Lt. Governor Delber Hosemann, listens on June 28, 2021, as legislators from other states describe how their states are handling the passage of medical marijuana. Credit: Vickie D. King/Mississippi Today

Lt. Gov. Delbert Hosemann has been the sole member of the state’s political triumvirate, which also includes Gov. Tate Reeves and Speaker Philip Gunn, to not categorically reject expanding Medicaid.

Hosemann has said multiple times that all options should be on the table in terms of expanding health care access for Mississippians. That sentiment has given hope to health care providers and others who support expanding Medicaid.

At last month’s Neshoba County Fair political speakings, the Republican again gave Medicaid expansion supporters reason for hope.

“We are working on making healthcare more accessible and affordable in Mississippi,” he said. “The time for simply saying ‘no’ to our options for working Mississippians has passed. When a cancer diagnosis can bankrupt a family, we have a responsibility to help. Further, no Mississippian should be further than 30 minutes from an emergency room. 

“This fall, the Senate will hold hearings and dig deeper into the delivery of healthcare in our state. From managed care, to scope of practice issues, to insurance options, everything is on the table.”

In the same fair speech, Hosemann reiterated one of his top priorities: increasing Mississippi’s dismal workforce participation rate.

“We are working on getting our fellow Mississippians back to work. Our labor force participation rate still sits at 56% — the second lowest in the nation and not improving with the pandemic shutdown,” Hosemann said, pointing out the workforce participation rate was bad before COVID-19 and remains bad.

Perhaps Hosemann could help achieve his goal of increasing the state’s workforce participation rate by expanding Medicaid.

Tim Alford of Kosciusko was a family medicine doctor for about 30 years before the grandfather of 10 made what some might see as the questionable decision to lighten his workload as the COVID-19 pandemic hit: He became a full-time emergency room doctor in his hometown.

At any rate, Alford has for years been talking about people who work jobs — often multiple jobs — without health care until they get ill with a chronic condition and can no longer work. If the condition had been treated earlier through preventive medicine, that person most likely could have managed his or her illness and continued to work.

Just like heart disease, diabetes, mental illness or many of the other maladies that impact Mississippians, “If people do not have health insurance, that is a medical problem,” Alford said. “They often end up in the emergency room where they are treated with a glorified Band-Aid that may or may not work.”

The emergency room, Alford pointed out, is not the place for effective preventive care.

The workforce participation rate references the percentage of working-age people with jobs. It makes a certain depressing logic that people who no longer work because of a debilitating condition would contribute to the state’s low workforce participation rate. And the sad irony is that if the person with that disability, which perhaps could have been avoided with proper medical care, qualifies for Social Security because of that disability, then that person is automatically eligible for the costlier-to-the-state, existing Medicaid program.

“It is so disappointing to see so many people not be able to function in society where with just a little investment on the front end in health care, they would be able to function,” said Alford.

Medicaid expansion was designed to provide health care coverage to primarily the working poor. It has been enacted in 38 states where the federal government pays 90% of the costs. In addition, the federal government is offering Mississippi more than $600 million in additional funds over a two-year period as an incentive to expand.

Alford cites the state’s high instances of people with schizophrenia as an example where Medicaid expansion could lead to better workforce participation rates. Often people with the mental disease lack the capacity to routinely take their medication to control it. He said a program like the state Health Department’s tuberculosis monitoring program, where staff members actually go to people’s homes to ensure they take their medicine, would be effective in dealing with those suffering from schizophrenia. If the people were on regular medication, Alford said they could be functioning members of society.

Hosemann talks about increasing the workforce participation rate and improving access to health care.

Maybe the next step is determining whether Medicaid expansion can help with both goals. Perhaps deep down, Hosemann already knows the answer to that.

“When our working Mississippians are healthy, they are holding down jobs, contributing to their communities, and supporting their families,” Hosemann said at the Neshoba County Fair. “We should treat our neighbors as ourselves.”


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Bobby Harrison, Mississippi Today’s senior capitol reporter, covers politics, government and the Mississippi State Legislature. He also writes a weekly news analysis which is co-published in newspapers statewide. A native of Laurel, Bobby joined our team June 2018 after working for the North Mississippi Daily Journal in Tupelo since 1984. He is president of the Mississippi Capitol Press Corps Association and works with the Mississippi State University Stennis Institute to organize press luncheons. Bobby has a bachelor's in American Studies from the University of Southern Mississippi and has received multiple awards from the Mississippi Press Association, including the Bill Minor Best Investigative/In-depth Reporting and Best Commentary Column.