BOBBY HARRISON: Arkansas, Mississippi offer stark contrast on Medicaid



Folks in Arkansas – as a general rule – don’t like Barack Obama much. Arkansans like the Democratic president even less than people in Mississippi do, and it appears to me that most people here dislike the president a whole bunch.

But Arkansas was one of only five states where John Kerry received a higher percentage of the vote while losing the presidential election than Obama received in 2008 while capturing the presidency with the largest vote total in the nation’s history.

In Arkansas, Obama garnered 38.8 percent of the vote in 2008 compared to 42.8 percent in Mississippi. In 2012, the gap was a little wider – 36.9 percent in Arkansas to 43.8 percent in Mississippi.

Yet Arkansas, with Republican majorities in both its House and Senate, is participating in Obamacare – officially known as the Patient Protection and Affordable Care Act.

To be precise, Arkansas is participating in the expansion of Medicaid that allows people and families earning up to 138 percent of the federal poverty level, or about $15,000 for an individual, to be covered by Medicaid.

In lieu of doing a straight Medicaid expansion as is allowed under the Affordable Care Act, the Obama administration is allowing Arkansas to provide private health insurance coverage to the people who would have been eligible to be covered by Medicaid expansion.

The federal government still pays for the coverage just as it does for a straight Medicaid expansion.

Arkansas is one of the few so-called Red states that normally vote Republican in presidential elections to participate in the Medicaid expansion, though it should be pointed out more Republican-leaning states are jumping on the Affordable Care Act-Medicaid expansion bandwagon, including Arizona, Kentucky and possibly others.

While a Red state, Arkansas Gov. Mike Beebe is a Democrat and well-respected as a problem-solver. Plus, much of the Arkansas business community, seeing the benefits of a healthier work force, got behind the expansion.

In Mississippi, Republican Gov. Phi Bryant has led the charge against the Affordable Care Act and the business community has been lukewarm or opposed to the expansion.

What is even more amazing about the Arkansas story is that it takes a three-fourths vote of the Arkansas Legislature to spend money. In other words, three-fourths of the Republican-dominated Arkansas House and Senate had to agree to the expansion.

There is no issue requiring a three-fourths majority to pass the Mississippi Legislature. It takes only a two-thirds majority to override a gubernatorial veto and a simple majority to spend funds. It does take a three-fifths majority of the Mississippi Legislature to raise or lower taxes.

Earlier this week, an amendment was offered in the state Senate to a Medicaid bill to opt Mississippi into the expansion. It was defeated in a straight party-line vote with all 32 no votes being Republicans and all 19 yes votes being Democrats.

Both Arkansas and Mississippi are similar in that both states have lots of poor and unhealthy people who as a general rule are less educated.

People in Arkansas often say, “Thank God for Mississippi because it keeps up from being last” while people in Mississippi have often said the said the same of Arkansans.

Time will tell whether the divergent paths the two neighboring and socioeconomically challenged states took on Medicaid expansion will render that familiar refrain of thank God for Arkansas or thank God for Mississippi outdated.

Bobby Harrison is Capitol Bureau chief in Jackson for the Daily Journal. Contact him at or (601) 353-3119.