Sunday, April 4, 2021

Bill Crawford: GOP Leadership Witless on Medicaid Math

Hard-headed and hard-hearted Mississippi leaders can’t do math. So wrote Greenwood Commonwealth editor Tim Kalich regarding Mississippi’s stand against Medicaid expansion.

“Gov. Tate Reeves and Republican lawmakers who resist Medicaid expansion have for years said that Mississippi cannot afford to extend health-care coverage to the working poor. They obviously don’t bother to do the math.”

You see, the latest COVID relief package makes Medicaid expansion much more affordable.

State Sen. Hob Bryan, chairman of the Senate Public Health Committee, told Mississippi Today, “there will be more money in the state treasury if we expand Medicaid than if we don’t.”

State Insurance Commissioner Mike Chaney explains. “The federal government puts up 80 cents of every dollar that we spend on Medicaid,” he told the Community Foundation for Mississippi’s local news collaborative. “If Mississippi were to expand, that amount would increase to 95 cents.”

Kalich explained further. “The Kaiser Family Foundation, a non-profit that focuses on U.S. health-care policy, particularly as it affects people of low income, ran the numbers.” He said that for Mississippi, the net effect would be an estimated $400 million more in direct federal payments. “Put another way, for every $1 that Mississippi were to spend to cover the new Medicaid enrollees, it would save $2.38 on its cost of covering the existing ones.

“If Reeves and Mississippi lawmakers still aren’t convinced,” wrote Kalich, the Mississippi Hospital Association has offered a plan to transfer the state’s cost of expansion to the hospitals and to the new Medicaid beneficiaries – leaving the state treasury with almost nothing to pony up.”

“Still Mississippi’s political leadership says, ‘No thanks.’ It would rather see those millions go elsewhere than to accept another Democratic welfare-state program,” wrote Kalich.

“I am opposed to expanding Medicaid in Mississippi,” Reeves reiterated in March. Asked if the new COVID rescue money would change his mind he said, “No, sir, it will not.”

This is where Republican hypocrisy reveals itself. The governor and lawmakers are okay with the federal dole for farmers, for paving highways and building bridges across the state, and for Community Development Block Grants used for economic development.

“It is only when it comes to helping the poor or the near-poor that Mississippi’s pride – and perhaps prejudice – gets in the way,” wrote Kalich.

“Medicaid expansion is not about putting people on the welfare rolls,” said Chaney, expressing a view different from other GOP leaders. “This is about expanding health care availability to those people that make 138% of the poverty level or less. And that’s about 300,000 to 400,000 people in this state.”  

These are people who work but don’t have employer insurance, cannot qualify for regular Medicaid or Obamacare subsidies, and cannot afford regular health insurance. Most private employers in Mississippi do not offer health insurance to employees.

Of course, Medicaid expansion is about more than numbers and politics. It’s about saving lives, saving hospitals, retaining and attracting more doctors, and providing a healthy workforce to attract jobs.

“This state’s stand on Medicaid expansion is hard-headed and hard-hearted,” concluded Kalich. No, it’s amoral, shortsighted, and witless, Tim.

“For they had not understood about the loaves; their hearts were hardened” – Mark 6:52.

Crawford is a syndicate columnist from Jackson.



Anonymous said...

Hey Bill, ever wonder where those federal dollars come from?

Anonymous said...

@12:52 most of them in this state come from other states with actual economies.

Anonymous said...

12:52, the shortfalls of payments attributable to the uninsured are being paid today by those of us that have insurance. I also hate insurance companies in general, and hopefully the Democrats will make the insurance industry subject to antitrust regulations.

Anonymous said...

"most of them in this state come from other states with actual economies."

No. They come from TAXPAYERS in other states. People like you and me.

Anonymous said...

Federal money = bribing the taxpayers with their own money, with lots of overhead thrown in.

Anonymous said...

Why, it sounds too good to be true that expanding Medicaid would save the State money. One thing to consider is that once you create or expand a think like Medicaid it will be almost impossible to withdraw from it. Even if the federal match is what it is said to be, there is no assurance that it will always be that way. If not, then the State would have to make up the difference. Another thing to consider is that the article doesn't say just how much more the State would have to come up with to expand Medicaid in terms of actual dollars. We are only given percentages. The idea of expanding Medicaid was rejected because of the increased cost to the State. Is anyone claiming that there will not be an increased cost to the State now or in the near future? If there will be an increased cost, why isn't that expressed in dollars?

Anonymous said...

No matter how much free money people like Bill think we should spend on social services it always comes back to the taxpayer who foots the cost. When it comes to money, free is NOT FREE! No matter how many liberals think that it’s so easy just to print out cash by the ton, taxpayers are required to cover the cost. Perhaps the GOP is leary of a government that takes from one hand and gives out free money from the other. Another legitimate question would be how many of of the 400 thousand of those poor are non citizens that have poured across the border, well dressed with charged up cell phones.

