Hosemann wrench doomed Medicaid expansion

Published 12:00 am Sunday, May 5, 2024

As the world turns so too does Lt. Gov. Delbert Hosemann. A year ago he championed expansion of Medicaid to benefit mothers and children. During last year’s elections he championed Medicaid reform to benefit the working poor. This year, with the House finally ready to act, he threw a monkey wrench into the works. Hosemann said he is for Medicaid expansion, but only if it includes a work requirement.

Now, the Lt. Governor is a smart man, an accomplished lawyer, a knower of details. He well understood that submitting a plan conditioned on a work requirement to the Centers for Medicare and Medicaid Services had zero chance of getting approved.

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The usually vocal Hosemann let his chosen chair of the Senate Medicaid Committee, Sen. Kevin Blackwell, take the lead for the Senate. Blackwell refused to budge on the front-end work requirement. Attempted compromises on other issues eroded support.

Prior to this year the House was the obstacle to Medicaid expansion, led by former Speaker Philip Gunn. New Speaker Jason White turned the House around. He appointed Rep. Missy McGee chair of the House Medicaid Committee. Together they crafted a bill that would achieve CMS approval. Their bill called for seeking a CMS waiver for a work requirement but would fully expand Medicaid while that process played out.

That position made sense. During the Trump administration several states that had expanded Medicaid sought and got CMS waivers for work requirements. Those waivers were cancelled by the Biden administration (court cases had blocked some). White and McGee knew that if Trump got re-elected, their waiver request would likely get approved.

They also put a four-year repealer in their bill. The cost of full expansion for those four years would be paid for by a federal bonus available to encourage holdout states to expand Medicaid. If that four-year experience showed future costs would be too high, a future legislature could cut back the program or simply let it die.

That smart approach should have appealed to a smart Hosemann. But it did not.

Why not?

Some suggested Hosemann has decided to run for governor in 2027. They saw his obstinacy as a move to appease the more conservative wing of the Mississippi Republican Party.

Others suggested he lost control of his Senate. They saw him trying to make the best of his weakened position.

Whatever the case, the wrench left Hosemann looking less than savvy and in charge.

Speaker White, on the other hand, has emerged as a smart, sensible leader during his first year in power.

Crawford is a syndicated columnist from Jackson.