Wednesday, May 8, 2024

Sid Salter: Missed Opportunity, Yes, but Medicaid Expansion's Prospects Changed This Session

While not an absolute, it’s been my experience that political change comes slowly in Mississippi – as slowly as molasses on a cold biscuit.

That’s my take on the disappointing failure of Mississippi lawmakers to reach a consensus on a plan to expand Medicaid coverage to our state’s working poor. The working poor are those fellow Mississippians with jobs who don’t make enough money to afford health insurance.

All of us who pay federal taxes in Mississippi are already paying for expanded Medicaid in 40 other states and providing healthcare opportunities for the citizens of those states. But not here, not for our own people.

But one thing is certain, the Mississippi Legislature in 2024 saw and heard an effective demonstration of the depth and breadth of public support for an expanded Medicaid program that provides a path to health care for working Mississippians.

And it would be disingenuous to suggest that likewise state lawmakers saw and heard that there is also broad-based taxpayer support for some form of work requirement in that expanded program. The disappointment of the 2024 regular session is that the Legislature came so close to getting it right before negotiations got stuck in the political mire.

A decade ago, Medicaid expansion in Mississippi was politically dead on arrival at every level in this red state – including the Governor’s Mansion, the House and the Senate. All one had to do to see the shadow of the political Grim Reaper was whisper the word “Obamacare.”

But as time passed, COVID struck, and inflation followed. Rural hospitals continued to struggle and some shuttered. The lack of availability of rural healthcare is a real danger.

Donald Trump was elected president and his policy change on implementing work requirements for expanded Medicaid programs impacted the political logjam as red states began to find ways to make Medicaid expansion politically palatable.

Trump’s policy change on work requirements for Medicaid expansion was more than a policy change. It was political white smoke coming from the White House giving Republican state legislators permission of a sort to seriously kick the tires and hold meaningful discussions about Medicaid expansion.

When current President Joe Biden was elected, his administration rejected the work requirement changes Trump had put in place and Republican state lawmakers in non-expansion states again faced roadblocks in trying to implement Medicaid changes.

But early in the 2024 Mississippi legislative session, new House Speaker Jason White led the Mississippi House by a margin of 98-20 to pass legislation that would have expanded Medicaid benefits to individuals aged 19 to 64 who earn no more than 138% of the federal poverty level. The bill contains a work requirement – which everyone knew the feds under Biden were likely to disapprove – but even so, the bill expanded Medicaid coverage in Mississippi for four years before a legislative repealer kicked in.

That action came even after White’s predecessor, former House Speaker Philip Gunn, had consistently opposed any expansion of the Medicaid program.

The initial reaction from the State Senate was mixed, but the two sides were negotiating. Late in the game, Senate negotiators offered a plan whereby a person who makes less than 138% of the federal poverty level must work 100 hours a month to receive expanded Medicaid. If federal officials denied the work requirement, the state could reapply later if CMS switched stances and approved another state’s work requirement, but there would be no access to expanded care without federal approval.

The House countered with a voter referendum offer, but by that point, negotiations turned contentious. That’s where the plan died for this year.

After the measure died, Lt. Gov. Delbert Hosemann suggested that the outcome of the 2024 presidential election may determine the fate of Medicaid expansion in Mississippi. It well might.

The Medicaid fight also reminded voters that they can no longer impact public policy through the referendum process without legislative permission. Lawmakers will hear about both issues from their constituents moving forward.

The proposed referendum would have asked: “Should Mississippi expand Medicaid? If so, should the expansion include a work requirement?”

It would seem most Mississippi voters would answer “yes” to both questions – which complicates finding a legislative solution.

Sid Salter is a syndicated columnist. Contact him at


Anonymous said...

Interesting that Delbert campaigned on M.E. But dropped the ball this session. I keep hearing he doesn’t have control of the Senate !

Anonymous said...

Lt. Governor wants a work requirement. Speaker does not want a work requirement. Which is conservative and which is liberal ?

Anonymous said...

“…working poor…”? Non-working poor is a more accurate description of those that would benefit.

Anonymous said...

8:09 Nice try-Lt. Gov. has total control . He is obviously a staunch conservative who runs the adult side of the legislature. This is why he recived more votes than any other state wide elected Republican in our state. People respect his integrity and honesty.

Anonymous said...

All the political posturing and righteous indignation regarding who works and who does not will fade away after the presidential election and Trump makes his pronouncement. The welfare of "the people" never mattered anyway.

Anonymous said...

Salter has never opposed any expansion of the Welfare State. On one hand he'll tell you that Mississippians are funding welfare state payments in other states and on the other, when it suits his narrative, he reminds Mississippi of its net Federal largesse beneficiary status and why that demands our kowtow to Uncle Sam. Are there any truly honest conservative columnists remaining in Mississippi? I think not.

Anonymous said...

Things do change slowly in Mississippi. That’s a big part of why the state’s still 2-3 generations away from general prosperity, and emerging from the last decile in every measure of quality of life.

First come the unskilled jobs (and a bigger tax base), then come the skilled jobs, and the prosperity grows and continues so.

Tater is doing a great job in this important area. But it’s still more than two generation away from impacting the general populace. So everybody chill.

Anonymous said...

When you put all the politics aside, we are still talking about giving money away. That's what this is. It's Mississippi taxpayer dollars matched up, according to some formula, with federal taxpayer dollars. But a lot of people had to work to pay those taxes that the politicians, and columnists, are now talking about giving away. Is this the proper role of government - to deduct money from a lot of paychecks just so career politicians can keep their leather chairs by giving that money away?

Anonymous said...

Our federal government “gives away” billions of dollars to other countries. I believe that is part of America’s world role. So is providing health care to the poor.

Anonymous said...

How this played out in the Senate is confirmation that Inglebert is already a lame duck with Watson waiting in the wings.

Anonymous said...

11:13 why is that America's role? Why is giving stuff away anyone's role? If I wanted the government to give me my house, or my car, would you say that's a legit role for government? After all, we all need shelter and a way to get to our jobs and other places. Where does it end? When does taking money from some people and giving it to others stop being the role of government?

Anonymous said...

Rukia woulda got it done

Anonymous said...

I disagree Sid; expansion would NEVER pass if voted on-
the silent majority out there would rise to vote it down.

Anonymous said...

If you could fund Medicaid without raising taxes on working folks or if Medicaid reimbursement rates were high enough to keep rural hospitals open, I might be for it. But you can’t and they aren’t, so I’m a no on any kind of Medicaid expansion. I’m tapped out on already on paying for other people’s free shit.

Anonymous said...

That is HILARIOUS! Keep wishing.

Anonymous said...

Sid talks politics but hasn't spent any meaningful time at the Capitol since the Musgrove administration.

Anonymous said...

4:40 - That's because Sid is comfortably bunkered-up in the safety of a public-employment cubicle at State College....checking daily on his PERS account.

The taxpayers are just a few short years from providing him with a nice, lifetime retirement. Then he can spend his remaining years hosting 'the working poor' at his Neshoba cabin.

Anonymous said...

medicade may not have been expanded but you can bet your ass all the administrative agencies of the state were given a healthy expansion to be filled with more government workers and Law enforcement wannabe badasses who will draw a good salary and full benefits and get paid to sit on their butts and not do anything all day.

oh and lets not forget all of the new boards, commissions, agencies, districts, and other government glee clubs that were created by the legislature this year so that politicians can hand out do nothing jobs to their chums. remember , this is mississippi .........

and the only growth industry is government.

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Trollfest '09

Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).

Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.

In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.

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Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

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