If anyone is looking for further proof of Mississippi’s fiscal irrationality on Medicaid expansion, it comes this week in the form of an emergency grant program the Legislature enacted for the state’s struggling hospitals.
That package, assuming it is signed by Gov. Tate Reeves, will produce an estimated $924,000 for Greenwood Leflore Hospital and almost $104 million for hospitals statewide.
That one-time money will be helpful, but it’s not a game-changer. In the case of Greenwood’s hospital, it will buy roughly an extra month’s time, leaving the nearly broke hospital to squeeze out — most likely with the help of Leflore County taxpayers — at least three more months before the hospital finds out whether it receives a federal designation that could keep it viable for the long term.
Mississippi’s health-care system would have been better served if the Legislature had taken that same $104 million and instead put it toward Medicaid expansion. Rather than $104 million spread over 110 hospitals, it would be more like $1 billion spread among most of the state’s health-care providers — hospitals, clinics, physicians and so on.
Who in their right mind turns down a 9-to-1 guaranteed return on investment? Only Mississippi and nine other states.
While other Republican-dominated states are gradually waking up to how stupid they have been for previously rejecting Medicaid expansion, most of the GOP leadership in Mississippi has continued to willfully wallow in its ignorance on this issue. No matter how many economic studies have shown that expansion will pay for itself, no matter how many incentives the federal government has added to entice expansion, no matter how many polls have shown public opinion shifting in favor of expansion, Gov. Tate Reeves, House Speaker Philip Gunn and presumably a majority of GOP legislators have dug in their heels in opposition.
They lifted their little toes this past session by voting for permanent extension of postpartum care for new mothers to 12 months after their child’s birth, but that’s just a smidgen of what should be done.
A decade ago, when Medicaid expansion under the Affordable Care Act first came into play, Republican opponents of the expansion in Mississippi and North Carolina were parroting each other. They warned that the federal government might reduce its contributions in the future, that the existing Medicaid program was already too expensive, that Medicaid expansion would further reduce people’s incentive to work, even though the expansion was specifically designed to provide insurance coverage to the working poor.
North Carolina shed all that nonsense, though, and this month became the 40th state to sign up for the “Obamacare”-related program. And it did so by overwhelming margins in both of its GOP-dominated chambers — 87 to 24 in the House, 44 to 2 in the Senate.
What flipped the script? In part, it was the rural health care crisis. Nine rural hospitals in North Carolina, 17% of the total, are believed to be at risk of closing because their revenues can’t keep up with their expenses. The situation in Mississippi is more than twice as bad, yet that has not swayed Reeves, Gunn and other GOP opponents.
Granted, it will take more than Medicaid expansion to save the hospital in Greenwood or others that are on the financial brink. But failing to expand is giving them a push over the edge. As reported this week by The New York Times, there appears to be a correlation between hospital failures and a state’s refusal to expand Medicaid. Almost three-fourths of rural hospital closures between 2010 and 2021 were in states that did not quickly accept Medicaid expansion.
Why Mississippi would ignore that connection is beyond comprehension. Just like passing up a 9-to-1 guaranteed return on investment.
