The hospital crisis has emerged as the state’s most dire problem. Yet with Mississippi’s major statewide primary election less than three weeks away, only one candidate for an office that could do anything about it is even acknowledging its existence.

Gov. Tate Reeves, who faces two Republican primary opponents on Aug. 6, would rather voters think about problems that apparently don’t exist in Mississippi like trans athletes and the influence of national liberals on our state’s policies — not the fact that dozens of hospitals are on the brink of closure.

Lt. Gov. Delbert Hosemann and his Republican primary challenger state Sen. Chris McDaniel appear most focused on out-flanking each other on the right and arguing over who is the truer conservative Republican. Never mind the fact that at least 200,000 working Mississippians cannot afford doctor visits and dying hospitals are underwater having to cover those bills.

Speaker of the House Philip Gunn isn’t running for reelection and has been missing in action the past few weeks. And speaker heir apparent Rep. Jason White, who does have a Republican primary challenger for his House seat early next month, has been a complete non-factor in the 2023 cycle.

Mississippi’s hospital system is failing, and as campaigns really begin to share their ideas and solutions with voters, just one single candidate for high office, Democratic gubernatorial candidate Brandon Presley, has focused meaningful attention on the crisis.

Right now, no Mississippi hospital — large or small, urban or rural, private or public — is immune from potentially debilitating financial concerns. Hospital leaders are having to make life-changing decisions about how they can balance their budgets. They’ve slashed health care services, laid off staff or even closed doors permanently just to make ends meet.

State Health Officer Dr. Daniel Edney put it bluntly a couple weeks ago on a radio program: “No one is knocking it out of the park right now. We have a spectrum of hospitals that literally see their drop-dead date ahead of them if something does not happen.”

Edney, in fact, has been desperately working to sound this alarm for months now, telling the State Board of Health in November 2022 that the crisis was worsening “and no one is coming to the rescue.” 

Boy, was that an accurate prophecy. Below are just a few of Mississippi Today’s headlines since Edney issued that warning:

• Vicksburg hospital, evicted by Merit Health, is now closed
• Jackson area’s only inpatient hospice facility closes
• St. Dominic lays off 5.5% of its workforce, halts mental health services
• Health care giant with dozens of facilities in Mississippi announces layoffs
• Memorial Hospital in Gulfport lays off nearly 100 employees
• North Mississippi health system announces layoffs
• In last ditch effort to stay open, Holly Springs hospital ends inpatient care
• ‘The funding just isn’t there’: Yazoo health department reopens just two days a week
• Delta hospital, once projected to close within 6 months, will stay open until next year
• ‘Leaving for greener pastures’: Mississippi’s nurse vacancy rates are at their highest in at least a decade
• Hospitals thought they’d get $450M in extra money this year. They’re actually getting much less.
• A quarter of Mississippi’s rural hospitals could close within three years, report shows

The proverbial walls are closing in on Mississippians. Emergency rooms across the state are constantly full with hours-long wait times. Cash-strapped health care systems are struggling to recruit and retain nurses and doctors, meaning fewer beds are available for people who need them. Ambulance services are struggling to meet demand and respond quickly when dispatched because of hospital bed backups.

So why aren’t our state’s best positioned leaders even mentioning the crisis — let alone offering solutions to it — on the 2023 campaign trail? Because it would be incredibly difficult for them to defend their past inaction on the crisis, which they’ve been warned about over and over and over again.

For several years, both private sector and government appointed health care experts have all but begged Mississippi’s elected officials to do something — anything — to slow the system’s bleeding.

The experts have even presented the politicians with a readymade solution to the hospital crisis: Medicaid expansion. Expansion — not a cure-all fix, but by all accounts a major assist — would bring an estimated $1.61 billion to the state’s health care system in year one. In year two, it would garner $1.64 billion. Projected out over several years, new revenue to the state would never fall below $1 billion per year. In new jobs and revenue created, several studies show, the policy would more than cover the marginal cost the state would have to pay to draw down the billions in federal funds.

READ MORE: FAQ: What is Medicaid expansion, really?

The politicians, however, have leaned on rosy, non-scientific anecdotes or weak, politically charged talking points to ignore the pleas to pass expansion or other programs that would help.

Reeves, the leader of the state’s opposition to Medicaid expansion for more than 10 years, has not mentioned the hospital crisis so far on the 2023 campaign trail without being prompted by reporters. He could not be more dug in on his opposition to expansion.

Meanwhile, his opponent Presley is devoting campaign resources on a clear pitch for expansion as a solution to the hospital crisis. Given Medicaid expansion’s broad popularity with Mississippi voters on top of its other benefits, this focus couldn’t have been a tough decision for Presley.

“Tate Reeves is fiddling while the health care system in Mississippi burns to the ground,” Presley told Mississippi Today earlier this month. “… There are ways to look at the Arkansas model or the Indiana model or models in other states in which we get something done on (Medicaid expansion).” 

READ MORE: Former UM chancellor: Gov. Tate Reeves privately acknowledged Medicaid expansion benefits

But then there are the others. Considering the questions their newfound focus on the crisis would raise, the silence from so many top 2023 candidates shouldn’t be all that surprising.

How can these leaders who have ignored the expert cries for years defend leaving at least $10 billion on the table since 2013, when Medicaid expansion was phased in? What about the additional $1.5 billion in each coming year that would help hospitals keep services going and doors open?

How would Hosemann, who at times has expressed openness to some version of expansion, answer questions about why he hasn’t worked in his last four years of immense power to at least start an earnest legislative debate? If he’s worried about not being conservative enough, he should ask the 15 Republican-dominated states that have already expanded how well their health care economies are doing. How on earth would McDaniel justify calling a program that would send billions directly to health care providers “an expansion of the welfare state?”

How would Gunn or White explain to their constituents that they have been sitting on their hands in Jackson on this issue?

And how would Reeves, a self-proclaimed “numbers guy” who focuses so much of his time boasting how “hot” the Mississippi economy is, explain why he’s rejecting a 10-to-1 return on state investment that would stand to save thousands of jobs and create new ones across the state? How is he justifying the hospital crisis when pitching business leaders who may want to move their companies to the state?

At least one major Mississippi hospital leader is apparently asking the same question of him.

“We don’t understand why Tate Reeves doesn’t understand why he needs a healthy workforce,” Delta Health Systems CEO Iris Stacker said just last week while publicly criticizing the governor for refusing to expand Medicaid. 

As the hospital crisis worsens and we search for answers to these questions and more, just look at the past records of these leaders. There, you’ll find all the answers you need. 

READ MORE: Mississippi leaving more than $1 billion per year on table by rejecting Medicaid expansion

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.