Wednesday, April 20, 2022

Sid Salter: Medicaid Expansion Vote Fears Linked to Failure of Ballot Initiative Fix

One of the state’s more mainstream conservative business groups last week unveiled a unanimous resolution endorsing Medicaid expansion in Mississippi – the venerable Delta Council. The resolution, adopted by the group’s Health and Education Committee, was clear and unequivocal in calling on lawmakers to act.

Mississippi is one of 12 remaining states that have not expanded Medicaid despite an increased federal match rate in which the state contributes 10 % to 9% federal funds under the American Rescue Plan Act.


The Delta Council endorsement of Medicaid expansion recognizes and acknowledges the risks inherent in Medicaid expansion – that changing congressional or White House leadership in Washington could change the program including match rates. The agribusiness group representing 19 Delta counties is also fully aware of the partisan opposition from Republicans.


Finally, legislators understand the retail political fear to granting a government service at constituents and then possibly having to take it away if funding changes or collapses.


But the Delta Council leadership also understands the fact that Mississippi taxpayers are already helping pay the freight (since 2010) on an expanded federal Medicaid program that they are not able to see their communities receive full benefits from. The group also recognizes the dire straits of rural Mississippi hospitals – particularly in the state’s Delta region – that are struggling to keep their doors open without the infusion of Medicaid dollars from an expanded program.


The Delta Council endorsement cites a report from the state economist which found that from an economic standpoint, Medicaid expansion would under present perimeters pay for itself without new costs. State Economist Corey Miller in subsequent interviews on the report confirmed that changing program perimeters in the future could change that assessment.


Another factor worth noting in the wake of Delta Council entering the debate is that it strains credulity that the probability of an effective ballot initiative seeking Medicaid expansion was not a key factor – likely an overriding factor – in the Legislature’s inability to reach agreement on a fix for the state’s broken ballot referendum system.


In assessing the status of Medicaid expansion efforts in Mississippi in February, the Kaiser Family Foundation reports: “Although Mississippi’s Secretary of State approved a 2022 Medicaid expansion ballot initiative for circulation in April 2021, on May 19 the organizing committee suspended its campaign following a Mississippi Supreme Court decision ruling that the state’s entire ballot initiative process is inoperable due to procedural errors regarding ballot initiative language in the state’s constitution. While Medicaid expansion was a key issue in the 2019 Mississippi gubernatorial election, current Republican Governor Tate Reeves opposes expansion, making it unlikely that the state will take up expansion through legislation.”


The scuttled ballot initiative was endorsed by the Mississippi Hospital Association and would have enjoyed financial and organizational support that could well have seen the issue succeed with referendum voters on the scale that the medical marijuana issue did.


Likewise, GOP House Speaker Philip Gunn has been a vocal and consistent opponent of Medicaid expansion in the state. Lt. Gov. Delbert Hosemann has been the most open of the state’s leaders on the topic of Medicaid expansion, but the issue languished during the 2022 regular session.


While Louisiana expanded Medicaid in 2010 and Arkansas followed in 2021 under an alternative expansion, most Deep South states have - as Mississippi as – failed to expand the program. Alabama, Florida, Georgia, North Carolina, South Carolina and Tennessee joined Mississippi, Kansas, Texas, South Dakota, Wisconsin and Wyoming as the 12 states declining to expand Medicaid.


The University Research Center at Mississippi Institutions of Higher Learning offered this economic analysis in their 2021 report: “We determine Medicaid expansion in Mississippi will positively impact state revenues and the overall economy. Between 2022 and 2027 we estimate the most the state will receive in additional annual revenues as a result of Medicaid expansion is around $44 million in a given year, a relatively modest increase. The largest portion of these additional revenues will come from the increase in individual income tax revenues.


“We estimate Medicaid expansion will increase the state’s real GDP each year from 2022 to 2027 between about $719 million and $783 million. In terms of employment, we find that Mississippi would add 11,300 jobs a year on average from 2022 to 2027 as an indirect result of Medicaid expansion,” the report observed.


Sid Salter is a syndicated columnist. Contact him at sidsalter@sidsalter.com

26 comments:

Anonymous said...

The “Delta Council” is the most outdated “clique” in Mississippi. At one time, it had some prominence, but this has faded out. If you need some proof of the fate of “the Mississippi delta”, just look on Wikipedia at the population drops over the last 30 years of Clarksdale, Greenwood, and Greenville, the only really habited towns in that area. The Delta people in their arrogance have never really accepted Vicksburg as a delta town. The only saving Grace for Cleveland has been a divided (now combined) school system and the college.

