Delbert Hosemann reported this past week no symptoms after being diagnosed with COVID-19 for the second time.
Is he sure of that?
It sounded as if the Republican lieutenant governor might have been experiencing a bit of brain fog when he said it was a “lazy question” when a Capitol reporter asked him about the possibility of Medicaid expansion during the 2022 session of the Mississippi Legislature.
“What you need to be thinking about is how are we going to cover people who are working in Mississippi who have catastrophic illnesses? That is the real question,” he said to the assembled press.
Sorry, Delbert, but it’s hard to see the difference.
The way — in fact the only way — that Mississippi is going to be able to afford to cover the uninsured working poor is through Medicaid expansion, as 38 other states and the District of Columbia have done.
To be fair to the lieutenant governor, he is the only one in the trifecta of state Republican leaders who has expressed an open mind to Medicaid expansion, although the term has come to have the same effect on him as a sour pickle.
Gov. Tate Reeves and Speaker of the House Philip Gunn have been consistently stubborn in saying they would not consider Medicaid expansion, no matter what.
The two of them follow the conservative GOP line that since Medicaid expansion was a Democratic initiative enacted during the presidency of Barack Obama, it has to be rejected, regardless of what the numbers show.
There have indeed been plenty of numbers — both from government and private economists — that consistently show Medicaid expansion should be a slam dunk for anyone in Mississippi open to reason and not motivated by purely political calculations.
Over and over again, when the numbers have been crunched, they come back showing that Medicaid expansion in Mississippi would pay for itself and then some.
Typical of the results was the economic analysis released recently by Manatt Health, a national consulting firm.
Its researchers concluded that if Mississippi were to expand Medicaid, it would cost the state in direct outlays — its 10% share of claims plus administrative costs — about $950 million over five years to provide coverage to some 230,000 adults. During that same time, the state would see an almost $1.2 billion reduction in what it is presently spending on Medicaid.
In other words, the state would save $200 million — or $40 million a year — by expanding Medicaid as opposed to not expanding. The surplus would be enough to cover the entire state’s cost for a sixth year.
Admittedly, the largest part of the projected savings — about $750 million — is a two-year bonus provided by the American Rescue Plan, the coronavirus relief package enacted by Congress last year, as an additional incentive for recalcitrant states such as Mississippi to get on board. That carrot goes away.
By the same token, though, the Manatt’s analysis is conservative on the projected financial benefits from expansion. It makes no allowance for the revenues coming into the state in sales and income taxes from the thousands of well-paying health-care jobs that would be created by the infusion of about an extra $1 billion a year in federal Medicaid funding sent to Mississippi. When those new revenues are also considered, Medicaid expansion would pay for itself for at least seven years, while also helping to shore up Mississippi’s financially struggling rural hospitals.
This state has seen a handful of hospitals close in recent years, and several others are on the brink. One of their major handicaps is the amount of uncompensated care they provide. Addressing that deficit is not the sole answer, but it’s a partial one. The Greenwood Leflore Hospital administration estimates, for example, that Medicaid expansion would cut its losses by about 10%.
When the public is educated about these facts — Mississippi being an outlier in not expanding, the state missing out on a huge infusion of federal dollars and the economic expansion that comes with it — support for Medicaid expansion rises.
An AARP poll released this week that posed the questions in just that way found that almost 70% of Mississippi voters 50 years of age and older are in favor of extending coverage to the working poor. Even among Republicans, more than 8 in 10 don’t think the state should reject the additional incentive that the American Rescue Plan offers for signing on, the survey found.
That should give Hosemann some political comfort in continuing to nudge the Legislature toward Medicaid expansion — even if he believes it needs to be called by some other name to get it passed.
- Contact Tim Kalich at 662-581-7243 or tkalich@gwcommonwealth.com.
