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

By: Sid Salter 

Mississippi House Speaker Philip Gunn’s GOP Caucus announcement that he was not seeking re-election in 2023 brings to a close a tenure as the state’s first Republican leader of the House of Representatives since Reconstruction.

The amiable but formidable Gunn’s service as speaker saw the undeniable progress of the state’s decision to leave the former state flag to history as the last state flag with Confederate symbols and the subsequent adoption of a new, more inclusive state flag not marked by racial controversy. Gunn played a meaningful, significant role in that arduous process.

The late Rep. Walter Sillers of Rosedale was the state’s longest-serving House speaker at 22 years from 1944 until he died in office in 1966. The late Rep. Tim Ford of Baldwyn served 16 years as speaker from 1988 to 2004. At the end of his current legislative term, Gunn will have served 12 years wielding the House gavel and will tie the late Rep. C.B. “Buddie” Newman of Valley Park as the third-longest serving House speaker in the state’s history.

In announcing his decision not to seek re-election, Gunn noted his willingness to consider other avenues of public service after his House tenure concludes. It would be surprising – whether by election or appointment – if Gunn doesn’t have that opportunity.

Gunn’s announcement was met with laudatory remarks from both Republican Gov. Tate Reeves and GOP Lt. Gov. Delbert Hosemann. Gunn has been rumored as a possible challenger to Reeves, but neither Gunn’s statement nor Reeves’ response implied anything in that political direction.

But there is at least one issue on which Gunn’s legislative tenure was in conflict with most Democrats and no small number of Republicans – particularly those who lives in the orbits of struggling rural hospitals. Gunn has been a powerful opponent of Medicaid expansion in Mississippi – a stance that seemed to intensify as speculation about a Gunn gubernatorial bid intensified.

Mississippi is one of twelve remaining states that have not expanded Medicaid despite an increased federal match rate in which the state contributes 10 % to 9% federal funds under the American Rescue Plan Act.

The Delta Council, one of the state’s more mainstream conservative business groups, earlier this year unveiled a unanimous resolution endorsing Medicaid expansion in Mississippi. The resolution, adopted by the group’s Health and Education Committee, was clear and unequivocal in calling on lawmakers to act. Other powerful business groups are said to be formulating plans to join the Delta Council in that stance in the next year.

The Health Insurance Resource Center (healthinsurance.org) makes this argument in favor of Medicaid expansion in Mississippi: “From 2013 through 2022, Mississippi has given up $14.5 billion in federal funding that would otherwise have been available to the state to help provide medical care for low-income residents.

“And since residents in states not expanding Medicaid still have to pay federal taxes, Mississippi residents have been subsidizing Medicaid expansion in other states. Over a decade, people in Mississippi are paying $1.7 billion in federal taxes that are used to pay for Medicaid expansion in other states.”

Regardless of the partisan national political ebb and flow, Medicaid expansion remains a top-shelf issue in Mississippi based on the growing threat to the availability of health care. Rural hospitals like Greenwood Leflore Hospital are on the verge of closure in a Delta region that has already seen healthcare cutbacks and where poverty remains pervasive and pronounced.

A prior effort to put Medicaid expansion on the ballot died as a result of the state’s legally flawed ballot initiative process. But many legislators are quietly talking about a review of the status quo on Medicaid expansion.

Gunn lives in Clinton near the high-rise Jackson major medical centers. House Speaker Pro Tempore Jason White, R-West, is the acknowledged leading candidate to succeed Gunn as House Speaker in 2024. White lives about 17 miles from the hospital in Kosciusko and about 20 miles from the hospital in Lexington.

Along with groups like Delta Council, there are a lot of rural Mississippians concerned about the financial futures of their local hospitals – particularly in areas where the high rate of delivery of indigent care outweighs the ability of the facilities to profitably operate.

The other bipartisan realization is that it is difficult to locate new industrial prospects in areas that don’t have ready access for their workers to high-quality medical care.