaker, Sen. Hob Bryan, D-Amory, holds sway in the process.
Bryan chairs the Senate Public Health and Welfare Committee. In a press briefing earlier this month, Hosemann indicated that he’s given Bryan wide discretion regarding policy proposals, and then suggested that some version of Medicaid expansion might surface either this year or next.
“I want to leave that up to Sen. Bryan,” Hosemann told reporters. “I want to leave him a clean slate.”
However, even though he supports the idea of expansion, Bryan is pessimistic about its outlook in the Legislature and indicated no plan to seriously pursue the idea through his committee.
“I don’t know what comments the lieutenant governor made,” Bryan said when asked about Medicaid expansion. “Maybe I should ask him.”
Bryan said that unless more support from high-ranking leadership, any Medicaid expansion bill is dead on arrival.
Even so, Bryan was unsparing in his criticism of the failure to expand Medicaid, calling it the “biggest policy failure” that he’s dealt with during his tenure in the state’s upper legislative body.
“It’s just out of spite or some sort of ideology or some sort of personal animosity toward President Obama that there is a refusal to allow the United States government to provide care for people who are suffering,” Bryan said.
States have the option to expand Medicaid under the Affordable Care Act, which was signed into law by President Barack Obama in 2010. The federal government would pay 90% of the total costs, and Mississippi would have to pay a 10% match, even though medical groups have previously offered to pay the state’s match.
According to Kaiser Health News, 38 states and the District of Columbia have expanded Medicaid to some degree. Mississippi is one of 12 states that have not expanded Medicaid access to citizens.
Studies estimate that if the state expanded Medicaid to more people, roughly 170,000 low-income Mississippians could receive access to health insurance.
Despite the low chance for legislative success, the Democratic leader of the Mississippi Senate has filed a bill that would expand Medicaid access to more citizens. The proposal has been endorsed by the Mississippi Legislative Black Caucus.
Senate Minority Leader Derrick Simmons, D-Greenville, told the Daily Journal he believes the state is losing money each year by not expanding Medicaid.
“It’s something that we really, really care about in light of the pandemic that we need to recover from,” Simmons said. “There is no better time than now in the state of Mississippi for us to expand access to health care and coverage.”
The three-term lawmaker acknowledged expanding Medicaid would be a tough battle to win.
“You can’t do anything in this body without the support of our legislative leaders,” Simmons said.
The Mississippi Legislative Black Caucus has endorsed expanding Medicaid, pointing to the heavy toll of COVID-19 on Black communities.
“We know that minority communities were hit extremely hard (by COVID-19), and with the expansion of Medicaid, we believe that will help those individuals receive the medical care that they need to stand up and fight the virus,” state Sen. Angela Turner-Ford, D-West Point, said.
Voters in Oklahoma and Missouri last year expanded Medicaid through a ballot initiative, which amended the state’s Constitution.
Simmons said that he would be skeptical of putting the issue to a ballot initiative because, if approved, lawmakers would be constrained on how they could review and amend the proposal.
“When things are in the Constitution, they are harder to change, because of course it requires a two-thirds vote of both chambers,” Simmons said. “It’s my hope we don’t fail to act and cause the citizens of the state to do something that we should do.”