Speaker Philip Gunn said he didn't know the human effects of killing a postpartum Medicaid extension bill. But top doctors say they gave him the details weeks ago. Credit: Eric J. Shelton/Mississippi Today

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After Speaker of the House Philip Gunn killed a Senate bill last week that would have extended postpartum Medicaid coverage for thousands of Mississippi mothers, he claimed he had not seen data or been part of discussions showing that the extension would save lives.

But five of the state’s major medical associations penned a letter to Gunn in February that laid out the relevant data and directly stated extending the program would save mothers’ lives.

The letter to Gunn and other members of the House detailed how extended coverage would reduce the state’s high maternal mortality rate and save the state money by reducing premature births. 

“Postpartum coverage also lowers the risk of pregnancy-related deaths,” the letter stated. “37% of these deaths occur (more than) six weeks after delivery, when these moms would traditionally have lost their healthcare coverage. Extending coverage to moms for 12 months would save many mother and baby lives.”

If postpartum Medicaid coverage is not extended, it would affect thousands of Mississippi mothers and their children. About 60% of mothers who give birth in Mississippi are covered by Medicaid. The state’s maternal mortality rate is nearly twice that of the national average, and Black women are nearly three times more likely to die as a result of pregnancy than white women, according to a 2019 report from the Mississippi Department of Health.

The speaker, defending his decision to kill the postpartum coverage bill that passed overwhelmingly in the Senate with bipartisan support, likened the program to expanding Medicaid under the Affordable Care Act.

“I have been very clear that I oppose Medicaid expansion, and that I believe we should be working to get people off Medicaid as opposed to adding more people to it,” Gunn said last week.

A spokeswoman for Gunn told Mississippi Today his office has not received the letter and reiterated that Gunn is opposed to expanding Medicaid. The extension of postpartum coverage would not add individuals to the Medicaid rolls, but instead extend already enrolled mothers’ eligibility.

When asked how the extension could be described as Medicaid expansion under the Affordable Care Act, the spokeswoman did not respond. 

READ MORE: Medicaid coverage helped this Mississippi mom fight postpartum depression. Now, she’s set to lose it.

Meanwhile, Lt. Gov. Delbert Hosemann is attempting to revive the extension via two other bills or through the appropriations process. A visibly frustrated Hosemann condemned Gunn in a Monday press conference for killing the bill and said he would work to convince the speaker to change his mind before the legislative session ends on April 1. 

“This is a good faith effort to keep our babies healthy and our mothers healthy,” Hosemann said in response to Gunn’s suggestion that this is considered Medicaid expansion. “And when our mothers are healthy, what do they do? They take care of their children, and they go back to work.” 

Hosemann plans to appeal to Gunn’s faith, he told reporters in his Capitol office on Monday. 

“Sometimes we get into the heat of legislation, and we forget where we came from,” Hosemann said. “I’d like to appeal back to his (Gunn’s) Christian values that we need to take care of these kids in addition to helping moms out.”

In a time when the state is flush with cash and legislative leaders are poised to approve hundreds of millions of dollars in tax cuts, the estimated cost for the state in the first year of extending coverage would be $6 million, according to the Division of Medicaid. That total represents less than 1% of the state’s general fund budget. In the second year, which would be the first full year of the extension, the state’s portion would be around $11.5 million.

Several other Southern states have extended the coverage as allowed by the American Rescue Plan Act of 2021, including Georgia, Florida, Texas and Tennessee. 

“It’s really a disappointment because it sends a very disconcerting message to expectant women … about how far we are willing to go as a state to ensure that they are not just valuable to us during the time they’re pregnant” but also after they’ve given birth, said Dr. Michelle Owens, the division chief of the Department of Obstetrics and Gynecology in the School of Medicine at the University of Mississippi Medical Center. 

“This is a very small step to at least ensure that when that baby has its first birthday, the mom is there to celebrate.” 

Dr. Anita Henderson, the president of the Mississippi chapter of the American Academy of Pediatrics, said new moms who have access to health care after giving birth are more healthy for their next pregnancy. 

Mississippi leads the nation in both preterm birth and low birthweight. A premature baby can cost up to $500,000 compared to a full-term birth, the letter adds. 

“Our point has been we want to continue that coverage. We want those moms to be able to get birth control and space their pregnancies so they’re healthier and more likely able to have a full-term baby the next time around,” said Henderson. “You actually would save the Division of Medicaid money if you could cut down on preterm birth.” 

Some Capitol observers believe Gunn killed the postpartum coverage bill because of the ongoing fight between House and Senate leaders over Gunn’s proposal to eliminate the state’s income tax. Senate leaders, including Hosemann, have adamantly opposed Gunn’s tax plan because they say the financial risks and economic unknowns are too great.

READ MORE: The Mississippi Republican income tax bet

No state has ever eliminated a personal income tax as Gunn has proposed. Senate leaders and other economic experts believe the plan could gut the state’s economy and drastically change the way government functions in the short and long term.

Several other Senate measures have been killed by Gunn and House leaders in recent days, and Gunn is threatening to hold hostage $1.8 billion in federal stimulus funds until Senate leaders adopt his income tax elimination plan.

A spokeswoman for Gunn’s office did not respond Tuesday when asked whether Gunn would be open to reconsidering the postpartum Medicaid extension.

But on Tuesday morning, Gunn told reporters at the Capitol: “My position on the postpartum bill has not changed.”

Hosemann said this week that he is going to try to change the speaker’s mind. 

I’m hoping that given the chance to look at it again, it won’t be tied up in some tax bill,” Hosemann said on Monday afternoon. “Those aren’t the same. There’s no quid pro quo here, there should never be. We all took the same oath when we came to work here.”


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Kate Royals is a Jackson native and returned to Mississippi Today as the lead education reporter after serving in the same capacity from 2016 to 2018. Prior to that, she was a reporter for the Clarion-Ledger covering education and state government. She won awards for her investigative work, including stories about the state’s campaign finance laws and prison system. She was a news producer at MassLive in Springfield, Mass., after graduating from Louisiana State University’s Manship School of Mass Communications with a master’s degree in communications.