It was not Delbert Hosemann’s finest hour.
The two-term lieutenant governor should have been able to get Mississippi across the finish line to Medicaid expansion, but he didn’t.
He had the timing and the momentum to make it happen. The Legislature — after a decade of digging in its heels against a golden opportunity to help the uninsured, the state’s hospitals and the state’s economy — was open to seriously discussing Medicaid expansion for the first time. A coalition of groups covering some of Mississippi’s most influential sectors — clergy, health care and business — had all endorsed expansion and made their presence known at the Capitol. It was also the first year of a new term, when normally most of the big items gets tackled, before lawmakers get cautious as they start worrying about their next election.
But the effort died, putting off for yet another year doing what 40 other states have done, some of which need the extra federal help a lot less than does Mississippi.
Before this year, of the three most influential positions in state government — governor, lieutenant governor and speaker of the House — only Hosemann appeared to be receptive to Medicaid expansion, even though he tried to avoid using the term. Gov. Tate Reeves and former House Speaker Philip Gunn were staunch opponents, so the idea was going nowhere as long as Mississippi didn’t have at least two of these key people on board.
With Gunn’s departure and the elevation of Jason White, the House flipped, but it’s now Hosemann who looks to be an obstacle — not a fire-breathing one like Reeves, but still an obstacle.
This means that either Hosemann does not have as much control over the Senate as has been believed, or he has further political ambitions and is worried that Medicaid expansion could harm him with another challenge from the far-right wing of the Republican Party. Last year, Hosemann was the only statewide Republican to face a serious primary challenger, when former state Sen. Chris McDaniel tried to beat him by depicting the pragmatic incumbent as a closet Democrat. That experience may have made Hosemann reluctant to be too closely identified with a cause on which Republicans are divided.
A week ago, though, it looked as if the House and Senate were close to a compromise that could get enough votes to overcome a threatened Reeves’ veto of any Medicaid expansion plan.
The last major sticking point was the Senate’s insistence that expansion be contingent on the federal government approving a work requirement for the new beneficiaries, a condition unlikely to be approved as long as Democrats hold the White House.
Expansion proponents tried several last-ditch efforts to get the Senate to soften on this.
The House speaker recommended putting the question of Medicaid expansion and the work requirement to a popular vote in November. Hosemann said his chamber wasn’t interested.
State Rep. Robert Johnson, the House Democratic leader, said his party’s opposition to the work requirement could be overcome if Republicans would only insist on seeking the waiver one time before going back to the drawing board. The Senate language called for the state to keep applying every year until the waiver got approved, a provision that could leave Medicaid expansion in a perpetual state of limbo. Johnson’s proposed compromise didn’t fly either.
The Senate Republicans’ attitude seemed to be that if the Biden administration wants Mississippi to expand Medicaid badly enough, then it will make an exception and let the state require proof that the newly Medicaid-eligible are working.
Even if the Senate Republicans had been right about that gamble, it doesn’t speak well for them. It suggests they believe the federal government is more interested in helping the poor in Mississippi than its own state government.
That might be true.
Mississippi is miserly when it comes to welfare assistance. For any social program in which the state has a say, it tries to provide some of the lowest benefits.
Not too long ago, Mississippi took a federal welfare program — Temporary Assistance for Needy Families — and abused the discretion that Congress gave the states for administering it. Rather than provide direct cash assistance to needy families, Mississippi — under Republican leadership — funneled the money to well-connected individuals, who spent some of the money on legitimate training and education programs but a lot of it on helping themselves, their family and friends, and pet causes that had nothing to do with alleviating poverty.
By remaining one of the holdouts on Medicaid expansion, Mississippi reinforces the narrative that it will continually work against its own best interests.
Delbert Hosemann knows there is truth in that perception, and he has usually tried to steer the state in a more progressive direction. He didn’t do so this time. Whatever his reasons, it’s disappointing.
- Contact Tim Kalich at 662-581-7243 or tkalich@gwcommonwealth.com.
