BILL MINOR: Medicaid is no ‘welfare queen’

By Bill Minor

Contrary to what many Mississippians seem to believe, Medicaid is no “welfare queen” health care plan trumped up by the Obama Administration. Far from it.
Furthermore, it has a 44-year history in Mississippi, launched in 1969 under an unlikely advocate, then-Gov. John Bell Williams. Two years earlier as a congressman, Williams had actually voted against creation of Medicaid under Lyndon Johnson’s “Great Society” program.
Williams was elected governor in 1967 on the Democratic ticket, but ran as a bitter critic of the National Democratic Party because Democrats stripped him of his Congressional seniority for openly supporting Republican Barry Goldwater in the 1964 presidential race. Mississippi went overwhelmingly for Goldwater because of his vote against the Civil Rights Act of 1964, but LBJ won by a landslide nationally.
Rather amazingly, John Bell, despite his earlier anti-LBJ, anti-Great Society stance, converted to a staunch advocate for implementing Medicaid. As he told a legislative joint session, he changed his mind after getting all the facts and finding out its importance to the health of Mississippians, especially the poor with no health insurance.
(Mississippi’s current Republican leaders–Gov. Phil Bryant especially–might well take note from the conversion of solidly conservative John Bell Williams in 1969 from foe to supporter of Medicaid when it was in its infancy.)
Williams convened the special session on July 22, 1969 after a 23-member committee made of legislative, health and lay leaders named by him studied the impact and problems of implementing Medicaid in Mississippi. The committee proposed initially installing at least the minimum compliance program under the new federal-state program, providing coverage for 202,000 needy people compared to the state existing medical vendor program that limited medical care to only 96,000.
Congress, he told lawmakers, would provide five dollars in federal funds for every dollar in state matching funds for the program. Though Williams stressed the economic benefits for Mississippi from Medicaid implementation, he emphasized its moral imperative, declaring it would cover “the poorest of the poor and the destitute…our unfortunate citizens.” Remarkably that’s essentially the same issue the state is facing today in deciding whether to implement expansion of Medicaid under the so-called Obamacare. Back then, Williams also pointed out, state hospitals were facing the same dilemma they do today: uncompensated emergency room care for indigent patients. Williams put the uncompensated health care deficits of hospitals then at $4 million. Today its some $300 million statewide. University Medical Center in Jackson alone is running a $100 million deficit.
How Williams suddenly developed a soft spot to extend medical care to the state’s “poorest of the poor” was indeed quite a switch for perhaps the last Mississippi governor elected by a hard-line racist campaign. I was never very fond of Williams because of his racial views (he even refused to appoint blacks to county draft boards when young African-Americans draftees were being shipped to Vietnam by the dozen) but I considered his Medicaid decision the finest hour of his four-year term.
Behind the scenes, the Medicaid conversion of Williams was in itself a noteworthy marker in Mississippi history. Two men, Dr. Alton Cobb and former Congressman David Bowen deserve much of the credit for convincing Williams.
Cobb, now 85, earned his degree in a public health medicine from Tulane University Medical School before joining Mississippi’s Health Department. He was tabbed to become director of the State Health Advisory Committee created to study Medicaid implementation and became Williams’ go-to man as they toured the state to sell the new program to legislators and the public. Later, when the program was installed in law, Cobb was named the first director of the State Medicaid Commission.
Today, Cobb who is a staunch backer of Medicaid expansion, modestly admits “I believe we did convert him” (to the program). Looking back on the years since, Cobb is proud of what Medicaid has meant to public health in the state over the years, now providing care to 644,000 Mississippians, more than half of them children or over-65 adults. Expansion of the program under the Affordable Care Act, he contends, would add 300,000 what he called “working poor” under 65 not now covered.
Bowen,79, had been Williams’ coordinator of federal-state programs who after a distinguished career in higher education, had coached the governor as to advantages of LBJ’s program to Mississippi. Bowen was later elected to Congress from what was then the state’s 2nd District. Facing redistricting in 1982, he retired from his seat.
Syndicated columnist BILL MINOR has covered Mississippi politics since 1947. Contact him through Ed Inman at edinman@earthlink.net.