STARKVILLE – Whether it’s the heated race between Mississippi’s incumbent Republican senior U.S. Sen. Thad Cochran and state Sen. Chris McDaniel in their GOP primary or the rather rematch between incumbent Republican 4th District U.S. Rep. Steven Palazzo and the veteran former Democratic U.S. Rep. Gene Taylor that Palazzo defeated to take the office, Medicaid expansion under Obamacare remains a political non-starter in Mississippi.
Despite recent Associated Press coverage of the fact that Medicaid rolls in are growing in states like Mississippi that rejected Medicaid expansion, it’s clear based on the campaign rhetoric in both the Cochran-McDaniel race and in the Palazzo-Taylor race that the candidates don’t believe voters will embrace Medicaid expansion despite the claims of advocates that rejecting Medicaid expansion is against the state’s economic interests.
The candidates have struggled to get to the right of each other on the question of opposition to Obamacare. While in Congress, Taylor in 2010 voted against it and was literally the first Democrat to sign Discharge Petition #11, which sought to force a vote on repealing the law.
Palazzo’s opposition to Obamacare was the centerpiece of his campaign to unseat Taylor and has never wavered. Palazzo gained success in his challenge to Taylor by tying him to a vote for former Democratic House Speaker Nancy Pelosi.
The political bogeyman of Obamacare has dominated the Senate race as well, but McDaniel has played the red herring that refusing to vote to shut down the government was the same as “supporting” Obamacare. It’s not.
Proponents of expansion point to the fact that the federal government has pledged to pay all medical costs for the newly eligible Medicaid enrollees in 2014, 2015 and 2016 and no less than 90 percent of their costs thereafter as evidence that Mississippi can't afford not to expand Medicaid.
But many Mississippi lawmakers understand all too well the history of Medicaid finance in this state. The state has traditionally authorized a more expansive Medicaid program than the state actually funded - and then in the latter stages of each legislative session scrambled to actually fund Medicaid with one-time money plans held together with political bubble gum and bailing wire.
So politics aside, is Medicaid expansion as clear cut as proponents would have us believe? In a word, no.
“From a social or humanitarian perspective, you could argue Medicaid expansion is a winner. But from a purely financial perspective, it's clearly a loser," Charles Blahous, a senior research fellow at the Mercatus Center, a market-oriented research center at George Mason University in Virginia, said last year.
A Mississippi Institutions of Higher Learning economic brief by state economist Bob Neal made the nuts-and-bolts of the Medicaid expansion question clear when Mississippi lawmakers first confronted the expansion question: “The results in each scenario indicate that Medicaid expansion will generate additional state Medicaid costs in years 2017-2025. From 2014-2020, cumulative state costs of Medicaid expansion, minus additions to state General Fund revenue, are projected to range from $109 million to $98 million. From 2014-2025, total state costs of Medicaid expansion, minus additions to state General Fund revenue, are projected to range from $556 million to $497 million.”
The Kaiser Commission on Medicaid and the Uninsured observed: “While some states will see net savings, others will need to weigh the trade-offs between small increases in state spending in return for large gains in coverage supported by mostly federal dollars.”
As the recession fades and the Affordable Care Act generates more of a track record in fact rather than in theory, Democrats in the Legislature will continue to push Medicaid expansion. But a listen to the campaign rhetoric makes clear that Medicaid expansion and Obamacare remain potent flashpoints on the state’s campaign trail.
Sid Salter is a syndicated columnist. Contact him at firstname.lastname@example.org.