Most of the debate about Medicaid expansion during the current session of the Mississippi Legislature has been focused on whether to permanently extend the insurance coverage for new mothers from two months after giving birth to 12.
Although that’s an important topic, it only nibbles at a much bigger issue, which is getting little time in the Republican-controlled Capitol: expanding Medicaid to cover not just new mothers but all of the working poor.
More than 15 bills, all sponsored by Democrats, to authorize this broader expansion of Medicaid died this week without a single hearing or vote. One House committee, to which all of the bills were assigned by Speaker Philip Gunn, an opponent of Medicaid expansion, did not meet at all before the legislative deadline.
The proposals weren’t given a chance. No debate about their merits. No testimony from health care and budget experts about the costs and benefits. No discussion about what the extra billion dollars a year from the federal government might mean for Mississippi’s endangered rural hospitals, the economy in general or the more than 200,000 individuals who have the constant stress of living without health insurance. No analysis of how Medicaid expansion has worked in the preponderance of states — 39 out of 50 — that have adopted it. Just a completely closed mind to consider the idea at all.
It’s as if the opponents — Gunn, Gov. Tate Reeves and the GOP lemmings in the Legislature who fall in line behind them — know they have the weaker argument. So as to not have their irrationality exposed for the political pandering it is, they refuse to give the issue a forum.
That has left lawmakers debating a much less ambitious idea: providing longer postpartum care to a smaller subset of beneficiaries — about 20,000 women a year — who might see better health outcomes as a result.
Mississippi has been providing this extended coverage and then some during the federal public health emergency resulting from COVID-19. That benefit, though, is due to be scaled back in May, when the emergency declaration is lifted, unless the Legislature acts to make 12 months of postpartum care the norm. That’s what 28 other states, including our neighbors in Alabama, Louisiana and Tennessee, have already done.
Some have questioned whether the data supports the commonsense assumption that longer care will translate into lower maternal and infant mortality rates.
It’s a chance well worth taking.
The estimated cost to Mississippi for providing 12-month postpartum care to Medicaid mothers is $7 million annually in total. That’s a tiny investment when considered against the $3.9 billion surplus the state presently enjoys.
The potential return, meanwhile, is tremendous, especially when it comes to spacing out the time between pregnancies and thus reducing the frequency of premature births.
Dr. Anita Henderson, a Hattiesburg pediatrician and a leader in her field, recently cited some numbers to note. The average cost for the first six months of care of an infant born at full term is around $6,300. For infants born at 24 weeks, the cost is more than $600,000 — or close to 100 times as much.
If longer postpartum care, and the contraceptive counseling and services that come with it, were to avoid just a dozen extreme preterm births a year, Mississippi would immediately recoup its investment. That’s not to mention how much would be saved by avoiding the lingering health and cognitive problems that often come with dangerously early births.
If the Mississippi Legislature won’t take even this modest step, there is no reasoning with it.
