Mississippi’s Democratic legislators held a hearing in Jackson this week to keep the focus on how much this state is forgoing by stubbornly refusing to expand its Medicaid program to cover the working poor.

Particularly compelling was the presentation made to lawmakers by Sarah Miller, a professor of public policy at the University of Michigan who, together with some of her colleagues, has done a lot of research on the impact of Medicaid expansion both in Michigan and elsewhere in the nation.

Michigan was one of the early states to accept the offer of the Affordable Care Act, more commonly known as Obamacare, to expand their Medicaid programs with an even more generous federal match than the generous one they were already receiving.

Miller said doing so has been a winner for almost everyone concerned — the enrollees, who previously made too much for traditional Medicaid and too little to purchase private insurance; the hospitals, who saw higher revenues and less uncompensated care; the economy, which saw increased jobs created in the health-care sector; and the state treasury, which was able to shift some of its costs to the federal government.

The benefits to enrollees have been multidimensional, bettering both their pocketbooks and their health. The expansion in Michigan, Miller said, has led to fewer unpaid bills, fewer bankruptcies and less credit card debt among enrollees. Meanwhile nationwide, states that expanded have seen the health outcomes among the newly insured improve. That’s best demonstrated by a 9% reduction in mortality among a particularly suspectible demographic — those who are economically disadvantaged and older, but not old enough yet to qualify for Medicare, the government insurance program for the elderly.

Expanding Medicaid is a no brainer, but the Republicans who oppose it either give no good reason for their opposition or make stuff up as they go, such as claims that the majority of Medicaid expansion enrollees don’t work or that hospitals would be in worse shape with Medicaid expansion.

On Nov. 5, one of the most important issues Mississippi voters will decide is whether this state continues to thumb its nose at a billion dollars a year in federal help for health care. The lines are clear on this in the governor’s race. A vote for Tate Reeves, the Republican nominee, is a vote to let people die unnecessarily, a vote to hold down Mississippi’s potential for economic growth, a vote to let hospitals, particularly rural ones, edge closer to insolvency. A vote for his Democratic challenger, Jim Hood, who endorses Medicaid expansion, is a vote for just the opposite.

Although Hood, more than likely, is going to have to work with large Republican majorities in both chambers of the Legislature, the GOP opposition to expansion will soften, as it did in Louisiana, once the roadblock is removed in the Governor’s Office.

It only requires a little leadership, more truthfulness and less partisan pandering to see the eminent sense in expanding Medicaid, just as 36 states already have seen.

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