BOBBY HARRISON: Gauging how far government needs to go

By Bobby Harrison/NEMS Daily Journal

The current Medicaid debate leads to the question of how much government is too much government. Answering that question – at least as it relates to Medicaid – has been difficult for Mississippians.
It took a special legislative session that ran from July 22 to Oct. 11 in 1969 for the state to opt into the original federal Medicaid program, being one of the last states in the nation to do so.
Then-Gov. John Bell Williams, who voted against the inception of the Medicaid program when a member of the U.S. Congress, and was elected governor in part by railing against the overreaching power of the federal government, led Mississippi’s efforts in 1969 to opt into the program.
If Mississippi’s current leaders so chose, they could opt out of the existing program now. And like Williams, Mississippi’s current leaders, including Gov. Phil Bryant and Speaker Philip Gunn, are fond of railing against the overreach of the federal government.
Heck, two of Gunn’s key committee chairs – Ways and Means Chairman Jeff Smith, R-Columbus, and Insurance Chairman Gary Chism, R-Columbus – even introduced legislation saying the state did not have to follow federal laws that it did not like even if the U.S. Supreme Court upheld the law in question.
It goes back to that old legal doctrine that apparently has been taught for decades in Mississippi law schools – known as “the rule of law unless we disagree with it” doctrine
But at any rate, I digress.
Both Bryant and Gunn have complained about the overreach of government.
“I do not support the expansion of government in any fashion,” Gunn wrote recently, explaining why he opposes any effort to expand Medicaid to cover those earning up to 138 percent of the federal poverty level, or about $15,000 yearly for an individual and about $32,000 for a family of four.
The current Medicaid program has been caught up in the fight over whether to expand Medicaid, as is allowed under federal law, and runs the risk of dying unless legislators act by July 1.
While Gunn and Bryant, and most other Republicans, complain about the overreach of government, they do not entertain any thoughts of discontinuing the existing program, that covers about 640,000 elderly, disabled, poor pregnant women and poor children. On the other hand they have no inclination to cover the estimated 300,000 primarily working poor Mississippians who would be covered by the expansion.
At one point, Mississippi Republicans used to rail against the existing Medicaid program. Haley Barbour did when he ran successfully for governor in 2003.
But when Barbour pushed through a program that removed about 60,000 elderly Mississippians who had worked at jobs where they had no health insurance from the Medicaid rolls, the backlash was fierce. A year later when Barbour’s Medicaid program faced a whopping $250 million deficit, the Republican governor, who liked to control every aspect of state government, was so timid as it related to Medicaid that he would not propose a solution.
Instead, he urged the Legislature to come up with a fix for the budget shortfall and, when it appeared the program might run out of money because of the Legislature’s inability to reach a solution, he took the unusual step of calling a special session within the session for lawmakers to try to solve the problem.
The Republican governor, after the backlash he endured from trying to remove some people from the Medicaid rolls, decided that he liked some government programs.
Gunn and Bryant are in the same boat. They desperately want to continue the existing program.
By continuing the existing program, Medicaid funds will be available to pay for about 90 percent of the people in nursing homes in Mississippi and for the disabled and for poor children and poor pregnant women.
The disabled include many who have had gut-wrenching debilitating illness for all their lives, but it also includes people who got life-altering injuries and diseases later in life.
Medical testimony tells us many of these people worked – often at jobs in Mississippi where they do not have health insurance. They received no medical attention until they became so sick that they ended up in a hospital emergency room where in many cases it was too late correct the health problem.
At that point, they end up on disability where they no longer work, but they are eligible for Medicaid.
Gunn, Bryant and others support a program to provide health care to those disabled. Thus far they have offered no solution to cover the working poor Mississippians.
At this point and time in our nation’s history, we all support some types of government programs – it is, like the speaker said, a matter of how far we want government to go.
BOBBY HARRISON is the Daily Journal’s Capitol Bureau Chief. Contact him at bobby.harrison@journalinc.com or call (601) 353-3119.