Medicaid bills introduced
After years of resistance, Republican leaders in the Mississippi Legislature are seriously considering expanding Medicaid — or “providing health insurance for working people,” as Lt. Gov Delbert Hosemann put it in an effort to downplay discussion of an Obamacare program.
Both the House and Senate have introduced bills to expand Medicaid, and this week the House Medicaid Committee held a hearing in which supporters of expansion discussed the potential benefits of joining 40 other states that have done so. Hosemann is focused on increasing the number of working adults in the state, and he says to do that, we need more healthy people.
These are big steps for Republicans, and they deserve praise for finally being willing to consider the idea that $1 billion per year in federal health care money actually might help Mississippi. Apparently it’s amazing how much things can change when a speaker of the House who’s opposed to Medicaid expansion retires.
But this is February. It’s still early in the legislative session, and a lot of things have to go right before Mississippi extends health care to the working poor who earn too much money to qualify for regular Medicaid. So here’s a primer on the sausage-making process of legislating.
For starters, the House bill first has to be approved by a committee, and then by the full House. Same thing on the Senate side. Since Republicans have more than 2-to-1 majorities in both chambers, that means a significant number of Republicans have to reject years of opposition to Medicaid expansion.
If that happens, there are certain to be differences between the House and Senate bills. So a conference committee of three lawmakers from each chamber will meet to iron out differences. If they can do that, both chambers must then approve the conference bill.
With House and Senate approval, the next step would be up to Gov. Tate Reeves. He has been an ardent opponent of Medicaid expansion, and he hasn’t changed his mind. The governor went on social media to criticize Republicans for considering the program, and added a screenshot from Donald Trump that said, “Obamacare Sucks!” This is understandable: The GOP counter-proposal might be better — if one had ever been offered.
It’s easy to forecast a Reeves veto for any Medicaid expansion bill. Of course, the Legislature could give Medicaid a better chance by attaching it to legislation providing hundreds of millions of dollars for economic development projects east of Interstate 55. But that’s a conspiracy theory for another day.
At any rate, if the governor vetoes Medicaid expansion, the House and Senate would need two-thirds of each chamber to override him and turn the bill into law. Would enough Republicans really oppose the governor? It remains difficult to envision until it actually happens.
Medicaid expansion does have a few things going for it. Politically, this is the first year of a four-year term — the perfect time to make a risky decision, because elections are three years away. It’s like 2020, when the Legislature changed the state flag in the first year of that term.
There also are economic benefits. Data at the House committee hearing, based on a 2021 study, said 210,000 people would be able to enroll in the Mississippi program, and 95% of them would have been without health insurance. Public-owned hospitals would see a 60% reduction in unpaid medical care costs (if a hospital currently provides $1 million worth of care for which it does not get paid, that amount would be reduced to $400,000).
The study says expansion would circulate an extra $1.2 billion through the state economy and create 11,000 jobs. But any extra cash or extra jobs are not reasons to expand Medicaid.
It’s better to look at it this way: We are doing a decent job of attracting more out-of-state investment. Companies are more willing to consider Mississippi. But we still need a better-educated and better-trained work force, and giving more workers access to medical care is a bridge to the day when Mississippi is moving upward, no longer ranked 50th in everything and generates more jobs that offer private insurance.
That’s a ways off. The first step is to see what the Legislature does in the coming weeks.
Jack Ryan
Enterprise-Journal
