Mississippi Rejects Medicaid Expansion: Wise Move for America’s Least Healthy State?

For the tenth year in a row, Mississippi has placed last in America’s Health Rankings, an annual report issued by United Health Foundation. With an increasing portion of the state’s population (19.2 percent) lacking any type health insurance coverage and a 21.3 percent poverty rate, also making it the poorest state in the union, Mississippi appeared to many as the state that would benefit most from extra federal funding for its Medicaid program; however, Governor Phil Bryant vehemently disagrees.

In his October 1, 2012 editorial in the Washington Post, Governor Bryant declared that he would fight against any efforts to expand the state’s Medicaid program. His stance makes Mississippi the sixth state in the Union, in addition to FL, GA, LA, SC, and TX, to officially reject Medicaid expansion under the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148). Some critics believe that these states, all led by Republican governors, are merely politically posturing for the upcoming November elections, in which PPACA repeal is a popular stance of Republican candidates.

Those in support of the expansion cite Mississippi’s population, poor in both health and finances, as a key example of why the Medicaid expansion is essential to health reform. They criticize the governor for turning down “free money” from the federal government that would allow the state to raise the ceiling for income eligibility for the program, with the federal government paying 100 percent of the expansion cost until 2017, when the state would be required to cover 10 percent of the bill. It is estimated that Mississippi could subsequently provide coverage for 400,000 additional residents. Hospitals have also voiced concern that refusing the expansion will stick them with unpaid medical bills of uninsured persons they are required by law to treat.

Governor Bryant is quick to caution his critics that free money is not truly free. He stated, “People tend to forget that government has no dollar that it has not gained through taxation or borrowing” and cautioned readers that in order to pay for health care reform, the federal government was “raiding funding from other programs and levying taxes against the American people.” He warned his residents that in order to even come up with the 10 percent contribution toward Medicaid expansion, Mississippi would have to divert funding away from education, public safety, and the creation of jobs in the states–all higher priorities than feeding a program that would be growing out-of-control to cover one of every three Mississippi residents.

The governor emphasized the importance of personal responsibility among the state’s residents to choose lifestyles that include exercise and healthy food choices and do not include smoking and teen pregnancy–choices that contribute to the state’s epidemic health problems. They main objective for state government, he said, was to provide a climate where business is successful, creating jobs for residents who can then obtain their own health insurance on the private market.