No Relief For America’s Sickest State

Sarah Varney covers Mississippi’s experience with Obamacare:

“There are wide swaths of Mississippi where the Affordable Care Act is not a reality,” Conner Reeves, who led Obamacare enrollment at the University of Mississippi Medical Center, told me when we met in the state capital of Jackson. Of the nearly 300,000 people who could have gained coverage in Mississippi in the first year of enrollment, just 61,494—some 20 percent—did so. When all was said and done, Mississippi would be the only state in the union where the percentage of uninsured residents has gone up, not down.

Why has the law been such a flop in a state that had so much to gain from it? When I traveled across Mississippi this summer, from Delta towns to the Tennessee border to the Piney Woods to the Gulf Coast, what I found was a series of cascading problems: bumbling errors and misinformation; ignorance and disorganization; a haunting racial divide; and, above all, the unyielding ideological imperative of conservative politics. This, I found, was a story about the Tea Party and its influence over a state Republican Party in transition, where a public feud between Governor Phil Bryant and the elected insurance commissioner forced the state to shut down its own insurance marketplace, even as the Obama administration in Washington refused to step into the fray. By the time the federal government offered the required coverage on its balky HealthCare.gov website, 70 percent of Mississippians confessed they knew almost nothing about it.

Beutler finds it “all the more galling when you recognize that, for the time being at least, Mississippi is actually paying for this outcome”:

For the next couple years, the Medicaid expansion would cost Mississippi $0. … The combined effects of non-expansion are striking. State spending on Medicaid will grow faster next year in states that declined the expansion than in states that accepted it. As Kevin Drum wrote for Mother Jones on Monday, non-expansion states “actually prefer spending more money if the alternative is spending less but helping their own poor with medical coverage.”