Eurapolous said...

Hold on...The Fed is only contributing 9%?

What the hell is 'retail political fear'?

Should 'program perimeters' be 'program parameters'?

Is this program intended to offer medical care to more folks or is the aim, as pointed out by Salter, to see an increase in jobs and money for the state?

Lastly, Salter, in his final paragraph, ties the success of the program to INCOME TAX (which is on the way out).

Kingfish: Please consider demanding your money back from Sid on this one.

Anonymous said...

Come on - expand-Its free

Anonymous said...

Sid sure does love dabbling in newspeak. Just another sabbatean trait he exhibits.

Anonymous said...

The group also recognizes the dire straits of rural Mississippi hospitals – particularly in the state’s Delta region – that are struggling to keep their doors open without the infusion of Medicaid dollars from an expanded program.

The issue is systemic and not one merely waiting upon a seemingly easy application of additional government debt-funded largesse.

Rural hospitals, especially in the Delta, are struggling because of population loss. Period. Subsidizing the resulting red ink throws good money after bad. The population loss will continue and without volume hospitals will continue to be shuttered.

The short term bridge of incremental top line revenue from Medicaid expansion will not stop population loss and only delays future closures.

Anonymous said...

Obviously, we should listen to the Delta Council. They've done a wondrous job growing the economy of their own region. They must be experts.

Anonymous said...

How about this.

Don’t have kids if you can’t afford them. Get a job. Pay for your own healthcare.

In addition, take responsibility for your own health.

Stop asking for handouts. Stop bleeding the system because of you laziness.

I pay enough taxes. F off.

Anonymous said...

Just high paid medical workers shamelessly asking for a fancy version of welfare.

Antard Ladumbass said...

Medicaid needs a new RFP.

Anonymous said...

@8:38 "state contributes 10 % to 9%" States contribute 9% or 10%, the feds pick up the rest.

Also, it's odd that the republicans fall all over themselves for anything that will grow the state's economy and add jobs. Anything that is except a program that provides medical services to the state's poorest people. Come to think of it, it's not odd at all, sadly.

Anonymous said...

Welfare for hospitals. Anyone who understands that the Quentin Whitwell types won't be taking pay cuts to help shoulder the load knows exactly which nests are getting feathered. Robbing me to pay you? No thanks.

Anonymous said...

Delta Council has meetings folks!.... They pass "Resolutions" all the time! And that Good Middling Lady every year... C'Mon

Krusatyr said...

Healthcare is not a right, one must work to pay for the insurance that pays for the healthcare.

1. Better education with 'choice' and vouchers, where merit, not teacher's unions, justify pay levels and...

2. Efficient government based on best practices, not nepotism and graft...

Can produce better jobs with more pay, thus enabling mostly private insurance, not socialism, to pay for better healthcare in MS.

Anonymous said...

For all the folks talking about paying taxes and that other people should, you realize that your federal taxes are going to pay for expansion in New York and California and Louisiana and Arkansas, and all the other expanded states. The significant part of the population expansion would affect are the working poor - landscapers, loggers, service industry types - that are working and trying to get ahead but their jobs don't offer coverage. If they can get some assistance with healthcare, they might just move on up the income ladder.

When you sign up for Medicare in your old age, you realize that the taxes you pay won't nearly come close to paying the tab for your bill unless you are totally healthy. Stop your own freeloading!

Anonymous said...

Delta Council has very little influence over statewide politics.

Anonymous said...

You need hospitals to have any kind of population. People are stuck between being not poor enough for Medicaid and not wealthy enough for ACA subsidies-thus going without insurance. Talk about being a drain on the system.

Someone should take away politician healthcare benefits and see how fast things change.

Anonymous said...

Sid, you are a little behind the times in calling the Delta Council one of the state's most mainstream conservative groups.

It was that, back in the 50's through the early 90's - but it is no longer. In fact, it is now more focused on the Delta Health Alliance and the grifting of federal dollars into pocketbooks of those that are employed there. A little study of recent audits might make you realize their reasoning behind this endorsement of the expansion of Medicaid - and its not for any of the reasons you are preaching in your column.

But thanks - gave me a good laugh to see how they hoodwinked you on this one, with your not having stayed abreast of this 'mainstream' once venerable organization.

