Some but not all legislators attended Monday's hearing in the Capitol to hear the conference's own experts try to help lawmakers and others unravel what are undeniably complex changes in how millions of Americans will have or gain health insurance coverage - the same kind of complexity most people see in health insurance coverage as it exists now.
Mississippi's state government should have a focused and open-minded interest in the law's provisions because our state has an inordinate number of low-income citizens who will become Medicaid eligible, beginning in 2014.
The national conference's health care policy director, Joy Johnson Wilson, told the public forum that 400,000 Mississippians could be added to Medicaid rolls because their income will be below 133 percent of the federal poverty level - $14,400 for an individual. However, she stressed that the federal government will cover 100 percent of the cost of insuring the newly eligible enrollees for three years, and then level off its matching portion of the cost for new enrollees at 90 percent, higher than the current, enhanced rate of 84 percent. The federal match is expected to return to approximately 76 percent when enhanced matching funding expires.
Most of the response to the mandate has been politicized and characterized by strong objections about increased costs to the state, and that certainly should be thoroughly analyzed with the same kind of independent scrutiny offered by the national conference.
On the other hand, the thousands of new Medicaid clients will be insured, assuring payment for health care, mostly delivered by the private sector.
The larger issue is the disturbing fact that a third of Mississippi's population would qualify for the new Medicaid coverage, a stark commentary on the undereducated, underemployed people whose health care costs push higher because they don't seek preventive care and see no incentive in taking better care of themselves.
In that context health care also becomes a question of political leadership and success in achieving higher educational attainment and economic development.
Public and personal health liabilities often are mired together in poverty, which links directly to lack of educational attainment, which circles back to poverty and poor health. Mississippi is the case study for that.
The national heath care reforms may fall short of political promises - just like the flawed and failed political promises and leadership that remain part of Mississippi's problems.