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Despite Gov. Reeves’ debate claims, experts say it’s hard to argue that states are ‘better off’ without Medicaid expansion

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Gov. Tate Reeves, the state’s most powerful opponent of Medicaid expansion, repeated a familiar claim at Wednesday night’s gubernatorial debate: that the program wouldn’t save the state’s failing hospitals.

But health care experts say that was always clear, that the governor’s argument is missing an understanding of the challenges facing the state’s health care system and that expansion, by potentially insuring about a quarter million Mississippians, would allow hospitals to get paid something for the care they provide to uninsured patients versus getting paid nothing.

The first and only debate between Reeves and Democratic challenger Brandon Presley ahead of the Nov. 7 election opened Wednesday night with questions about Medicaid expansion, which has remained a title issue of the campaign cycle.

Mississippi is one of just 10 states that have not expanded Medicaid. Though most Mississippians support the policy, the governor has remained steadfast in his opposition.

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

“Medicaid is not the best policy for rural hospitals, but you don’t have to look very far to prove that,” Reeves said at the debate, before citing data from the Center for Healthcare Quality and Payment Reform’s rural hospital report about Louisiana and Arkansas, two Southern states that have expanded Medicaid.

The center’s most recent version of the report, which was updated last month, shows that Louisiana and Arkansas still have high rates of rural hospitals at risk of closure — 42% and 43%, respectively.

According to the report, 42% of Mississippi’s rural hospitals are at risk of closure.

“Guess what? The difference is… Louisiana and Arkansas have expanded Medicaid,” Reeves continued. “Mississippi has not. (Medicaid expansion) is not the financial windfall that Brandon Presley would have you believe.”

READ MORE: Brandon Presley again vows to expand Medicaid as Gov. Tate Reeves reiterates opposition

The heart of Reeves’ argument misses some major points, experts said.

“To say that other states that expanded have had the same problems is a very true statement,” said Ryan Kelly, executive director of the Mississippi Rural Health Association. “But would they be worse off without (Medicaid expansion) in the current environment? Yes, I think they would be.”

According to the center’s report, the average percentage of rural hospitals at risk of closure in non-expansion states is over 37%, while the percentage in expansion states is much lower at 26%.

“What [Reeves is] saying is true,” said Harold Miller, leader of the Center for Healthcare Quality and Payment Reform. “Those are the numbers.”

However, expansion is about more than just “saving” hospitals, Miller said — it’s about insuring vulnerable people, allowing them to receive regular health care.

While emergency rooms cannot turn down patients regardless of their insurance status, doctor’s offices can, preventing people from receiving preventative and other non-urgent forms of health care.

Somewhere between 200,000 and 300,000 Mississippians would be affected by Medicaid expansion, according to projections. The policy would potentially bring in billions within its first few years of implementation in Mississippi, an influx of cash that the state needs. Just minutes later during the same debate, Reeves touched on Mississippi’s economy, and the “competitive disadvantage” the state’s up against when it comes to economic development.

Miller said hospitals in states that have expanded Medicaid do have greater losses on Medicaid services — Medicaid typically reimburses hospitals at lower rates than commercial insurance for health care services.

Reeves used that argument during the debate.

“The unintended consequence of expanding Medicaid to 300,000 Mississippians is moving individuals off of private insurance,” he said. “That’s bad for rural hospitals as well, because the fact is that when you move them from private insurance, the reimbursement rates… are actually lower when they go on Medicaid.”

But that’s better than not getting paid at all, according to Kelly.

Hospitals report losing about $600 million on uncompensated care annually, or services provided to people who aren’t insured. That number would reduce drastically if Medicaid was expanded.

Experts agree that the hospital crisis, while heightened by the COVID-19 pandemic, has been caused by a multitude of factors. In the same vein, it won’t be solved by one policy.

Kelly cited all of the other challenges hospitals are up against, including timely insurance reimbursements and rising health care costs, but he conceded that expansion would aid hospitals’ uncompensated care losses, an issue that’s fueling the crisis.

“You’re going to have a real hard time finding someone who would say hospitals would be better off without Medicaid expansion,” Kelly said.

READ MORE: ‘It is a moral obligation’: Faith leaders, advocates, doctors cite Christianity as reason to expand Medicaid

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

Mississippi Today

On this day in 1956

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mississippitoday.org – Jerry Mitchell – 2025-02-24 07:00:00

Feb. 24, 1956

In 1976, the statue of U.S. Sen. Harry F. Byrd Sr. was erected near the Virginia Capitol. In 2021, the statue was finally removed. Credit: Wikipedia

U.S. Sen. Harry F. Byrd Sr. coined the term “Massive Resistance” to unite white leaders in Virginia in their campaign to preserve segregation. The policy appealed to white Virginians’ racial views, their fears and their disdain for federal “intrusion” into the “Southern way of life.” 

Virginia passed laws to deny state funds to any integrated school and created tuition grants for students who refused to attend these schools. Other states copied its approach. 

When courts ordered desegregation in several schools in Charlottesville and Norfolk, Virginia Gov. James Lindsay Almond Jr. ordered those schools closed. When Almond continued that defiance, 29 of the state’s leading businessmen told him in December 1958 that the crisis was adversely affecting Virginia’s economy. Two months later, the governor proposed a measure to repeal the closure laws and permit desegregation. 

On Feb. 2, 1959, 17 Black students in Norfolk and four in Arlington County peacefully enrolled in what had been all-white schools.

