Conservatives believe there is a better, less expensive way to help the uninsured and Mississippi’s struggling rural hospitals than expanding Medicaid.
David Williams, president of the Washington,D.C.-based Taxpayers Protection Alliance, recently floated some of these alternatives in a column published in the Clarion Ledger.
Rather than going through the middleman of Medicaid to channel reimbursements to hospitals, he says that federal and state governments could directly reimburse hospitals for the free care they provide to low-income patients.
Or they could give a refundable tax credit, based on income, that would allow the uninsured to purchase a private health-care plan of their own, plus have a little left over to cover co-pays and deductibles.
Or they could do a combination of the two — direct reimbursements to hospitals and a tax-credit subsidy for individuals.
Any of these options, Williams argues, would be significantly less expensive for taxpayers. Some would also be more beneficial to low-income Mississippians by giving them better options for health care since private insurance is more widely accepted by providers than is Medicaid.
Some of this may be true, although Williams fails to mention that hospitals already get government subsidies for uncompensated care — just not as much as they did before Medicaid expansion became an option almost a decade ago.
But the main problem is that if there is a better way to try to leverage this money — a billion dollars a year or more — the federal government has been all but begging Mississippi to take, there has been no real effort by the state’s Republican leadership to pursue that supposedly better way.
The response of Gov. Tate Reeves and that of outgoing House Speaker Philip Gunn has been to shut down any possibility of discussion. Lt. Gov. Delbert Hosemann, the other Republican in the triumvirate, has expressed interest at times in the models of other states that have received waivers to adapt Medicaid expansion to be more private-sector-oriented, but he hasn’t pushed the issue because of fears of being attacked from his party’s right flank — a fear realized in the primary challenge this year of ultraconservative state Sen. Chris McDaniel.
That obstinate attitude by the GOP leadership continues even while the public steadily warms to the idea of Medicaid expansion. This week, Mississippi Today released its latest public opinion poll on the question of whether Mississippi should join the other 40 states that have expanded Medicaid. It showed that 66% of respondents — including 52% of Republicans — support doing so.
It is baffling why Reeves and other opponents still seem to ignore not only the growing embrace of Medicaid expansion in other Republican-dominated states but also the changing public sentiment within Mississippi itself. People in elected office are usually adept at picking up on trends in public opinion and revising their positions accordingly.
Reeves could back something along the lines of what David Williams is recommending and still maintain — with a straight face — his anti-Obamacare position. Other Republican former governors — Asa Hutchinson in Arkansas and Mike Pence in Indiana, for example — have taken that approach in expanding Medicaid in a way that was politically palatable in their conservative states.
Instead, from Reeves there comes almost zero leadership on this or on the larger crises facing the state’s rural hospitals.
Only no, no, no.
