JACKSON, Miss. — The day her doctor told her that she had acute renal failure and had to start dialysis, Mary Davis was more concerned about the cost of the procedure than about her health.
“I thought, ‘how can I afford it?’ I had no idea,” Davis, 54, recalls. “I was already worried about paying my monthly utility bills.”
As it turned out, her three-days-a week dialysis cost about $20,000 for the first three months. Davis, who had quit her $10-an-hour job as an office-cleaner in downtown Jackson as her health worsened, had no insurance. Fortunately, as a single parent of two daughters, she was eligible for Mississippi’s Medicaid program for low-income adults. Two years later, she says she wouldn't have made it without Medicaid.
Mississippi has some 500,000 uninsured individuals. Nearly three-fourths of them belong to families with at least one member working full- or part-time. About 46.7 percent of African Americans in the state are uninsured, compared to 28.1 percent of whites. Over 43 percent of Mississippi's 42,000 Hispanics are uninsured, according to the National Council of La Raza, a figure that reflects the state's high number of undocumented Hispanics.
If the state agrees to expand Medicaid to those Mississippians at or below 138 percent of the federal poverty line under the Affordable Care Act, about 300,000 adults and 50,000 children would be eligible for health care insurance under Medicaid, according to a 2012 study by the University Research Center of Mississippi’s Institution of Higher Learning (IHL).
But full implementation of ACA in Mississippi has been facing an uphill battle in the state’s legislature. While Democrats push for the expansion, saying that it would benefit hundreds of thousands of low-income individuals, Republican leaders, including Mississippi Governor Phil Bryant, remain skeptical, arguing that the expansion could dramatically increase the state’s spending on Medicaid to cover additional enrollment of currently eligible parents and children.
But, according to the Washington, D.C.-based Center on Budget and Policy Priorities, Mississippi will spend $152 million – just 7.6 percent -- more on Medicaid to cover additional enrollment of eligible children and parents through 2022.
But, assuming there will be a high participation rate under the Medicaid expansion, the IHL study found that the federal dollars that will flow into Mississippi would range from an estimated annual amount of $426 million in 2014 to $1.2 billion in 2025. The study found the Medicaid expansion would also add thousands of jobs –4,178 jobs next year and 8,860 jobs in 2025.
“Right now, we’re in a political battle between the Red and Blue,” said Kim Robinson, program manager of National Policy Initiatives for Children’s Defense Fund, at a briefing here with ethnic media, organized by New America Media.
The reality is that it would hurt Mississippi’s economy if the state would not opt for expansion, Robinson added. With more and more uninsured patients showing up in the emergency rooms, “hospitals here would eventually shut down...and we will see a lot of job layoffs and budget decreases,” she said. “With Medicaid expansion,” on the other hand, “the state will receive the full benefits of ACA from the federal government.”
Starting in 2014, for the first three years, the federal government will pay 100 percent for the associated costs for those who are newly eligible for Medicaid. After that, the percentage that the federal government covers will gradually decline. By 2020, the state will shoulder only 10 percent and the federal will continue to pay 90 percent of the costs.
“My main concern is getting the public informed,” Linda Rigsby, health law attorney for the Mississippi Center for Justice, said during the briefing, “and that they should get the right information and dispel the myths.”
One myth is that the federal government may not be able to deliver the funding and the state would suffer all the more with additional enrollees in the Medicaid program.
“That fear of [the] federal government—we can’t operate that way in the 21st century,” said Rims Barber, director of Mississippi Human Services Coalition. “We have to change the mindset and mandate the healthcare expansion.”
Another myth, according to Rip Daniels, host of a local radio talk show targeting African Americans, is that “there are many people who go for free stuff. The reality is, even myself who has a job and insurance, it is not enough to cover larger medical costs."
Daniels challenged the elected people of color in the legislature “who speak with silence” to openly support the Medicaid expansion because they know that it would help the state and its residents.
As for Mary Davis, she has no doubts that there are thousands of people—it could be a brother, a sister, or a friend— who face medical problems like her, who are going to benefit from Medicaid expansion.
“Whatever people say, it is a life-saver,” she said.
This story was written as part of a series of press briefings on healthcare reform with ethnic media organized by New America Media and funded by the Atlantic Philanthropies.