By Bill Minor
Bible-totin’, scripture-quotin’ politicians in Mississippi who wouldn’t be caught outside the church amen pew on Sunday have a problem:
How do they reconcile rejecting some $13 billion in federal money to provide health care coverage for more than 220,000 of Mississippi’s needy citizens with the Bible’s strong message that believers have a duty to help the least of our brethren?
Well, right here in Mississippi we have hundreds of thousands of the least of our brethren. We don’t need to recruit them, they live right alongside us. Now the highest court in the land says it’s up to each state to accept federal funds with a tiny state match under an (almost) universal health care program covering residents with incomes of 138 percent of the poverty level. Every other developed nation has had universal care for years.
Our top three state governmental leaders (all Republicans) said the tiny state tax effort needed to expand the Medicaid program and significantly upgrade health care coverage for thousands Mississippians at the low end of the economic ladder – many who are employed but have no health coverage – will “bankrupt the state.” That’s pure hokum. Fear-mongering of the worst kind.
Injection of billions of federal funds under the Affordable Care Act into the nation’s economically poorest state will exponentially improve the health level of average Mississippians. At the same time, as non-partisan studies by several respected groups have shown, the state would get back far more money than it invests when the state match will reach a maximum of 10 percent in 2020. Notably, the major part of the program doesn’t begin until 2014.
For the first three years the state gets a 100 percent federal match then it gradually reduces the next four years.
Knee-jerk foes of President Barack Obama’s health care reform, as could be expected, fell back on the tired old lament that ACA was just more “welfare state.” They’ve got it terribly wrong. This is not welfare; this is health care. No “welfare queens” will be getting a handout to tool around in a Cadillac.
This is solely to pay for necessary medical and dental care – eyeglasses, dentures, prescription medicines, etc. Rather than wind up in a hospital emergency room for care they can’t pay for (with the tab picked up by the hospital or those of us with insurance.)
Understandably, the state hospital association is a staunch advocate for Medicaid expansion. As their spokesperson said, it can make the difference in keeping the doors of many community hospitals open. They can’t continue eating the cost of uncompensated care.
Before he went out of office, Haley Barbour as putative head of the state Medicaid Division, contracted with a reputable company, Milliman Inc., to study the fiscal impact and state cost of Medicaid expansion under ACA. Their report showed three levels of enrollment – high, medium and low. Milliman conceded the middle number of around 250,000-290,000 would be the most likely enrollment number under Medicaid expansion.
However, Barbour in a letter to legislators last October only emphasized the highest level, with an estimated 10-year state cost of $1.6 billion and an enrollment increase of 400,000. What Barbour – and now Gov. Phil Bryant – also neglect to say is that Mississippi would get back in federal money seven times the amount it puts up, plus creation of thousands of jobs at hospitals, clinics, medical equipment stores, drug stores and pharmaceutical firms.
“Expansion of Medicaid under the Affordable Care Act is equivalent to the biggest economic development I can think of,” said Dr. Alton Cobb, Mississippi’s first Medicaid director when it came under the new program in 1968.
One bright spot in the whole Medicaid expansion picture as far as Mississippi is concerned is state Insurance Commissioner Mike Chaney (himself a Republican) who courageously bucked the current GOP tide and notified Secretary of Health and Human Services Kathleen Sibelius that Mississippi will build a state health insurance exchange under the reform law for citizens to choose a coverage plan that best suits their needs. “This is not a Democratic idea or a Republican idea, this is a free market idea,” he said.
Bill Minor has covered Mississippi politics since 1947. Contact him through Ed Inman at firstname.lastname@example.org.