Note: This article was first published in Mississippi Today’s weekly legislative newsletter. Subscribe to our free newsletter for exclusive early access to legislative analyses and up-to-date information about what’s happening under the Capitol dome.
Democratic legislative leaders will propose a plan this week to address a problem they say most of their Republican counterparts won’t even fully acknowledge: the Mississippi hospital crisis.
State health officials have warned lawmakers that 38 rural hospitals across the state are in danger of imminent closure because of budget problems. Some of those hospitals are larger regional care centers, such as Greenwood Leflore Hospital.
Even the large metro hospitals are understaffed and struggling to provide adequate care due to rising costs. Physicians and other health care leaders are sounding the alarm about the entire state’s ability to maintain a reliable system of care.
Given the growing urgency of the crisis, Democratic leaders under the dome say they can’t wait around for their Republican counterparts to propose solutions.
“I feel silly trying to explain to (Republicans) why we need to do something about this quickly when the need is right there smacking them in the face every single day,” said Rep. Robert Johnson, the House Democratic leader. “These people have the best possible access to the best possible information about the state, and they’re ignoring it. They’re running away from the problem. The house is fully on fire right now, but it’s fine because Republicans say it’s not really burning.
“I don’t know what they’re waiting on, but this crisis needs to be addressed right now,” Johnson continued. “I don’t know where their plan is, but we have one.”
That plan, shared with Mississippi Today before legislation is filed in coming days, has two key components:
- A bill that would appropriate $150 million as a “lifeline” to rural hospitals. The state would send cash directly to the hospitals to help temporarily balance their budgets and fund health care services. Public hospitals that can demonstrate financial hardship would apply for grants from the new fund, which would be administered by the Department of Finance and Administration. This proposal would flow from several funding sources: $135 million from American Rescue Plan Act funds lawmakers haven’t yet spent; $13 million from the state’s Health Care Expendable Fund; and $2 million from the BP settlement fund.
- Several bills that would expand Medicaid under the Affordable Care Act, as 39 other states have done. Numerous economists say Medicaid expansion would provide $1 billion in new revenue to the state and help hospitals better cover the rising costs of providing care to poor, working Mississippians. Many Democrats have filed bills to expand Medicaid for more than 10 years, but GOP leaders at the Capitol have deeply dug their heels in opposition to it, claiming without proof that the state cannot afford it and writing it off as a liberal policy of former President Barack Obama.
Rep. John Hines, who authored the rural hospital lifeline bill, said the first bill is intended to help hospitals temporarily until Medicaid expansion, the more long-term solution, is passed. Johnson, who has fought for Medicaid expansion for several years, panned the legislative Republicans who have blocked it.
“The Black man who was president is far enough removed now for Republicans to wake up and realize that every single Mississippian — white, Black, Democrat, Republican — is losing money and might lose out on critical care because of this crisis,” Johnson said. “We’re leaving $1 billion on the table every year while our hospitals close and people die. It’s as simple as that.”
The Republican leaders at the Capitol, House Speaker Philip Gunn and Lt. Gov. Delbert Hosemann, are at odds about how to meet the moment. And in the early days of the session, no Republican appears eager to move quickly to pass a hospital crisis fix.
Gunn, who along with Gov. Tate Reeves is directly responsible for the state’s resistance to Medicaid expansion, proposed in December a one-time, $50-$70 million appropriation for hospitals this year. That was panned by critics and even inspired a statewide newspaper column that bluntly asked: “Will closed hospitals be Gunn’s legacy, too?”
Hosemann, to his credit, has been the one Republican leader who has directly acknowledged the hospital crisis. In December, he said he sought solutions to the crisis “not just for next year, but for the next generation.” He floated several ideas, including expanding a Medicaid program for new mothers — an effort he successfully led in the Senate last year but was killed by Gunn and the House — and increasing Medicaid reimbursements to struggling hospitals.
Hosemann has long been one of few Republican leaders open to discussion of Medicaid expansion, but he said last month it’s not likely lawmakers will tackle that issue this year. He also said it’s not a cure-all.
“I don’t think that’s the answer,” Hosemann said in December. “Even if we had that expansion, (Greenwood Leflore) would not make it, it would still be short.”
After just the first week of the legislative session, key lawmakers and legislative observers are already repeating the refrain: “Don’t expect anything major to gain steam this year because it’s an election year.” Indeed, all 174 legislative seats and all eight statewide offices are up for grabs this November.
But that logic isn’t sitting well with Johnson and other Democratic leaders, particularly as the Mississippi hospital crisis worsens by the day.
“This is quite literally a matter of life and death, and we seem to be the only people in this building united behind providing relief for hospitals and health care for all Mississippians,” said Sen. Derrick Simmons, the Democratic leader of the Senate. “We’re going to push Republicans hard on this. We aren’t elected for three years and a vacation to Jackson during election years.”
Simmons continued: “We’ve got a plan. Here it is. ‘No’ is no longer an acceptable answer from the Republicans standing in the way of addressing this issue. If you don’t like it, and you have a better idea, then let’s hear what the plan is.”