Republican ethos of unilateral cuts will get ballot test


The Mississippi Hospital Association says it’s found a way to accept $1.35 billion annually in federal money to expand health insurance for the poor without costing the state anything.

The state has to match 10 percent of the total dollars, and the hospital association wants to do that by having hospitals put up roughly half ($78 million of $150 million) and having the new recipients of the Medicaid coverage to do the rest by paying $20 each per month, which would generate $72 million if you had 300,000 enrollees.

Tim Moore, CEO of the hospital group, laid out details of the plan, called “Mississippi Cares,” in a talk to the state Press Association last Friday in Biloxi.

From an economic perspective, the idea could provide a crucial boost for the state’s economy in a time where it has struggled with population loss and flat economic growth. Health care is a rapidly growing field and with aging Baby Boomers it figures to continue to be for decades. Its jobs pay well.

From a medical perspective, it could help the state’s working poor get better coverage that could save everyone money in the long run. The hospital association says about two-thirds of the 300,000 people who would be covered by Medicaid expansion work but don’t get coverage through their employer and can’t afford it on their own. Moore makes the case that those people who are trying to better themselves deserve help more than those currently on Medicaid who don’t work at all.

Now they go to the ER for non-emergency issues, where hospitals are required to treat them. If they can’t pay, it both ruins their credit and the hospital loses money by providing care it never gets paid for. Moore said the state’s hospitals have an annual uncompensated care cost — not what they charge but what it actually costs them — of $624 million. No wonder they’re willing to pay $78 million toward helping insure them.

It’s also important for keeping the doors open at rural ERs, which are a life-saving part of the medical system. When someone has a heart attack or is seriously injured in an accident, getting them immediate care within 30 minutes of their home is often truly a matter of life and death. Yet five Mississippi hospitals have closed since 2010; many more are in serious financial binds.

Considering the important health and economic roles that hospitals play in every Mississippi community, if they say Medicaid expansion is needed, then state leaders ought to listen.

Of course, the opposition has never been rooted in facts, but rather a political idea that opposing anything to do with Obamacare will score points with the conservative voters who dominate in Mississippi.

Now the Hospital association is giving the legislature cover by presenting a plan that won’t require any state appropriations. It also has conservative bona fides by the fact that Vice President Mike Pence, a solid conservative, successfully implemented a similar plan in Indiana when he was governor there.

Moore calls it “Medicaid reform” rather than expansion and says it is not Obamacare. Call it what you want, but growing the number insured by states’ Medicaid programs to alleviate the costs on hospitals of uncompensated care for the uninsured was part of Obamacare, which remains in place today and figures to be here for the foreseeable future.

“Realize now that you’re already paying the tax on a federal level to fund the $1.3 billion ... We’re paying it in all but 14 states ... Why are we not taking advantage of it? It just makes absolutely no sense,” Moore said.

Moore said the push for Mississippi Cares is the strongest grassroots effort that the Mississippi Hospital Association has made in many years. If the state’s Republican leadership rejects the hospitals on this, you wonder exactly how many influential voting blocs they can afford to ostracize.

Teachers are upset about low salaries and not fully funding education according to the state’s own standard.

The Mississippi Economic Council, which represents the state’s industrial leaders, has been rejected for years over its plan to raise the gas tax to fix roads and bridges. Don’t forget farmers, who need good infrastructure to bring their crops to market, county supervisors, who are taking heat daily about potholes, and road builders, whose livelihood is tied to how many miles get paved.

The question is, with the new Tea Party-inspired Republican ethos of flatly rejecting all government spending without consideration of the particulars involved, do these groups have a voice any longer under the current leadership in Mississippi?

If not, why don’t they use their voting strength to change things up?

Charlie Smith is editor and publisher of The Columbian-Progress. Reach him at (601) 736-2611 or

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1. He drove a blue ‘77 Chevy Nova in high school. 2. He played on Jackson Prep’s 1985 and 1986 state championship basketball teams.