Anonymous said...

Since Phil and Friends have prohibited us from collecting $1 billion/year for five years....it is probably time to jump in. Really stupid to have not been "in" for these past five years.

Anonymous said...

10:38-

“If they can get some assistance with healthcare, they might just move on up the income ladder.”

Yes. Let me tell you about my logger-lawyer cousin. That healthcare got him to a better career!

What idiotic thinking.


Anonymous said...

@10:38 what taxes, Mississippi is a federal tax pig. They don’t understand that this will grow the economy

Anonymous said...

Some of you seem to want to go back to the good old days of children disabled or dead from curable illnesses and TB hospitals and even further speed women dying in childbirth .

You want to officially be a 3rd world country where no one gets health care unless a charitable team shows up.

You are so clueless as to believe that jobs with healthcare are plentiful. Newsflash, even college grads with JOBS don't get health care coverage on day 1 and can't afford health care for a single person.

Y'all have zero understanding of what the 'real world' is like. You just think you " did it alone". The quality of your nuitrition from day 1 of your life, the care and attention you were given, the teachers you had and family connections/good reputation that got you in the door of your interview.

Really smart people know they "owe" others . You have to be awfully dumb to think you came out of womb making life altering decisions!

Anonymous said...

My first great choice was to pick out a brilliant, handsome father who married a very smart beautiful woman.

Then, I chose a great neighborhood with the best schools and teachers.
I never had any subject I didn't immediately understand so I had my choice of college majors and thanks to the great parents I picked, I didn't have to pay for them.
I had my choice of spouses, all of whom came from well to do parents and had chosen as wisely as I.
I excelled in everything I did.
But, that parental choice is a good start so I don't have the burden of a chip on my shoulder or any doubt that I did it all alone with no help.

Anonymous said...

4:08. Cry me a river.

You sound unhinged. There is NOBODY that goes without healthcare in the US. Rather, you have people that make poor life decisions (single parents, drugs, lack of education) or they don’t invest in their own health (lack of exercise, poor diet, etc). Add to it that some people live in very remote parts of the state, and you have what can be perceived as unlevel access to healthcare.

When I was young, I made very little money. I made far less than the poverty level. But, I always paid for my health insurance because I knew it was important. I invested in myself and did cry that healthcare should be GIVEN to me.

If parents can’t provide basic needs for their kids, maybe the state should take them away. If you want kids then act like a freaking adult.

Anonymous said...

408 what an idiotic comment. Likening 'going back to the good old days' of TB hospitals, women dying in childbirth, and other bullshit to opposing the expansion of Medicaid.

This is not doing away with Medicaid, it is not expanding it to people that earn 138% of the median family income, which in Mississippi is a pretty big jump. The expansion would use Medicaid to pay for health care which is largely being provided now by ---- wait for it ---- the private sector through the workers employment.

These folks aren't currently dying from curable diseases as you suppose, they are getting treated at the state's underused hospitals. The agenda here, as proposed by the Delta Council is not a healthcare proposal it is a jobs program. It is an economic boost by pumping dollars into the local economy. The hospitals want it --- why? So that they can get more patients in the door and keep them around with their sniffles - but out of their Emergency Rooms. The real solution is that many of these rural hospitals need to close their (hospital) doors and admit that they are nothing but an Emergency Triage facility; then they wouldn't need this additional subsidy. But of course it would be hard to justify the big ass administrative salaries if the facility were not claiming to be a 'hospital'.

Check the latest statistics and see what the average daily count of hospital bed useage is in these rural facilities, discounting the COVID spike.

Anonymous said...

4:08 : Emergency rooms stay full of "my elbow hurt" and "my baby elbow hurt" .......drug addicts.....but at the end of the day it's available to all people in this country at no charge. They send you a bill and "my elbow hurt" doesn't pay the bill. "My elbow hurt" is killing the system . What's the argument again ?

Anonymous said...

6:08 here:

Sarcasm was missed apparently though most of you try to dish it. I was trying to point out the overcall attitude against any sort of progress and longing for the past.

Please, anti people, see the difference between the States which accepted Expansion and those which did not.

Sometimes, believe it or not, money can be an investment that saves money in the long run and pays for itself. That's true even for the government.
Fiscal conservatives used to be able to tell the difference when led by the knowledgeable, like Bill Buckley, instead of self-promoters.


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