This week, Mississippi Republican Gov. Phil Bryant had great news for the residents of the Magnolia State. Whether you have insurance or not, cancer or cardiac disease, diabetes or dialysis, Bryant declared, "There is no one who doesn't have health care in America."
Rejecting the Affordable Care Act's expansion of Medicaid which would enable coverage for 200,000 more Mississippians, Bryant surprised no one by echoing the same GOP prescription offered by President George W. Bush, Tom Delay, Mitch McConnell, Paul Broun and most recently Mitt Romney that "you just go to an emergency room." Still, Gov. Bryant's statement is shocking nonetheless, given that his state's health care system ranks dead last in the entire country.
Unlike his counterparts in Republican-run Nevada, Arizona, North Dakota and New Mexico, Gov. Bryant told Kaiser Health News he would have no part of "massive new program" to help the 21 percent of Mississippi residents who are uninsured:
"There is no one who doesn't have health care in America. No one. Now, they may end up going to the emergency room. There are better ways to deal with people that need health care than this massive new program."That would be news to the authors of America's Health Rankings and the Commonwealth Fund's State Health Care Scorecard, which ranked Mississippi 49th and 51st, respectively. Making matters worse, in 2009 another UnitedHealth Group funded study concluded that Bryant's home state had the unhealthiest residents in America.
As it turns out, Mississippi is the poster child for the phenomenon that defines health care in the United States. That is, health care is worst where Republicans poll best.
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In its 2009 state scorecard, the Commonwealth Fund ranked Mississippi dead last in its assessment of health care access, prevention, equity, affordability and lifestyles. Mississippi led the Republican south—and the entire country—in providing dismal health care. Again, while nine of the top 10 performing states voted for Barack Obama in 2008 and 3012, four of the bottom five (including Arkansas, Mississippi, Oklahoma and Louisiana) and 14 of the last 20 backed John McCain. (That at least is an improvement from the 2007 data, in which all 10 cellar dwellers had voted for George W. Bush three years earlier.)
Despite that pitiful performance, Gov. Bryant like his predecessor Haley Barbour wants the Obama administration to turn over Medicaid dollars to the states in the form of block grants. As Bryant protested:
"Mississippi must be given the flexibility to run the program at the state level. The numerous unfunded mandates and unprecedented federal interference of ObamaCare will hamper the State of Mississippi's ability to pay its Medicaid obligations. Having block grant authority would give states the flexibility and opportunity to run the program in a way that is best suited to their own residents, not Washington."Two years ago, then-Gov. Barbour explained why:
"We have people pull up at the pharmacy window in a BMW and say they can't afford their co-payment."That whopper didn't merely earn a "Four Pinocchio" rating from the Washington Post. It also obscured the fact that Mississippi is already home to perhaps the least generous Medicaid program in the nation:
Mississippi provides some of the lowest Medicaid benefits to working adults in the nation. A parent who isn't working can qualify only if annual family income is less than 24 percent of the poverty line. Working parents qualify only if they make no more than 44 percent of the federal poverty level. Seniors and people with disabilities are eligible with income at 80 percent of the poverty line...Back in April 2011, Jonathan Cohn of the New Republic issued a warning about the certain impact of the block grant proposals championed by the likes of Mitt Romney and Paul Ryan:
Translated from the federal poverty guidelines, that means a working Mississippi couple with one child could earn no more than $8,150 a year and still qualify for Medicaid, seniors and people with disabilities could earn no more than $8,700, and a pregnant woman could earn no more than $20,000 a year.
That's not to say plenty of governors wouldn't take advantage of block grant status to change their Medicaid programs in ways they cannot now. They surely would--by capping enrollment, thinning benefits, increasing co-payments, and so on.That is to say, exactly what Mississippi has been doing for years.
But Mississippians, who lead the nation in almost every measure of social dysfunction, should have no fear. Before your blood pressure jumps over your governor's rejection of federal health care dollars, Phil Bryant wants you to remember that you can always go to the emergency room. Unless, that is, you already have high blood pressure.