Note: This essay is part of Mississippi Today Ideas, a new platform for thoughtful Mississippians to share fact-based ideas about our state’s past, present and future. You can read more about the section here.
Patients frequently show up in the emergency room at Neshoba General in Philadelphia without any health insurance.
Sometimes the issue is a bad cold, a cough or a fever — common illnesses that will go away over time, though treatment by a healthcare professional could ease symptoms. Many times, the diagnosis is much more complicated because of delayed care.
Almost all the time, the person who needs our help has a job (or two).
Last year, the Legislature filed a conference report which would have made Mississippi the 41st state to expand Medicaid, creating a payor source for patients like these. Though it did not pass, six influential lawmakers, including House Medicaid Chair Missy McGee and Senate Medicaid Chair Kevin Blackwell, signed off on the report.
Included in the language was a work requirement, with exceptions for full and part-time students, caregivers of non-school age children and others. In his first term, President Trump’s administration approved such requirements and is likely to approve them again. Under the bill, the state would not be saddled with additional financial obligations. Instead, managed care companies who stand to benefit from expansion would pay for it.
All in all, Mississippi got closer to a compromise on Medicaid expansion during the 2024 legislative session than we ever have before.
The state’s decision not to expand has been expensive for us. Federal law requires hospitals participating in Medicare and offering emergency services to screen and treat patients regardless of whether they can pay for services. Any other business forced to provide goods and services to customers who cannot pay would close.
It has also been expensive for the state. Mississippi’s labor force participation rate is usually the lowest, or next to the lowest, in the nation. When people are not healthy, they are not working. We all know the domino effect from there: less taxpaying citizens, less business growth, less economic viability, more government dependency.
The biggest issue, though, is the personal impact not expanding Medicaid has on our friends and neighbors in Mississippi.
People who present in our emergency rooms without insurance are most always people we know in our community. They face tough decisions every day about how to use limited resources. Paying for childcare or groceries, for example, means forgoing preventative services or delaying life-saving treatment.
While the substantial increases in federal MHAP supplemental payments (funded by a tax on hospitals) have helped stabilize hospitals, the program is fragile and subject to annual renewal. More importantly, none of those funds go to help individuals under 138% of the federal poverty level (those earning about $21,600 annually) procure health insurance.
We are so thankful for the Legislature’s significant efforts and pray the conversation about Medicaid expansion continues this year. The state needs expansion to grow our work force and thrive. Hospitals, particularly in rural areas, need expansion to survive.
However, hard-working Mississippians holding down low-wage jobs that are crucial to our economy are the ones who need — and deserve — it the most.
Lee McCall is CEO of the Neshoba General Hospital in Philadelphia and chair of the Mississippi Hospital Association.
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