BOBBY HARRISON: Mississippi was reluctant on Medicaid from the start

By Bobby Harrison/NEMS Daily Journal

It’s an old, oft repeated story, but it is worth retelling because of its similarities with what is going on now in the Mississippi Legislature.
The reluctance of Mississippi politicians to opt into a federal health care program, as is occurring now, is not new to this state.
Flashback to the 1960s when the original Medicaid program was created by Congress. At that time, Mississippi, which opted into the program in 1970, was one of the last states to agree to participate in the state-federal health care program, which many called socialism at the time.
Flash ahead to the 2013 session of the Mississippi Legislature. There currently is an intense debate ongoing on whether the state should participate in a federal expansion of Medicaid that would provide health care coverage to those making up to 138 percent of the federal poverty level – or about $15,000 annually for an individual or about $34,000 for a family of four.
Republican Gov. Phil Bryant is adamant the state cannot afford the expansion even though the federal government will pay the bulk of the costs. Plus, he said he does not believe it is the role of government to provide health insurance.
In the 1960s, John Bell Williams was a Democratic congressman from Mississippi who voted against the original Medicaid program and supported Republican Barry Goldwater for president. Because of that, U.S. House Democrats stripped Williams of his seniority.
He came home in 1967 to run for governor. He campaigned against the national Democrats.
Yet he hired the future U.S. Rep. David Bowen, and Dr. Alton Cobb, then a state Health Department physician, to look at the federal programs that could impact the state.
Hearings were held throughout the state on the issue of Medicaid. Cobb, who later became state health officer, and Bowen said Williams attended every one of those hearings.
At their conclusion, he called a special session in 1969 where he urged state legislators to pass a bill so that Mississippi could participate in the Medicaid program.The special session started on July 22 and ran until Oct. 11. Hurricane Camille ravaged the Gulf Coast during the middle of the special session.
At the opening of the session, speaking to a joint session, Williams said, “Let us not delude ourselves into the false notion that we can – or will – evade the burden of caring for these unfortunate people. Our society, through the instrument of government, has always shouldered this responsibility, and I am sure it always will.”
Williams added the state could not afford to turn down a federal health care program that would require the state to provide only 20 percent of the matching funds. He spoke of the economic impact it would have on the state.
“The simple fact is that someone pays for health services, and we must decide, who will do it and how,” he said.
It should be noted that the most the state will ever have to pay for those covered by the expansion is 10 percent. For the first three years, starting in 2014, the federal government pays all of the costs.
This time around there have not been meetings across the state by the state’s political leadership to garner input from the public about the issue.
Last week a Senate Public Health Subcommittee heard testimony from the working poor who could be covered by the expansion. Experts say a vast majority of the about 300,000 people who could be covered by the expansion are the working poor. The largest group of those – perhaps 15,000 – would be cashiers from grocery stores and convenience stores.
Bryant had a representative at the hearing, but he did not attend. It will be interesting to see if he attends a hearing on the issue slated for next month by the House Medicaid Committee.
In the 1960s, Mississippi was one of the last states to join the Medicaid program, which now covers about 640,000 elderly, disabled, poor pregnant women and poor children.
This time around it appears Mississippi will be one of the last states to opt into Medicaid expansion, or perhaps one of the few who say thanks, but we do not want that federal money.
Bobby Harrison is Capitol Bureau reporter for the Daily Journal in Jackson. Contact him at (601) 353-3119 or bobby.harrison@journalinc.com.