Jonathan Smith of Amory was on Christmas break from his job as a forklift operator in 2017 when he thought he was having a stroke.

Doctors instead found a brain tumor, then determined he had a rare cancer of the nervous system.

Smith said his company was in the process of switching insurance providers, and employees were without health coverage for about three months — including Smith when his cancer was diagnosed. Many treatments and surgeries later, Smith, now 35, cannot work, owes more than he could ever repay for medical care, and his family struggles. He’s just learned he needs another surgery.

Smith on Tuesday spoke to a crowd of medical providers and advocates for the kickoff of the “Yes on 76” drive to put Medicaid expansion before Mississippi voters on the 2022 midterm ballot. Smith says he would be one of about 200,000 uninsured Mississippians who could receive health coverage if Mississippi were to expand Medicaid through the federal Affordable Care Act, with federal tax dollars footing most of the bill.

“A lot of times I feel helpless,” Smith said. “But today I feel pretty good. This is something I can do, something I can help with… I’d like to be healthy enough to be a better father to my children… I should be battling the cancer, not worried about how to pay for my medicine.”

Physicians and nurses on hand for the kickoff of the drive at the Mississippi Hospital Association office inked the first signatures on the petition for Initiative 76. Organizers — led by MHA — must gather about 106,000 to put a constitutional amendment to expand Medicaid on the ballot.

READ MORE: ‘Let voters decide’: Mississippi Medicaid expansion ballot initiative filed

“This is a human issue, not a political issue,” said Hattiesburg pediatrician Dr. John Gaudet, who helped file the initial paperwork for the initiative in February. “It’s a human issue, with a common-sense solution.”

But the issue has been political in Mississippi, and brought heated — and most often partisan — debate. Mississippi, despite being the poorest state and otherwise dependent on federal spending, is one of just 12 states that has refused to expand Medicaid. Most of the state’s Republican leadership, starting with former Gov. Phil Bryant, have opposed expansion, saying they don’t want to help expand “Obamacare” and don’t trust the federal government to continue footing most of the bill. This has left hundreds of thousands of “working poor” Mississippians without health coverage, with the state rejecting at least $1 billion a year in federal funds to provide it.

Proponents estimate that expanding Medicaid would provide coverage for at least 200,000 working poor Mississippians, in addition to the roughly 750,000 poor pregnant women, children, elderly and disabled people already on Medicaid.

Meanwhile, Mississippi’s hospitals, especially smaller rural ones, say they are awash in red ink from providing millions of dollars of care each year to uninsured and unhealthy people. Six Mississippi hospitals have gone under in the last decade, and a recent study said that about half of the other rural hospitals statewide are at risk of closure, as hospitals have to eat about $600 million a year and growing in uncompensated care.

MHA President Tim Moore said that in most rural Mississippi communities “lucky enough to have a hospital,” it’s typically the area’s largest employer. MHA says Medicaid expansion would help the state’s economy and create thousands of jobs, beyond helping impoverished Mississippi tackle one of the global and persistent problems that keeps it on the bottom: the unhealthiness of its people.

“We’re talking about chronic issues that could have been dealt with on the front end, like detecting diabetes and treating it and not losing a leg down the road,” Moore said. “… If you believe in your community and your believe in small town Mississippi, you have to believe in Medicaid expansion… It’s time to bring our Mississippi tax dollars back home from D.C. … 38 states have already done it.”

Gaudet said that Mississippi chapter of the American Academy of Pediatrics, the state chapter of the NAACP, ACLU of Mississippi, Mississippi Center for Justice, Mississippi Health Advocacy Program and the Southern Poverty Law Center Action Fund have joined in the initiative drive. He and Moore said they expect other groups to join as it gets rolling, including state business leaders.

“We are committed to creating the biggest, broadest, nonpartisan effort the state has ever seen, in order to bring health care to 200,000 of our citizens,” Gaudet said. “… As physicians, we want to bring our tax dollars home to take care of our patients here, just like Louisiana, Arkansas and Oklahoma have done.”

Nakeitra Burse, CEO of Six Dimensions, a health research and health equity advocate, said Medicaid expansion would help Mississippi improve its worst or near worst in the nation status in categories such as maternal and infant mortality. Other states have seen rates of such chronic problems drop with Medicaid expansion.

“I have no doubt Mississippians will hear the call to action, and we will get the 106,000 signatures we need to get this on the ballot,” Burse said.

Two Mississippi firms have been hired to collect signatures for the drive, Moore recently said, and people and organizations have already lined up as volunteers. The drive has a website for people to learn more or volunteer, YesOn76.org.

Gov. Tate Reeves and House Speaker Philip Gunn have recently reiterated their opposition to Medicaid expansion. Lt. Gov. Delbert Hosemann has said he’s open to discussion on the issue, one of few state GOP leaders to openly say so.

Hosemann in a statement on Tuesday said: “Key chairmen in the Senate will likely hold hearings later this year to learn more from providers, advocates, patients, and other stakeholders in the healthcare community about the delivery of healthcare in Mississippi. Our office is not involved in the ballot initiative.”

Moore said MHA and others have pushed lawmakers to expand Medicaid for nearly a decade, to no avail, so it was time for voters to take matters in hand through the state’s ballot initiative process. He believes, in part based on polling, that the push will have bipartisan support.

“Mississippians have the chance to do the right thing in 2022, and also be fiscally conservative,” Moore said.

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