The most common refrain of prominent Mississippi elected officials who have long rejected the expansion of Medicaid under the Affordable Care Act — that the state cannot afford the costs of the program — was refuted this week by the state’s leading economic expert.
State Economist Corey Miller, a researcher employed by the state’s public university system, released a comprehensive report this week showing that expanding Medicaid would effectively pay for itself and the state would incur no new expenditures.
Under the Affordable Care Act, the federal government would cover 90% of the health care costs related to expansion, while Mississippi would have to cover 10%. The economists found that the 10% state match would be more than covered by health care-related savings to the state and new tax revenue generated.
Two of Mississippi’s most prominent elected officials — Gov. Tate Reeves and Speaker of the House Philip Gunn — oppose Medicaid expansion, repeating that the state cannot afford the costs. But this week’s research directly refutes their claim for Mississippi, one of just 12 states that have not expanded Medicaid.
“Based on our estimates of the costs and savings associated with Medicaid expansion, Mississippi could enter Medicaid expansion in 2022 and incur little to no additional expenditures for at least the first decade of expansion,” Miller and senior economist Sondra Collins wrote in the report.
What’s at stake, the researchers found, is providing health care coverage to between 228,000 and 233,000 Mississippians who are not currently insured. This estimate primarily includes Mississippians who politicians often refer to as the “working poor” — people who are employed but cannot afford health insurance.
Mississippi, if leaders chose to expand Medicaid, would have to foot a bill between $186 million and $207 million from 2022 to 2027, the researchers found. But cost savings to the state in several other areas — most significantly from reductions in uncompensated care costs that the state’s hospitals must currently cover — would more than offset the costs to the state in at least the first 10 years of expansion, the research found.
The report was released this week, as there’s more incentive than ever to expand Medicaid. In addition to covering 90% of the costs, the federal government would provide Mississippi an additional $600 million to expand Medicaid under recent legislation passed by Congress. Mississippi lawmakers would have virtually no limitations on what they could spend that money on.
In addition to the health care benefits, the researchers showed that expansion would be an economic boon to the state, creating almost 11,300 jobs a year between 2022 to 2027. A majority of these jobs would be added in the health care and social assistance sector.
Medicaid expansion would also increase the state’s gross domestic product (GDP) each year between about $719 million and $783 million, and it would increase the state’s general fund revenue by about $44 million per year. That added revenue would come primarily from an increase in individual income tax collections, the researchers found.
Additionally, Medicaid expansion would also increase the state’s population by about 3,300 to 11,500 new residents per year between 2022 and 2027. This is notable given that Mississippi was one of just three states in the U.S. to lose population between 2010-2020.
Similar reports from economists in recent years have not moved several prominent elected officials. Reeves, an ardent opponent of Medicaid expansion, will not hear a question about expanding without quickly using the term “Obamacare” and promising to never support it.
Gunn is also among prominent leaders to reject talks of Medicaid expansion.
“I am not open to Medicaid expansion,” Gunn said at the end of the 2021 legislative session in April. “… I don’t see Medicaid expansion as something that is beneficial to the state of Mississippi. I just don’t think the taxpayers can afford it. That is what it boils down to is the taxpayers. It is their money. I just don’t have taxpayers calling saying we want you to raise taxes so we can expand Medicaid.”
Gunn argued that the “most sick, those who are the poorest” have health care coverage now. He said expansion is “to bring in another class of citizens who are not in the lowest category. This would be the next tier up. I just do not think we can afford it.”
Lt. Gov. Delbert Hosemann is open to considering some version of Medicaid expansion, though he will not refer to it by that term. The Senate, under Hosemann’s leadership, plans to hold hearings on the issue in October.
“We are working on making healthcare more accessible and affordable in Mississippi,” Hosemann said in July at the Neshoba County Fair. “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.”