The U.S. Supreme Court will likely not take up the appeal of the 5th U.S. District Court of Appeals ruling that struck down the Affordable Care Act’s individual mandate in December 2019, at least not before the 2020 election.

Democrats in Mississippi took to social media unhappy with the SCOTUS decision.  The Mississippi Democratic Party tweeted, “Here’s another reminder that no matter how many ways Republicans try to spin it, Republicans are still coming for our health care.”

The Obamacare individual mandate is the key element of the hotly debated health care law.  The individual shared responsibility provision, as it is officially termed, requires virtually all citizens and legal residents of the United States to have health insurance with a financial penalty for those who do not comply.

Those who were uninsured in 2019 will not owe a penalty on their tax returns filed in 2020 following the Tax Cuts and Jobs Act enacted by Congress in 2017 eliminating the individual mandate penalty.

Meanwhile, U.S. Senate candidate Mike Espy continues to push for Medicaid expansion in Mississippi.

But according to an analysis by the Congressional Budget Office in November 2017, with the repeal of the individual mandate some 5 million people would come off of the Medicaid rolls with an estimated savings to federal spending of $179 billion by 2027.

This means, in practical terms, individuals would once again choose whether or not to purchase health care coverage rather than the government forcing them to do so, which could result in more uninsured across the nation, something that concerns hospitals across the state.

However, as the CBO report estimates, federal budget deficits could be reduced by nearly $338 billion between 2018 and 2027 with the removal of the individual mandate and the reduction of people using government funded health care.

While there have been several unsuccessful efforts to expand Medicaid substantially in Mississippi, the potential invalidity of the provision by the Supreme Court injects considerable policy risk.  If Mississippi substantially expanded Medicaid only to have SCOTUS unwind the mandate, Mississippi taxpayers could be stuck with a massive unfunded expansion.

Governor Tate Reeves has been resolutely opposed to Medicaid expansion at the state level.

“I’m opposed to Obamacare expansion in Mississippi. I’m opposed to Obamacare expansion in Mississippi. I’m opposed to Obamacare expansion in Mississippi,” Reeves said in January 2019.  “I don’t know how many ways I can explain this to y’all but I’m opposed to Obamacare expansion in Mississippi because it is not in the best interest of taxpayers.”

Reeves campaigned against Medicaid expansion and won, defeating Republican Bill Waller and Democrat Jim Hood who both featured it as a platform issue.