Republican House Speaker Philip Gunn wants a state tax overhaul, including elimination of the personal income tax and increases to sales and other taxes.

Republican Lt. Gov. Delbert Hosemann wants lawmakers to consider a state health care fix, which — although he is loathe to even utter the term — would most assuredly include some form of Medicaid expansion with federal dollars.

Each appears disinterested in, if not outright opposed to, the other’s initiative.

Both proposals are subject of much fear and loathing among state lawmakers, other elected leaders and policy wonks. Both could be subject to Gov. Tate Reeves’ veto stamp — a high hurdle to overcome. And both have ardent supporters and detractors among the citizenry and industrial complex. Both could possibly be taken out of the hands of lawmakers by voters, should lawmakers ever get off their duffs and reinstate the ballot initiative process the Supreme Court laid waste to this year.

Could there be room for some good, old-fashioned political horse trading at the Capitol on these two supercharged issues?

Possibly. It depends on a lot of ifs, what-ifs and leadership. We should know more after some Senate hearings on “health care delivery” (don’t call it Medicaid expansion) allegedly planned for sometime in September.

READ MORE: State’s chamber of commerce mulling Mississippi Medicaid expansion

READ MORE: Business leaders oppose Gunn’s income tax elimination-sales tax increase

For starters, Hosemann would have to come out a lot stronger for health care reform (don’t call it Medicaid expansion). He’s said he’s open to it, wants to study it and “everything is on the table” and said that people shouldn’t get hung up on “monikers” such as Medicaid expansion (although he wouldn’t utter those words even when he said this). But he’s stopped short of outright publicly endorsing expansion.

His strongest verbiage to date perhaps came at this year’s Neshoba County Fair, when he said: “We are working on making healthcare more accessible and affordable in Mississippi. The time for simply saying ‘no’ to our options for working Mississippians has passed. When a cancer diagnosis can bankrupt a family, we have a responsibility to help. Further, no Mississippian should be further than 30 minutes from an emergency room. 

“This fall, the Senate will hold hearings and dig deeper into the delivery of healthcare in our state. From managed care, to scope of practice issues, to insurance options, everything is on the table.”

Hosemann would have to come out much stronger pushing what has been a Republican bugaboo in Mississippi. He would have the backing of hospitals and other groups. He might wind up with the backing of state business leaders through the Mississippi Economic Council. MEC has said it’s in the process of polling its membership on Medicaid expansion, but results are still pending. Another big what-if.

As for Gunn, he’s been pretty staunchly opposed to Medicaid expansion, and ostensibly has higher political ambitions for which such a measure could be an anvil necklace in a GOP primary.

All jesting aside, leaders would have to come up with a program that provides some political cover for rock-ribbed Republicans, and they would have to call it something other than Medicaid expansion.

Gunn really, really wants his tax reform plan. He’s called it the most important policy proposal of his career. Would he be willing to consider health care reform in exchange, particularly if the business community gets behind it? Of course, lawmakers are constitutionally not supposed to do such trading, but the realpolitik is it happens often.

Should the House and Senate leadership come to terms on tax and Medicaid proposals, then would come the heavy lift: Getting a veto-proof majority of two-thirds of lawmakers to sign on.

Gov. Reeves has again and again and again vowed opposition to any form of Medicaid expansion, which he calls “Obamacare expansion.” He’s also vowed opposition to any tax deal (he supports just getting rid of income taxes) that includes a “tax swap,” increasing any taxes to make up for cuts.

Reeves would likely not be a party to or facilitator of any legislative negotiations on such proposals. Negotiations and facilitating negotiations are not his thing, and his relationship with the Legislature cannot really be called a relationship. He’s either fer something or agin’ it, and he’s usually agin’ most things proposed by others.

The bottom line: As leaders ponder the many what-ifs, two of the most monumental policy issues before lawmakers in recent history hang in the balance.

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