I usually agree with Tate Reeves. Overall, I think he’s done a good job under difficult circumstances. When it comes to Medicaid expansion, I think the governor is dead wrong.
Granted, I don’t know all the details of the bills to expand Medicaid. I don’t think anyone does because the Senate and House versions will be revised before a compromise bill is sent to the governor. I understand both raise the limits on what a person can make and still be eligible. I’m perfectly in agreement with that, provided the budget projections say our tax base can handle it without a rate increase. Here’s why.
In the past two weeks I’ve heard two stories from people who would surely benefit from the new limit. One works, one is a stay at home married mom with a hard working husband and a special needs child. She doesn’t work because she has to stay home with the kid.
The mom’s story isn’t unusual. Her husband, an all-around good guy who tries hard to do things the right way, works 50+ hours a week and makes just barely enough for his family to not be Medicaid eligible. His job pays for his insurance and offers insurance for his wife and children. The premium cost for family coverage would decrease his take-home enough that buying groceries would be a major problem. He chooses to buy food instead of insurance. I can’t say that I blame him one bit.
Mom and dad are now separated. Because of that mom and kids are Medicaid eligible. I don’t think that’s a good solution, but they’re good parents and good parents do whatever they have to do to take care of their kids. I’d much rather see my tax money pay for that family’s health care than to have the family split up.
The other person I spoke with is a previously healthy 50ish man. He works every day, but his job doesn’t offer a group plan and he can’t afford private insurance. Recently he’s had episodes of passing out. I witnessed one of those a few weeks ago. He needs to be worked up for this problem, possibly with cardiology or neurology consultations. At the least, he needs lab work and EKG, probably with a week or more of continuous heart monitoring.
I talked with him a couple of weeks later. Nope, no doctor visit yet because he can’t afford it.
These are just two examples of hard-working people who could benefit from increasing the income limits on eligibility for Medicaid. There are thousands of similar stories across Mississippi, stories of people who are working and trying and doing their best.
Here's another question. What happens when these people who don’t have any coverage and can’t pay for primary preventive care end up sick enough to go to the ER and get admitted to the hospital?
For starters, the patient ends up with a bill. This bill is very likely a lot bigger than the office visits that would have caught the diabetes that led to the foot amputation, or the high blood pressure that ended up in a stroke, or the undetected breast cancer that led to a funeral.
Who pays that bill? Probably nobody. The patient who couldn’t pay for an office visit surely can’t pay the hospital charges. This means the hospital gets stuck with another uncollectable account on its books. For many of Mississippi’s struggling rural hospitals, uncollectable accounts like these are the reason they’re struggling. In 2023, Mississippi ranked third in percentage of rural hospitals in danger of closing, trailing only New York and Alabama. Uncollectable bills are a big reason for the financial struggles.
Medicaid expansion would alleviate this in two ways. First, by allowing more people to visit primary care clinics instead of ERs, this preventing costly ER visits. Earlier care also prevents bigger problems that require hospital stays. Second, expanded Medicaid would enable struggling hospitals to collect something on what is now unreimbursed care.
We hear about how we need to improve infrastructure to attract jobs to Mississippi. How many industries are going to move to a place with no hospitals? No money eventually equals no hospital.
The state House and Senate are making the effort. I hope they find a middle ground and succeed. It’s time to lend a hand to our Mississippi families who are trying but need a little help.
It's also time for the Governor to do the right thing.
