Gov. Tate Reeves and Republican lawmakers who resist Medicaid expansion have for years said that Mississippi cannot afford to extend health-care coverage to the working poor.
They obviously don’t bother to do the math. Other folks have done it, however, and they repeatedly show that expanding Medicaid — since the federal government foots most of the cost — pays for itself and then some.
For the next two years, if Mississippi were to drop its resistance to expansion, that “some” would come to hundreds of millions of dollars.
That’s because the $1.9 trillion coronavirus relief package recently signed into law by President Joe Biden includes an additional incentive — Republicans call it a “bribe” — to the dozen states that have stubbornly refused to expand the government health program.
If the states get on board, they will be eligible not just for the 90% federal match on this new category of enrollees, but they will also receive for the next two years a 5-percentage-point bonus on those who are already enrolled in traditional Medicaid.
The Kaiser Family Foundation, a nonprofit organization that focuses on U.S. health-care policy, particularly as it affects people of low income, ran the numbers of what this would mean for the holdout states.
For Mississippi, the net effect would be an estimated $400 million more in direct federal payments. This does not count the indirect economic benefits of having that much additional money flowing through the state’s health care sector.
Put another way, for every $1 that Mississippi were to spend to cover the new Medicaid enrollees, it would save $2.38 on its cost of covering the existing ones.
Even after the extra incentive goes away, the deal would still be sweet. Studies in nearby states have shown that the additional tax receipts produced by Medicaid expansion — because of the jobs and economic spinoffs that the infusion of new federal funding creates — are covering those states’ 10% share of the cost.
If Reeves and Mississippi lawmakers still aren’t convinced, the Mississippi Hospital Association has offered a plan to transfer the state’s cost of expansion to the hospitals and the new Medicaid beneficiaries — leaving the state treasury with almost nothing to pony up.
It’s as close as you can get to a “no lose” proposition, and still Mississippi’s political leadership says, “No thanks.” It would rather see those millions go elsewhere than to accept another Democratic welfare-state program.
Maybe you could admire this dig-in-your-heels stand for self-sufficiency if Mississippi were consistently a go-it-alone place. It is not.
Whenever a tornado or hurricane hits, we beg for federal aid to recover and rebuild. Whenever crop prices are low or yields or bad, we line up for federal subsidies. When COVID-19 hit, Mississippi didn’t turn back a dime of stimulus money from Washington.
We are a beneficiary state, not a benefactor state. We get much more from the federal government than we pay in federal taxes.
It is only when it comes to helping the poor or the near-poor that Mississippi’s pride — and perhaps prejudice — gets in the way.
This state’s stand on Medicaid expansion is hard-headed and hard-hearted. Maybe no amount of federal money can fix that condition.
