When Philip Gunn announced last week that he would step down from the Legislative Assembly after one more year, several of his political admirers have gushed with praise for the President of the Republican House.
He has been credited with being a catalyst for from Mississippi economic growth, for a series of tax cuts for businesses and individuals, for pro-life legislation that led to the overturning of Roe v. Wade and for a new state flag to replace the long-standing racist one.
But there’s another legacy that neither Gunn nor his fans should be so proud of.
He has been a major impediment to Medicaid expansion, costing that state approximately $8 billion federal funding and counting, left 200,000 to 250,000 modestly paid Mississippians without insurance and helped push a growing number of hospitals in that state, including Greenwood Leflore Hospitalat the precipice of closure.
Gunn dug his heels against Medicaid expansion only slightly less stubbornly than Tate Reeves, who has been a filibuster as lieutenant governor and now as governor. They made it politically dangerous for any Republican lawmaker to support Medicaid expansion, regardless of the numbers, research, or experience of other states that have expanded Medicaid.
Why, then?
Because they made the political calculation that opposing anything associated with the former president barack obama or his Democratic successor, Joe Bidenis a winner for them in a state dominated by Republican conservatives — and no reason or financial incentive for this state has convinced them otherwise.
Since the Affordable Care Act, better known as Obamacare, was passed in 2010, at least eight government or private studies have been conducted on the impact of Medicaid expansion on Mississippi, according to a recent report from Mississippi Today. All but the oldest study, conducted before the Medicaid expansion took effect, found that the expansion would be a net financial benefit to Mississippicompletely refuting the contention of Republican opponents that the state could not afford to accept a dollar for each nine dollars contributed by the federal government.
Gunn didn’t care.
In 2021, in the first months of the Biden administration, the Democratic majorities in Congress tried to attract Mississippi and the other 11 states without expansion with an even better offer. Not only would the federal government pay 90% of claims for new policyholders, but it would also reduce the state’s share of costs for two years for people covered by the regular Medicaid program. To Mississippithis incentive is equivalent to an estimate $600 million at $700 million.
In other words, Mississippi would make money by expanding Medicaid in the first two years, and after that it would at least break even, given the additional state tax revenue generated by the injection of federal dollars.
Gunn still wasn’t moving.
The continued opposition not only defies economic reason, but it has serious consequences for hospitals like ours.
When the Medicaid expansion was signed into law, the authors of the legislation said the government would largely pay for it by eliminating, or at least drastically reducing, payments the federal government gave to hospitals that treat a disproportionate share of patients. uninsured. The reasoning was that diverting these so-called DSH payments was reasonable since any state would be crazy not to accept what the federal government was offering in their place.
Congress underestimated how mullet head Mississippi perhaps.
The stubbornness of Gunn, Reeves and others like them dealt a double whammy to Greenwood Leflore Hospital. Not only did he lose the additional revenue that Medicaid expansion would bring, he saw his DSH payments reduced by approximately $6 million per year to less than half a million.
It would be simplistic to say that expanding Medicaid alone would save Greenwood Leflore Hospital. It could, however, be an important part of a solution that would require some or all of the following: higher reimbursements from government and private insurers; cracking down on managed care companies that try to deny benefits; reductions in Medicaid taxes that hospitals pay to the state; and, at least in the short term, grants from the city and county co-owners of the hospital.
Gunn shocked expectations by becoming the state’s first prominent Republican elected official to call for a new state flag. He needs to pull off an equally dramatic surprise and reverse his stance on Medicaid expansion. And it has to come quickly, or not only from Greenwood hospital likely to fail, but several more soon after.
Reeves will not change positions. It is a given. He has given too much political weight to his opposition to any expansion of social safety net programs, despite being more than comfortable handing out welfare to corporations.
That means it would take non-veto majorities in both houses for Medicaid expansion to happen. It’s a huge lift, and it becomes impossible without Gunn’s support.
Gunn’s retirement announcement suggests he may have cooled off the idea of running for governor. Whether he did or not, he has a chance to redeem himself for helping to put from Mississippi rural hospitals in the state they are in now. Hope he tries.
– Contact Tim Kalich at 662-581-7243 or [email protected].
