A new health care alliance will unite several of Mississippi’s largest hospital systems – all of which left the state hospital association following controversy over Medicaid expansion – under the umbrella of one of the state’s largest and most influential lobbying firms.

The new group will be helmed by former Mississippi Medicaid Director Drew Snyder, who served under two Republican governors who thwarted Medicaid expansion and the flow of billions of federal dollars to provide health insurance to low-income Mississippians for over a decade. 

The new collaborative will focus on “providing sustainable solutions to challenges facing access to care,” said a press release. It will include representatives from the state’s leading acute and trauma care hospitals, rural hospitals, mental health providers and primary care providers.

Critics, along with the Mississippi Hospital Association, say the new group’s formation is motivated by partisan politics.

A slew of hospitals left the hospital association after the organization’s political action committee made its largest-ever contribution to Democratic gubernatorial candidate Brandon Presley, a strong supporter of Medicaid expansion, in 2023. All but one have joined the new collaborative. 

This means lawmakers in 2025 will hear from two separate groups of hospitals and health care organizations, raising questions about whether their overall impact will be diluted without a unified voice.

Snyder, who declined repeated requests for comment for this story, will lead the Mississippi Healthcare Collaborative under the umbrella of multi-state, Jackson-based lobbying firm Capitol Resources and its new health policy consulting division, Health Resources.

Capitol Resources is a strong supporter of Republican Gov. Tate Reeves. The firm’s political action committee has contributed nearly $75,000 to Reeves since 2018.

Five of Capitol Resources’ scores of Mississippi clients hold multi-million dollar contracts with the Division of Medicaid. 

A query to the Mississippi Ethics Commission published just days before Snyder announced his resignation from the Division of Medicaid sought an opinion on how a former head of an agency could work for a lobbying firm with clients in the same field as his or her public service without violating state law. Requests for opinions are anonymous.

The Ethics Commission ruled that the public official could not work for compensation on matters “which he or she was directly or personally involved while working for the government,” but would not be forbidden from working for a company that does. 

A national ethics expert told Mississippi Today that when public officials transition to private sector work, particularly in the same field as their public service, it can raise ethical issues. 

The knowledge and information public officials hold can be used as a “leg up,” which leads to unfairness in private companies’ and lobbying organizations’ business dealings with government entities, said professor John Pelissero, the director of Government Ethics at the Markkula Center for Applied Ethics at Santa Clara University.

Capitol Resources has for years represented Centene, a company that currently holds $5.2 billion worth of contracts for managing Medicaid beneficiaries care through its subsidiary Magnolia Health. The company has paid the lobbying firm $3.9 million over the last decade, according to the Secretary of State’s website.

Tim Moore, the former head of the Mississippi Hospital Association, said he has concerns about the conflict posed by a lobbying firm representing two health care organizations with competing interests. 

“How do you represent a managed care company and a bunch of hospitals at the same time?” he said. 

Moore was ousted by the Mississippi Hospital Association’s Board of Governors following hospitals’ withdrawal from the organization.

Clare Hester, the founder and managing partner of Capitol Resources, did not respond to a request for comment by press time.

The evolution of the Mississippi Hospital Association

The Mississippi Hospital Association was for many years one of the most powerful lobbies at the Capitol. But that began to change with the passage of the federal Affordable Care Act, which created a partisan rift over whether or not the state should expand Medicaid. 

The trade association splintered in May 2023, starting with the departure of the state’s largest hospital system, University of Mississippi Medical Center, in May. Four additional hospitals, all led by Gregg Gibbes, left the association in 2024. 

Hospital leaders at the time declined to say what precipitated their decision to leave, other than to cite concerns about the hospital association’s leadership. But the exodus was widely interpreted as a rebuke of the association’s support for Presley and, specifically, Medicaid expansion. 

Research has shown that Medicaid expansion would provide millions of dollars to Mississippi’s struggling hospital system. 

As Reeves faced an uphill reelection bid, due in part to his opponent’s support of Medicaid expansion and his adamant opposition, he worked with Snyder to create a new program to provide supplemental payments to hospitals to offset low Medicaid payments. While the program did not directly support low-income Mississippians, it was estimated to generate $700 million for the state’s largest hospitals. 

Republican House leaders pushing for Medicaid expansion in the last legislative session said the program prevented some large hospitals from being strong advocates for expansion, in part due to fear that Gov. Reeves would punish such a move by doing away with the expanded payments.

The Mississippi Hospital Association has 76 current hospital members, according to its online directory. Some are members of hospital systems. 

“The Mississippi Hospital Association will continue to be the trusted voice in health care and to offer education and quality advocacy solutions based on sound health care policy – and not politics – as we have successfully done for almost 100 years,” president and CEO Richard Roberson told Mississippi Today. Roberson is the former head of TrueCare, a provider-led, nonprofit managed care organization that contracts with Medicaid.

Kent Nicaud, one of Reeves’ top campaign donors and the president and CEO of Memorial Hospital, will serve as chair of the collaborative’s board. Memorial Health System left the hospital association in 2023, and is a current client of Capitol Resources. 

Moore said having two major health care trade associations in the state will “create division among the industry, which is not good.”

“…The best thing for all hospitals is to be united in one voice, because they have similar issues, whether they’re a small hospital or a large hospital,” he said. 

Along with hospitals that left the association, Mississippi Healthcare Collaborative incorporates several existing Capitol Resources clients, including the state’s 21 Federally Qualified Community Health Centers, and Universal Health Services, a company with five behavioral health centers in Mississippi. 

“For too long, too many health providers have been siloed in our advocacy. It’s time to sit down at the same table and work together,” said Terrence Shirley, CEO of the Community Health Center Association of Mississippi, which represents the Federally Qualified Community Health Centers, in a press release. 

Other members of the new group include Methodist Rehabilitation Center and Northwest Regional Medical Center in Clarksdale.

The group’s members are based in 78 of Mississippi’s 82 counties.

Ochsner Medical Center, which left the Mississippi Hospital Association last year and is a client of Capitol Resources, is not listed as a member of the new collaborative. Ochsner did not respond to Mississippi Today by the time of publication.

Geoff Pender contributed reporting.

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