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Capitol Dispatch: Medicaid extraction | Jake McGraw

Last Friday was the deadline for bills to pass out of their original house, although several motions to reconsider are still being resolved today. Once again, Medicaid expansion has little chance of passage this session, but an interesting Medicaid bill still has legs.

Authored by powerful representative Trey Lamar (R-Senatobia) ? no friend of Gov. Reeves ? HB 1013 would take away the governor?s control over Medicaid and give it to a new seven-member commission. The governor would control only three seats on the commission, with the other four going to the lieutenant governor (with the speaker?s de facto choice on two of them). The commission would then appoint the executive director, much as the State Board of Health and State Board of Education currently operate.

For a best-case scenario of how this plays out, look at Dr. Dobbs, the state health officer. He has worked closely with the governor on the state?s Covid-19 response, but he has been outspoken when he feels policy has deviated from medical science. As long he retains the confidence of his board (which includes medical professionals), he can speak and act freely.

His job prospects would look much different if he reported directly to the governor. For one, it?s unlikely that he would have gotten the job in the first place. It?s even less likely that he would?ve kept it. The same could be said for Superintendent of Education Carey Wright.

So what?s the purpose of this legislation? The stated intent is to create more transparency in the $6 billion/year Medicaid program. The commission would be subject to open meetings laws, unlike the policy deliberations that take place within the Governor?s Mansion. It is also clearly a game of political tug-of-war between the legislative and executive branches. Mississippi?s already-weak governor would lose control over the largest segment of the state budget. Gov. Reeves surely would not sign a bill that weakened his office, but it may not matter, since the bill passed the House with a veto-proof supermajority.

Some have speculated that this is a backdoor attempt to expand Medicaid. I don?t think it?s so clear-cut, but given Gov. Reeves?s implacable opposition to expansion, anything that reduces his power would help the cause. Still, full expansion would require an act of the legislature, and most GOP legislators have not been willing to take that vote yet. However, the new commission might be able to do more to sign up the estimated 60,000 people who are currently eligible but unenrolled — and a pro-expansion executive director who does not serve at the pleasure of the governor could be an effective lobbyist and public advocate.

Other key bills still alive:

  • ?Fairness Act? (SB 2536): Creates penalties if trans student-athletes play on sports teams that align with their gender identity. Passed Senate.
  • Voter purge (SB 2588): Allows registrars to remove eligible voters who do not vote or respond to mailed notices. Passed Senate.
  • Criminal Justice reform (HB 525): Expands parole and probation eligibility. Many details are TBD. Passed House.
  • Brain drain tax incentives (HB 1136): Creates income tax rebate and remote work incentives for college grads. Passed House.
  • Food banks/SNAP (SB 2426): Creates grant to support regional food banks and incentives for SNAP purchases at farmers markets. Passed Senate.
  • Reentry programs (SB 2574): Creates pilot reentry court and establishes rehab and workforce development programs in corrections system. Passed Senate.
  • TANF increase (SB 2759): Increases TANF monthly payment to $250 for family of three. Passed Senate.
  • Teacher pay raise (SB 2001): Increases base salary by $1,000. Passed Senate.
  • Winter-Reed loan repayment (HB 1179/SB 2305): Creates student loan repayment assistance for new public school teachers. Passed respective houses. ?
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