Helping Mississippi’s Working Poor Get Healthcare is Economic Development in Action

• Columnist Sid Salter says the Mississippi Legislature should finish the job and expand Medicaid.

In recent decades, Mississippi has defied the odds in economic development. Landing first Nissan and then Toyota automobile manufacturing plants, Steel Dynamics and Aluminum Dynamics flat-roll operations, and recently Amazon Web Services in Madison County and EVE Energy battery plant in Marshall County, Mississippi is, as Gov. Tate Reeves often repeats, “open for business.”

Those job victories are in addition to the $8.8 billion in agricultural production value led by Mississippi’s poultry and timber industries.

To keep Mississippi “open for business” it is incumbent on our state’s leadership to make sure current and future employers can invest in our state with a reasonable assurance of quality public schools, a well-maintained system of transportation infrastructure, green spaces and amenities that offer a reliably good quality of life, and an accessible, affordable and effective healthcare system.

Mississippi is finally taking steps toward reclaiming a portion of the federal tax dollars Mississippians have been paying to provide public healthcare for the working poor in 40 other states but not in our state where healthcare disparities are achingly real and politically inarguable.

The Mississippi House of Representatives has by a margin of 98 to 20 passed legislation that would expand Medicaid benefits to individuals aged 19 to 64 who earn no more than 138% of the federal poverty level. The bill contains a work requirement – which the feds are likely to disapprove – but even so, the bill would expand Medicaid coverage in Mississippi for four years before a legislative repealer kicks in.

The bill now awaits the action of the Mississippi State Senate, where Lt. Gov. Delbert Hosemann has been a champion of providing healthcare for Mississippi’s working poor along the general lines of the House proposal. If the Legislature can agree on a plan, that plan would then go to Reeves’ desk for his signature, veto, or decision to allow the bill to become law without his signature.

Opponents of any form of Medicaid expansion in Mississippi and the other 10 states across the country that have not expanded coverage make three primary arguments – the state can’t afford the state share of the costs, expanding Medicaid will discourage finding work, and states should not increase enrollment in a “broken program.”

But a scholarly article from the Journal of American Medicine in 2020 entitled “The Benefits of Medicaid Expansion” argues that Medicaid expansion impacts the state’s economy in three tangible ways: “1) Helps low-income families’ health and financial well-being, especially those in which someone has lost a job; 2) Expanding Medicaid reduces hospitals’ uncompensated care…uninsured patients will still be cared for, as hospitals on the front line have demonstrated every day throughout the coronavirus pandemic; and 3) Medicaid expansion creates or protects jobs.”

The academic study, first published in 2019 by the National Bureau of Economic Research, was written by University of Michigan scholars Thomas C. Buchmueller and Helen G. Levy, and Betsy Q. Cliff of the School of Public Health, University of Illinois at Chicago.

The trio of scholars found: “Comparing trends in states that implemented the Medicaid expansion to those that did not, we find that the ACA Medicaid expansion substantially increased insurance coverage and improved access to health care among unemployed workers. We then test whether this strengthening of the safety net affected transitions from unemployment to employment or out of the labor force. We find no meaningful statistical evidence in support of moral hazard effects that reduce job finding or labor force attachment.”

The House version takes advantage of the fiscal realities of expanding Medicaid with a work requirement. The repealer gives state government a chance to review and assess the program after four years. And it provides a revenue source for Mississippi’s beleaguered rural hospitals.

Let me repeat this because it bears repeating. Mississippians who pay federal taxes are already paying for expanded Medicaid that benefits the working poor in other states. They were paying for it under Presidents Obama, Trump and Biden. The catch is, that none of your fellow Mississippians who are working but can’t afford health insurance can access that care.

The Mississippi Legislature should finish the job and change that irrational fact. Working poor Mississippians deserve the same medical care available to 80 percent of their American cousins.