Democratic gubernatorial candidate Brandon Presley talks about ethics reform in state government during a press conference, Tuesday, May 16, 2023, at the Mississippi Capitol in Jackson. Credit: Eric Shelton/Mississippi Today

MERIDIAN — In his latest pitch to voters on expanding Medicaid coverage to the working poor, Brandon Presley said he would consider a model similar to Arkansas or Indiana’s version, a plan some Republican lawmakers have already endorsed. 

Presley, the Democratic candidate for governor, said if elected, he will not operate in a “Disney World” type of naive governance on Medicaid. Rather, he would work with legislative leadership to compromise on a deal that expands the program to working people.

“There’s going to be legislative influences, and there are going to be legislative changes, and there ought to be,” Presley said. “I’m not against that. There are ways to look at the Arkansas model or the Indiana model or models in other states in which we get something done on it.” 

What’s notable about Presley’s latest announcement is some conservative legislators at the state Capitol have already gotten behind an Arkansas model, though they might not describe it as a type of expansion.

Arkansas, in 2014, first utilized a private insurance route. Instead of expanding Medicaid to provide health insurance to primarily the working poor – up to $18,500 per year for an individual – with the federal government paying 90% of the costs, Arkansas draws down those funds to help people purchase private health insurance policies.

Senate Medicaid Chairman Kevin Blackwell, a Republican from Southaven, told Mississippi Today in December that he opposes traditional Medicaid expansion, but he would support a program that uses federal dollars to connect the working poor to private insurance. 

Rep. Jason White, the presumptive incoming speaker of the House, also told the Daily Journal in March that he wants to consider examining the state’s Medicaid policies, though he did not mention a specific type of expansion policy. 

“… My Republican colleagues are not going to come for a straight-up Medicaid expansion package,” White said. “But they would consider something if the private businesses would get involved in that conversation, whatever it is.” 

Other conservative states, such as Indiana when current presidential candidate Mike Pence was governor, have used alternative strategies to expand Medicaid access to more people. Eligibility for Indiana’s Medicaid program is more strict than federal limits and requires beneficiaries to create health savings accounts. 

Mississippi’s burgeoning hospital crisis has emerged as one of the major issues of the statewide election cycle as more medical centers in the state continue to slash patient services to remain in business.

Since Presley and Republican Gov. Tate Reeves have started campaigning for office, the crisis has worsened. St. Dominic Memorial Hospital in Jackson laid off over 5% of its workforce and eliminated its mental health services, and Memorial Hospital in Gulfport cut 2% of its employees. 

A third of Mississippi’s rural hospitals are also at risk of closure within the near future, according to a recent report from the Center for Healthcare Quality and Payment Reform.

“Tate Reeves is fiddling while the health care system in Mississippi burns to the ground,” Presley said on Monday. 

Reeves’ campaign did not respond to a request for comment, but the incumbent governor running for a second term has consistently rejected Medicaid expansion as a solution to the burgeoning health care crisis. 

Instead, Reeves believes in abolishing the state’s certificate of need laws, or CON laws, because he thinks it will cause more innovative medical services to emerge in the Magnolia State.

CON laws require medical facilities to seek approval from the state Health Department before they create a new health care center or expand an existing facility’s services in a specific area. 

Mississippi is one of the 10 states in the country that has not passed any form of Medicaid expansion. Economic experts say the remaining states, many in the Deep South, would experience an economic boon if officials expanded the program. 

Neighboring Louisiana under Democratic Gov. John Bel Edwards’ administration passed Medicaid expansion. Bel Edwards cannot run again because of term limits, and none of the candidates trying to succeed him are looking to undo his expansion policies. 

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Taylor, a native of Grenada, covers state government and statewide elections. He is a graduate of the University of Mississippi and Holmes Community College. Before joining Mississippi Today, Taylor reported on state and local government for the Northeast Mississippi Daily Journal, where he received an award for his coverage of the federal government’s lawsuit against the state’s mental health system.