Will closed hospitals also be Gunn’s legacy?

When Philip Gunn announced last week that he would step down from the Legislative Assembly after one more year, many of his political admirers praised the Republican House Speaker.

He has been credited with being a catalyst for Mississippi’s economic growth, a series of corporate and personal tax cuts, pro-life legislation that led to the overturning of Roe v .Wade and a new state flag to replace a long-running racial offensive. a.

But there’s another legacy that neither Gunn nor his fans should be so proud of.

He’s been a primary obstacle to the expansion of Medicaid, which has cost this state an estimated $8 billion in federal funding and counting, left 200,000 to 250,000 modestly paid Mississippians without insurance, and helped push a number growing number of hospitals in this state, including Greenwood Leflore Hospital, on the brink of closure.

Gunn has opposed Medicaid expansion with slightly less stubbornness than Tate Reeves, who has been a filibuster as lieutenant governor and now as governor. They made it politically dangerous for any Republican lawmaker to support Medicaid expansion, regardless of the numbers, research, or experience of other states that have expanded Medicaid.

Why, then?

Because they’ve made the political calculation that opposing anything associated with former President Barack Obama or his Democratic successor, Joe Biden, is a winner for them in a state dominated by Republican conservatives – and no reason or financial incentive for this state convinced them otherwise.

Since the Affordable Care Act, better known as Obamacare, was passed in 2010, at least eight government or private studies have been done on the impact of Medicaid expansion on Mississippi, according to a recent report from Mississippi Today. All but the oldest study, conducted before the Medicaid expansion took effect, found that the expansion would be a net financial benefit to Mississippi, completely refuting Republican opponents’ claim that the State could not afford to contribute one dollar for every nine dollars contributed by the federal government.

It didn’t matter to Gunn.

In 2021, during the first months of the Biden administration, Democratic majorities in Congress tried to lure Mississippi and the other 11 non-expanding states with an even better offer. Not only would the federal government pay 90% of claims for new policyholders, but it would also reduce the state’s share of costs for two years for people covered by the regular Medicaid program. For Mississippi, this incentive amounts to approximately $600 to $700 million.

In other words, Mississippi would make money by expanding Medicaid in the first two years, and after that it would at least break even, given the additional state tax revenue generated by the injection of federal dollars.

Gunn still wasn’t moving.

The continued opposition not only defies economic reason, but it has serious consequences for hospitals like ours.

When the Medicaid expansion was signed into law, the authors of the legislation said the government would largely pay for it by eliminating, or at least drastically reducing, payments the federal government gave to hospitals that treat a disproportionate share of patients. uninsured. The reasoning was that diverting these so-called DSH payments was reasonable since any state would be crazy not to accept what the federal government was offering in their place.

Congress underestimated how mule-headed Mississippi can be.

The stubbornness of Gunn, Reeves and others like them dealt a double whammy to Greenwood Leflore Hospital. Not only did he lose the additional revenue that Medicaid expansion would bring, but he saw his DSH payments drop from about $6 million a year to less than half a million.

It would be simplistic to say that Medicaid expansion alone would save Greenwood Leflore Hospital. It could, however, be an important part of a solution that would require some or all of the following: higher reimbursements from government and private insurers; cracking down on managed care companies that try to deny benefits; reductions in Medicaid taxes that hospitals pay to the state; and, at least in the short term, grants from the city and county co-owners of the hospital.

Gunn shocked expectations by becoming the state’s first prominent Republican elected official to call for a new state flag. He needs to pull off an equally dramatic surprise and reverse his stance on Medicaid expansion. And it must come quickly, or not only Greenwood Hospital risks failing, but several others soon after.

Reeves will not change positions. It is a given. He has given too much political weight to his opposition to any expansion of social safety net programs, despite being more than comfortable handing out welfare to corporations.

That means it would take non-veto majorities in both houses for Medicaid expansion to happen. It’s a huge lift, and it becomes impossible without Gunn’s support.

Gunn’s retirement announcement suggests he may have cooled off the idea of ​​running for governor. Whether he did or not, he has a chance to make amends for helping restore rural Mississippi hospitals to the state they are today. Hope he tries.

– Contact Tim Kalich at 662-581-7243 or [email protected]