Harrison: Mississippi politicians have long history of opposing efforts to provide health care for their citizens

Below is a political analytics column by Bobby Harrison:

There’s a strong feeling of déjà vu in Mississippi politics.

When Haley Barbour began his successful 2003 gubernatorial campaign, he criticized Democratic incumbent Ronnie Musgrove for expanding the state’s welfare rolls.

Barbour was referring to the fact that during the Musgrove administration, enrollment in the Children’s Health Insurance Program (CHIP) increased significantly.

When Musgrove took office in January 2000, a little more than 12,000 Mississippi children were signed up for the health insurance program that was enacted by Congress in 1997. When Musgrove left office, defeated by Barbour in his 2003 reelection bid, almost 83,000 children were enrolled in the program.

CHIP is a federal program that provides health insurance for children of the working poor — parents who make too much money to qualify for Medicaid, but work in jobs where employer-based insurance is not provided and their pay makes purchasing insurance prohibitive.

Musgrove was proud that his administration increased enrollment in CHIP. He viewed obtaining health insurance for children who otherwise would not have it as a good thing. After all, the federal government was paying the bulk of the cost.

In Mississippi politics, the more things change the more they stay the same.

This year, 20 years later, Democrat Brandon Presley is challenging Republican incumbent Gov. Tate Reeves and is making Medicaid expansion a focus of his campaign. Presley has argued it would be good to expand Medicaid like 40 other states have done to provide health insurance for primarily the working poor, with the federal government again paying the bulk of the cost.

Reeves, who could be considered a Haley Barbour disciple, has said he is opposed to the expansion “of government run health care.” Reeves has said that he supports people getting health insurance through good paying jobs, not through a government program.

It is reasonable to assume that people want good paying jobs that offer health insurance. But after a decade of not expanding Medicaid and waiting for those good paying jobs, Mississippi still has the nation’s fifth highest rate of uninsured residents. All 40 states that have expanded Medicaid have lower uninsured rates.

According to the Kaiser Family Foundation, Mississippi’s uninsured rate as of 2021 was 11.9%. Two states that Reeves says he wants to emulate because they have no income tax – Texas and Florida – are among the four states with higher rates of people without health insurance than Mississippi. Texas is first with an uninsured rate of 18% and Florida is fourth with a rate of 12.1%. The other state that Reeves likes to tout because of the absence of a state income tax – neighboring Tennessee – has an uninsured rate of 10.1%.

The national uninsured rate is 8.6%. Two of the three Southeastern states that have expanded Medicaid – Kentucky and Louisiana – have a smaller percentage of people without health insurance than the national average. The third state, Arkansas, has a percentage of uninsured slightly above the national average.

Every state has some uninsured residents. Massachusetts is the lowest with an uninsured rate of 2.5%. Some healthy people will not sign up for health insurance even if Medicaid expansion is available.

But surely more people with insurance is better than fewer people with insurance. And for struggling health care providers in Medicaid expansion states – especially hospitals – they have the option to help the uninsured sign up for Medicaid if those people are undergoing expensive medical procedures with no ability to pay.

All three governors of Southern states that expanded Medicaid said during recent interviews with Mississippi Today that they believed it was better for those treatments to be paid through Medicaid than the other options.

Those other options include:

• The medical providers passing the costs on to private insurance and to those with private insurance.
• Medical providers, especially hospitals, closing or dramatically cutting back services because of the money they are losing on uncompensated care.

Former Mississippi Gov. John Bell Williams recognized these facts way back in 1969 when he convinced the Legislature to opt into the original Medicaid program. Previously, as a member of Congress, Williams had voted against creating Medicaid.

But later as governor, Williams told legislators, “In fairness, I must point out that my philosophical reasons for resisting the program as a member of the United States Congress is neither relevant nor applicable to the present issue before us. The program is a reality. It is available to our state and now devolves wholly into a question of whether you, in your wisdom, should determine our participation will be in the best interests of our state and people.”

Haley Barbour, too, recognized this after he was elected governor in 2003. Though he railed against the CHIP program during the 2003 campaign against Musgrove, he did nothing to try to roll it back during his two terms as governor.

There’s a strong feeling of déjà vu in Mississippi politics.

— Article credit to Bobby Harrison of Mississippi Today —