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Stevenson: The Great Jackson Obamacare Boondoggle

Note: The following is an opinion-editorial article on issues in the Mississippi Legislature, offered and written by Jon Stevenson, a DeSoto County resident, businessman, and concerned citizen.. The article reflects Stevenson’s opinion and not necessarily that of this publication.

By Jon Stevenson

On Wednesday, Feb. 28, the Mississippi House of Representatives passed HB 1725: one of the most cynically titled bills to pass a Legislature since the Democratically led Congress passed the Federal Inflation Reduction Act.

HB 1725, which has been described by the Speaker of the House of Representatives as the Healthy Mississippi Works Act is an Obamacare expansion of Medicaid that is a $3.85 billion welfare boondoggle, given away to the Mississippi healthcare industry. This boondoggle, which has no hope of improving the health outcomes of Mississippi’s poor citizens, will pull an estimated $385 million per year out of the state budget that could be spent actually improving the lives of the people of the State in areas such as infrastructure improvements to attract good paying jobs. Unfortunately HB 1725 will instead, pad the pockets of wealthy healthcare industry insiders. 

The “Healthy Mississippi Works Act” Obamacare expansion would seek a waiver to allow for Medicaid coverage for persons making $20,000 per year or less. Wait a second, you might say; making sure that poor people have healthcare is a good thing, right? Why would a moral person want to stop people from obtaining access to healthcare? As House Medicaid Chairwoman Missy McGee says, this is a “moral imperative” so I must be a heartless person to want to stop a bill like this? 

These are the platitudes being bandied around in an attempt to stifle debate around this issue. All the while, the proponents of Obamacare expansion are walking around the capitol in Jackson barely able to hide their glee of an extra estimated $3.85 billion in government health spending, and the attendant profits that come along with it. Due to the legislative process that has been created for pushing this bill through the legislature, members are wrapping themselves in the moral protective cloak of doing good for the poor and the virtue signaling that attends it, usually the domain of Democrats! 

The problem with the arguments for this Obamacare-Medicaid expansion is that they don’t hold up under even the smallest bit of scrutiny. This will help improve the health of our workforce! Unfortunately health insurance doesn’t lead to better health.  Better health comes from better education, better nutrition, more exercise and healthier lifestyles; not health insurance.  When people are having to access the healthcare system on a regular basis we have already missed our chance to promote better health.  We are managing disease at that point, not health. People do need access to healthcare, but access to Medicaid is only one way to make this happen; not the only way.

Another argument being made by legislative leaders is that they will attach a work requirement to the Obamacare expansion. The CMS, the federal agency responsible for any Medicaid expansion has made it clear, under the Biden administration, that it won’t approve a work requirement. Even if the Biden administration would miraculously approve a work requirement, of the thirteen waivers granted during the Trump administration for a work requirement, all have either been overturned by Federal Courts or are being litigated with none in effect. Our legislative leaders are using this as a positive argument for expansion knowing that it won’t happen.  To be generous, they are being dishonest.

Another objection to opponents of this Obamacare expansion is the statement: “If we don’t pass this, these people won’t have access to health insurance.” This is probably the most pernicious falsehood in the entire batch. All of these people have free or nearly free health insurance available to them though the Affordable Healthcare Act Insurance exchanges where the Federal Government will pay 100% of the insurance subsidy. While the insurance available under the ACA exchanges are not as generous as Medicaid, it is insurance and will help the uninsured.

So why, may you ask, are we not helping poor Mississippians to sign up on the ACA Insurance exchanges? That is a great question. A better use of the State’s budget would be to hire an army of workers to go around the state and assist the poor citizens of the state to sign up on the exchanges. Spending $20 million per year to do this would surely close the gap of the uninsured in the state to a negligible amount and cost the state budget a whole lot less than the estimated $385 million per year for an Obamacare expansion of Medicaid. That would leave $365 million per year for other priorities in a state that has no shortage of needs while still satisfying the “moral imperative” of health insurance that both the Democrats and some legislative Republicans talk about with their unholy alliance. 

They also paper over the fact that this is just the beginning of the costs to the state. When Medicare was first initiated in the State of Mississippi the state’s match was $22 million per year. Now it is nearly $1 billion per year. The fact of the matter is that a dollar of Obamacare-Medicaid spending in year one will become $1.05 in year two and increase each year thereafter. Also they paper over the fact that when individuals qualify for Medicaid, they will automatically qualify for additional categories of Federal Assistance that will cost additional matches to the state budget and none of those costs are being considered in this debate. 

None of these matches are accounted for in the cost estimates of this legislation and none of the cost escalators are either. It is possible that the original $385 million match that is estimated within three years could be as high as $550 million per year toward the State budget, but none of this is being discussed in the rush to pass this Obamacare expansion. If you are wanting to see a case study in how Obamacare expansion will create billion dollar holes in a State budget just look at the problems that Indiana is experiencing with their Medicaid expansion.

Unfortunately the healthcare lobby and some legislators have decided to push Obamacare expansion this year with legislative gimmicks to curtail debate. They are assisted by a massive push from a healthcare lobby that is greedily grabbing at the potential profits of the expansion.

Republicans are supposed to be about expanding economic opportunity for all. Infrastructure projects in poor areas that would allow industry to expand economic opportunity in the Delta by revitalizing ports and industrial parks with critical infrastructure to take advantage of on- shoring opportunities would do more to improve health outcomes than expanding Obamacare through Medicaid. 

Supporting economic opportunity for all doesn’t matter to the army of healthcare lobbyists in Jackson. They see an easy opportunity to increase healthcare spending in the state and like all good businesses they want to take the most efficient and easiest path to increasing their profits as they can. Why take a multi-year effort to sign people up on the exchanges to save the State money and provide more opportunity and health insurance for our citizens when we can pass one bill and poof: it’s raining money! That is what is happening in Jackson right now. 

In a remarkable bit of political courage, the DeSoto County House delegation, en masse, voted against the expansion staying true to Republican principles of conservative stewardship of the budget while wanting to provide equal opportunity for all. This provides a beacon of hope for the future. It probably helped that most of the delegation are freshman House members that haven’t been corrupted yet by Jackson’s culture and the few House members that DeSoto has with seniority are men of conviction rather than expediency. 

Unfortunately many Republican legislators have deluded themselves into believing that this Medicaid expansion will wrap them in the cloak of virtue, usually the domain of the suburban liberal Democrat. Unfortunately people delude themselves before they mislead others. I have to say to these Republicans, that anytime virtue signaling Democratic mouthpieces are praising you for your legislation, as a Republican, you have to question whether you are doing the right thing. 

The Republican Party has traditionally supported moving authority and spending from the Federal Government to the State and Local levels. Why are Republican legislators in the Mississippi House and Senate now wanting to further send authority and spending power to the Federal Government and handicap future State budgets in the process? The State Republican Party leadership in the legislature as well as the rank and file members have forgotten their roots. In their rush to populism, and their rush to buy votes they have forgotten the core principles that made our county great: Federalism and limited government. In pushing more authority and spending to the Federal Government’s Obamacare-Medicaid expansion our Republican legislators would do well to remember Ronald Reagan’s famous quote; “The nine most terrifying words in the English language are: I’m from the Government and I’m here to help.”