Every session of the Mississippi Legislature begins with speculation over which topics will command the majority of lawmakers’ attention.
The 2023 session, which began on Tuesday, is no different.
Those in the Legislature, and those who watch them, say to expect lawmakers to be consumed with the debate over tax relief. Gov. Tate Reeves, who has officially commenced his run for reelection, is not backing off a years-long push to totally eliminate the income tax. Lt. Gov. Delbert Hosemann, also seeking reelection, advocates a more cautious approach: a one-time rebate of up to $500 per taxpayer. House Speaker Philip Gunn, who is not seeking reelection, recently nudged away from Reeves’ corner and said he would be open to other ideas than total elimination of the tax.
However that comes out, it pales in importance to what should be lawmakers’ No. 1 concern: resuscitating the state’s hospitals, particularly those in rural areas, before it’s too late.
Granted, our perspective comes with some local bias. Greenwood Leflore Hospital has become the poster child for the financial dilemma into which many Mississippi hospitals have found themselves. Broke and on the verge of closure, the hospital is being temporarily propped up by the money or free services being provided by its two owners, the city of Greenwood and Leflore County.
But that infusion, about $4 million in all, is only worth a few months of additional time — basically long enough to see if the Legislature addresses one of the major reasons that hospitals are struggling: too little reimbursement for the treatment they provide to the poor.
There are many ways that Mississippi can fix this through its Medicaid program. It can get over its irrational hang-up about Obamacare and expand Medicaid to cover the working poor who are presently uninsured. It can increase Medicaid supplement payments. It can decrease hospital taxes on Medicaid revenue.
Mississippi can afford to do all of this and then some. That’s because it’s got an unprecedentedly large surplus — the same surplus that supposedly makes additional tax relief doable — and an unusually generous offer from the federal government to pay most of the cost of adding the uninsured to the Medicaid rolls.
The federal government could help out even more — for example by granting a waiver to the Greenwood hospital so that it qualified for higher reimbursements from Medicare, the other major government insurance program. If there’s indifference from Washington, though, it’s somewhat understandable. Medicare is on an unaffordable trajectory, thanks to America’s aging population. In addition, unlike Mississippi’s record surplus, the federal government is deeply in the red. Whatever it does to raise Medicare spending will only add to both of those problems.
But the biggest reason that Congress may be short of sympathy is that for more than a decade, it has offered Mississippi an easy way to shore up hospital finances via Medicaid expansion. Although the net cost of expansion, by most estimates, would be less than zero for Mississippi, the Legislature and those who have occupied the Governor’s Mansion have repeatedly thumbed their nose at it.
If that attitude persists, Mississippi is saying it does not care if rural health care — and the jobs and economic activity it creates — implodes. Is it really the responsibility of Congress to rescue our state from its self-inflicted wounds?
This crisis has a solution that’s heavily within Mississippi’s control. If state lawmakers fail to respond, the blood will be on their hands.