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

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If Tate Reeves calls a tax cut special session, Senate has the option to do nothing

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mississippitoday.org – Bobby Harrison – 2025-02-23 06:00:00

An illness is spreading through the Mississippi Capitol: special session fever.

Speculation is rampant that Gov. Tate Reeves will call a special session if the Senate does not acquiesce to his and the House leadership’s wishes to eliminate the state personal income tax.

Reeves and House leaders are fond of claiming that the about 30% of general fund revenue lost by eliminating the income tax can be offset by growth in other state tax revenue.

House leaders can produce fancy charts showing that the average annual 3% growth rate in state revenue collections can more than offset the revenue lost from a phase out of the income tax.

What is lost in the fancy charts is that the historical 3% growth rate in state revenue includes growth in the personal income tax, which is the second largest source of state revenue. Any growth rate will entail much less revenue if it does not include a 3% growth in the income tax, which would be eliminated if the governor and House leaders have their way. This is important because historically speaking, as state revenue grows so does the cost of providing services, from pay to state employees, to health care costs, to transportation costs, to utility costs and so on.

This does not even include the fact that historically speaking, many state entities providing services have been underfunded by the Legislature, ranging from education to health care, to law enforcement, to transportation. Again, the list goes on and on.

And don’t forget a looming $25 billion shortfall in the state’s Public Employee Retirement System that could create chaos at some point.

But should the Senate not agree to the elimination of the income tax and Reeves calls a special session, there will be tremendous pressure on the Senate leadership, particularly Lt. Gov. Delbert Hosemann, the chamber’s presiding officer.

Generally speaking, a special session will provide more advantages for the eliminate-the-income-tax crowd.

First off, it will be two against one. When the governor and one chamber of the Legislature are on the same page, it is often more difficult for the other chamber to prevail.

The Mississippi Constitution gives the governor sole authority to call a special session and set an agenda. But the Legislature does have discretion in how that agenda is carried out.

And the Legislature always has the option to do nothing during the special session. Simply adjourn and go home is an option.

But the state constitution also says if one chamber is in session, the other house cannot remain out of session for more than three days.

In other words, theoretically, the House and governor working together could keep the Senate in session all year.

In theory, senators could say they are not going to yield to the governor’s wishes and adjourn the special session. But if the House remained in session, the Senate would have to come back in three days. The Senate could then adjourn again, but be forced to come back if the House stubbornly remained in session.

The process could continue all year.

But in the real world, there does not appear to be a mechanism — constitutionally speaking — to force the Senate to come back. The Mississippi Constitution does say members can be “compelled” to attend a session in order to have a quorum, but many experts say that language would not be relevant to make an entire chamber return to session after members had voted to adjourn.

In the past, one chamber has failed to return to the Capitol and suffered no consequences after the other remained in session for more than three days.

As a side note, the Mississippi Constitution does give the governor the authority to end a special session should the two chambers not agree on adjournment. In the early 2000s, then-Gov. Ronnie Musgrove ended a special session when the House and Senate could not agree on a plan to redraw the state’s U.S. House districts to adhere to population shifts found by the U.S. Census.

But would Reeves want to end the special session without approval of his cherished income tax elimination plan?

Probably not.

In 2002 there famously was an 82-day special session to consider proposals to provide businesses more protection from lawsuits. No effort was made to adjourn that session. It just dragged on until the House finally agreed to a significant portion of the Senate plan to provide more lawsuit protection.

In 1969, a special session lasted most of the summer when the Legislature finally agreed to a proposal of then-Gov. John Bell Williams to opt into the federal Medicaid program.

In both those instances, those wanting something passed — Medicaid in the 1960s and lawsuit protections in the 2000s — finally prevailed.

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

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On this day in 1898

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mississippitoday.org – Jerry Mitchell – 2025-02-22 07:00:00

Feb. 22, 1898

Lavinia Baker and her five surviving children. A white mob set fire to their house and fatally shot and killed her husband, Frazier Baker, and baby girl Julia on Feb. 22, 1898. Left to right: Sarah; Lincoln, Lavinia; Wille; Cora, Rosa Credit: Wikipedia

Frazier Baker, the first Black postmaster of the small town of Lake City, South Carolina, and his baby daughter, Julia, were killed, and his wife and three other daughters were injured when a lynch mob attacked

When President William McKinley appointed Baker the previous year, local whites began to attack Baker’s abilities. Postal inspectors determined the accusations were unfounded, but that didn’t halt those determined to destroy him. 

Hundreds of whites set fire to the post office, where the Bakers lived, and reportedly fired up to 100 bullets into their home. Outraged citizens in town wrote a resolution describing the attack and 25 years of “lawlessness” and “bloody butchery” in the area. 

Crusading journalist Ida B. Wells wrote the White House about the attack, noting that the family was now in the Black hospital in Charleston “and when they recover sufficiently to be discharged, they) have no dollar with which to buy food, shelter or raiment. 

McKinley ordered an investigation that led to charges against 13 men, but no one was ever convicted. The family left South Carolina for Boston, and later that year, the first nationwide civil rights organization in the U.S., the National Afro-American Council, was formed. 

In 2019, the Lake City post office was renamed to honor Frazier Baker. 

“We, as a family, are glad that the recognition of this painful event finally happened,” his great-niece, Dr. Fostenia Baker said. “It’s long overdue.”

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

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