BILL CRAWFORD: Health care for working poor a challenge

By Bill Crawford

Politicians like to fix things … or promise they will. But, history doesn’t give them high scores for implementing real fixes.
Most things politicians want to fix – deep-rooted social, economic, and educational problems – can’t be readily fixed. Ron Heifetz, distinguished author of “Leadership Without Easy Answers,” calls these adaptive challenges – perplexing problems without easy answers.
He says adaptive challenges require asking hard questions, finding committed leaders and stakeholders, and getting people to adapt their beliefs, values, and/or behaviors in order to achieve solutions.
This challenging, frustrating process is unappealing in today’s quick-fix society.
A timely example of an adaptive challenge facing Mississippi is health care for the working poor…not moochers, but hard-working people who can’t afford health insurance. Remember, Republicans made getting people off welfare and into work a national priority. Without health care, though, working poor are more likely to turn back to welfare.
Against this as background, consider the following:
Mississippi has the highest poverty rate and the lowest per capita income in the nation.
Only about 50 percent of Mississippi’s workers are covered by employer health plans, down from 60 percent in 2000. Lower wage workers tend to be those without employer coverage.
Mississippi’s Medicaid program does not cover the working poor unless they have children … and, then, only minimally. Workers with children with income below 43 percent of the federal poverty level are eligible. For a family with one child the income limit is $4,836; with three children $8,160. For reference, one person working full-time at minimum wage earns $15,080.
This topic is timely because Obamacare is offering states additional funds to expand Medicaid. This would expand coverage to the working poor including those with children. Coverage would include those with incomes up to 133 percent of the federal poverty level … families with one child with income up to $13,579; with three children up to $22,836.
A just released study by IHL’s University Research Center says the Medicaid expansion likely would have an annual net cost to the state budget of $31 million by 2018 and $96 million by 2025.
Meanwhile, Mississippi hospitals bear the brunt of uninsured workers’ health costs. Uncompensated care totaling $525 million was provided by 116 Mississippi hospitals in 2011, $325 million unreimbursed by any federal or state program. In 2014 Obamacare begins reducing the limited reimbursements the state does get.
An unhealthy workforce is unproductive, unattractive to industry, and harmful to the state’s economy.
But, hospitals don’t want a heavier uncompensated care burden, many businesses don’t want to provide workers coverage, and Republicans don’t want to pay to expand Medicaid.
At least Republican Insurance Commissioner Mike Chaney pursues a partial solution. His competitive insurance exchange should make coverage more affordable to businesses willing to offer it.
Any others willing to adapt to fix this challenge?
Bill Crawford ( is a syndicated columnist from Meridian.

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