Studio portrait of Sid Salter. (photo by Beth Wynn / © Mississippi State University)

By: Sid Salter

Republican Mississippi Lt. Gov. Delbert Hosemann continues his consistent message that the state he helps to lead needs a more realistic Medicaid program in which the state’s values match the state’s policies – and that getting hung up over the term “Medicaid expansion” is an outdated obstacle to that goal.

The context of that stance is that hospitals are struggling to keep their doors open in the state and those that remain open are cutting key services. Over the summer, Delta Health System’s The Medical Center in Greenville closed its neonatal intensive care unit citing $1 million in annual losses – the only NICU serving four Mississippi Delta counties. The Greenville hospital also closed its cardiac rehab unit.

Likewise, financial and infrastructure issues have reduced some services, closed others and seen layoffs at the Greenwood Leflore Hospital in Greenwood. Merit Health Central hospital in Jackson is struggling as units and services are closed. Hosemann often tells the story of a low-wage working woman in Greenwood who died of cancer because she had no health insurance or available health monitoring.

It bothers him from both a moral and fiscal standpoint. No one’s bleeding heart liberal, Hosemann is a fiscal conservative who happens to believe taking a hard look at Medicaid in the poorest state in the union makes more fiscal sense than most realize.

In January, just before the 2022 regular session, Hosemann said in response to a reporter’s question about Medicaid expansion: “What does that mean? What is the expansion of Medicaid? That is a lazy question. What you need to be thinking about is how we are going to cover people that are working in Mississippi that have catastrophic illnesses. That’s the real question.”

Repeating that theme, Hosemann told a Starkville Rotary Club crowd last week that the state was fiscally prepared for the current global economic uncertainties which he believes likely will include recession – and that on top of ongoing inflation, the impacts of the Covid pandemic and the war in Ukraine.

With $2.5 billion in hand in the early part of the current fiscal year, Hosemann said the state is prepared and can move forward on several fronts – and that after a $246 million teacher pay hike and the state’s $525 million income tax cut.

“We have positioned Mississippi, in just three years, to where we have paid down our debt, we’ve given the largest teacher pay raise, cut taxes, have $2.5 billion in the bank and we are prepared for the next three years,” Hosemann said.

Hosemann said the state had cut the total number of state employees by 3,000 over the last three years and had retired $295 million in state debt – with a plan in place to cut another $305 million in debt this fiscal year.

That litany of conservative economic policy paves the way, Hosemann asserts, for the state to make a logical decision on Medicaid in a key area – postpartum care.

In the wake of the landmark Supreme Court decision in the Dobbs case that overturned Roe v. Wade and triggered abortion bans, Hosemann argues that more babies will be born to the poor who will need postpartum care in Mississippi – which has historically struggled with infant mortality issues.

Hosemann said: “We had a study group… on what to do about mommas of children from zero to three … assuming that we will have more now that we are a strictly a pro-life state. We are anticipating more life, so how are we going to take care of them and how healthy are they going to be?”

The lieutenant governor advocates spending $7 million to expand postpartum Medicaid from the present two months to include up to a year of coverage.

“Do you all know what the cost is for moms that are working to be able to go to the doctor for longer than two months, for up to 12 months? It costs $7 million. We have $2.5 billion in the bank, and we can’t take care of our children for working people? That doesn’t seem to make a lot of sense to me.”

The fiscal and moral realities of the Dobbs case – more babies born into poverty, shrinking health care opportunities for them – may well resonate with state lawmakers. It should.