When Philip Gunn explained his support for Gov. Tate Reeves’ decision to implement a statewide shelter-in-place order for Mississippi, the speaker of the House said something curious.
Hours before Reeves announced his decision Wednesday, Gunn had consulted with two of the state’s leading health officials — Dr. Lou Ann Woodward, the head of the University of Mississippi Medical Center, and Dr. Thomas Dobbs, the head of the state Department of Health — to get their input on what Reeves was considering. Gunn recalled asking them the following question: “If you did not have to have concern for political or economic or any other ramifications, if you were just making a decision based on what is in the best health interests of the citizens of our state, what would you do?”
Their response — to order most Mississippians to stay at home for the next couple of weeks — convinced Gunn that the state had to take this dramatic step, he said. Otherwise, its health-care system could be overwhelmed treating those critically sickened by the virus.
“I don’t want it to be said that someone died because we couldn’t provide them the health care that they needed,” Gunn said.
If only the speaker — and the governor, too — could bring that same perspective to an issue not as dramatic as a pandemic: Medicaid expansion.
When they have been told by health experts over and over again, and for years, why Mississippi should expand Medicaid to cover the working poor, they have repeatedly chosen to ignore the experts.
For what reasons? Political mostly, and secondarily economic, even though there is plenty of analysis out there that questions their belief that Mississippi cannot afford its small share of the expansion. Thirty-six states have expanded, and some have found, when they crunched the numbers, that the expansion pays for itself and then some from the added jobs and other economic activity it creates.
Gunn and Reeves — and most of the rest of the Republican political leadership in this state — have not made it a priority to worry about the health of an estimated 300,000 uninsured working Mississippians (or at least they were working before the coronavirus outbreak). They have decided repeatedly that there is more to be gained politically from shunning Medicaid expansion because it is associated with a Democratic former president, Barack Obama, and the Affordable Care Act he championed.
They have ignored the well-being of the state’s medical system, especially its rural hospitals, many of which are drowning under the load of uncompensated care.
They have ignored the health of those Mississippians who would have better outcomes if they had insurance coverage.
They have told those 300,000 that if they get sick enough, just go to the emergency room, where by law they have to be treated even if they can’t pay for it. They discount the research that shows people with insurance are more likely to have their health problem addressed before it reaches a crisis stage.
It is almost certain the Republican leadership’s choice — to manage the health of the uninsured on a crisis-only basis — has resulted in preventable deaths. But because no one is tracking these deaths or reporting on them daily, they are easy for politicians such as Gunn to ignore.
COVID-19 will eventually pass. What will still linger after this crisis dissipates is the negligence of policymakers in a state that has more to gain from Medicaid expansion than most.