Anonymous said...

Whoa with the Trump Tax cuts, and the stimulus checks, who exactly is paying for anything or will pay for it in the future, how many of us make over 400k a year? Ask someone who does make that much, if they mind paying a little more in taxes so that everyone can have affordable health care. With only a handful of people in Mississippi at this income level it’s hard to think that it would any negative effects, it just another freebie.

Calm Down said...

Free government programs aren't free.

Anonymous said...

I do see the hypocrisy in the face of the delta, the land of the rich welfare recipients (farmers, crop insurers, etc.)

Anonymous said...

Latest status of state Medicaid expansion. I expect MS will see a ballot initiative in support of Medicaid expansion in 2024 if the MS legislature does not address the issue.

Anonymous said...

Once again Bill Crawford expounds on the magic of Medicaid expansion without bothering to simply include a “full disclosure” disclaimer letting readers know that he himself is a hospital board director and that his employer would be a prime beneficiary of more taxpayers dollars. Just irritating that he never even mentions his own dog in the fight.

Anonymous said...

simply from an economic development view, medicaid expansion makes sense. mississippi already recieves more federal dollars than we pay in but somehow, mississippi has the gall to say it won't take federal dollars. Ms would factually be a 3rd world country without federal dollars. because our leadership is more interested in dog whistle politics and keeping Ms boarders closed, we have the weakest economy in America. The data speaks for itself mornons but hey, you turn your nose up from the ole USA federal dollars. Mississippi is independent by damned!

Kingfish said...

One of the main reasons was when Medicaid expansion rolled out, the state's share when it had to start paying was estimated to be $100 million or so. No small sum.

I don't know if that is still the case or if the formula has changed. After ten years, we should be able to look at other states and see what they had to pay.

Anonymous said...

The ruling Republicans would have to actually care about poor people to do anything on this. They don’t see the upside in helping the states poor, I mean what can some poor black guy in the delta do for Tater? Unless there’s a steak dinner and some free money under the table, they aren’t interested.

Anonymous said...

KF, again, that sum was always without cost/benefit analysis.

At any rate, our Governor can't see the economic benefits of a vaccine passport either.

He apparently doesn't understand that a room of vaccinated people is the only way to " normal". Nor, does he seem to understand that those with the most money to spend, got vaccinated. Instead, what he will see is what is happening overseas and here, younger people getting hospitalized by the new mutation he's invited to " prosper" instead.

Anonymous said...

Medicaid expansion has made a big difference in the availability of medical care across the country. It would do the same in MS for relatively little financial contribution from Mississippian taxpayers. Sadly, this is just another black v white and rich v poor issue for Tate Reeves. When it comes to helping anyone bunch rich Republicans, Reeves could care less. He is, in a word, heartless.

Anonymous said...

Mississippi is a terrible place to be poor in. If your on the bottom of the social economic system, do whatever it takes to leave. Eventually you and your offspring will be much better off.

Anonymous said...

My elderly mother, then about 85 years old, walked into Jeff Anderson Regional Medical center (where Mr. Crawford is a board member) one day about three years ago and was informed that she "can be on Medicaid," based on the fact that she is widowed and living on social security. Never mind the fact that she had two houses, 80 acres of harvestable pine timber and vehicles --- all paid for, and a family that helps her with most of her basic needs. She immediately signed up for Medicaid thinking that was the thing to do, and dropped her longstanding, and quite cheap, Humana policy which, along with Medicare, had taken care of most of her considerable health needs. So, I found this situation quite instructive as to how Medicaid rolls are expanded, and I can only imagine what type of additions we'll have to the Medicaid rolls if there is any expansion --- a dramatic inclusion of folks who, when all is said and done, are not the most needy among us, but who'll go on the taxpayer dole anyway because apparently some folks believe the government has unlimited resources. And, "yes" what seems to be a bargain for Mississippi is anything but a bargain for the US Taxpayer, many of whom actually do live in Mississippi. I being one.

Anonymous said...

"...simply from an economic development view, medicaid expansion makes sense."

As if that's the logic behind expansion. Healthcare should not revolve around the concept of being an employment agency or a driver of economic activity. Sadly, there are people who think like you. Reminds me of the generator manufacturer who welcomes hurricane season.

Anonymous said...

@4:58pm Agreed. Government was NEVER meant to promote "economic development". It was meant only to regulate it IF actually necessary.
But when the unemployed and poor are clamoring "off with their head" it plays well for politicians wanting to survive.

Health providers are to blame using Medicaid, they're reimbursements are less likely to be denied that with private insurance. So, they think - get'em on that Medicaid and milk it as much as possible while you can!

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