The bleak outlook for hospitals across the state, especially those in rural areas, was highlighted Monday during a hearing of the Senate Public Health Committee.

While possible solutions were discussed, senators indicated that long-term fixes might not be coming during the upcoming 2023 session.

State Health Officer Daniel Edney told committee members that 38 rural hospitals across the state “are in danger of immediate closure or closure in the near term.” Some of those hospitals are larger regional care centers, such as Greenwood Leflore Hospital.

Edney said nearly all of 111 hospitals across the state are facing financial difficulties with many areas – particularly in the Delta and some parts of southwest Mississippi – becoming “health care deserts.”  Edney, representatives with the Mississippi Hospital Association and others have been warning of the crisis facing health care in Mississippi for some time caused in part by rising costs and changes in the structure of health care in the nation – all of which have been exacerbated by the COVID-19 pandemic.

The Public Health Committee met Monday to be updated on the crisis and to hear possible solutions.

The Hospital Association offered six possible steps that could be taken to help the hospitals survive – ranging from increasing the state-federal Medicaid supplemental payments to hospitals, to eliminating the taxes hospitals pay to expanding Medicaid. Of those steps, the one that would not require legislative action and is most likely to occur would be the state Division of Medicaid seeking federal approval to increase payments to hospitals.

Tim Moore, chief executive officer of the Hospital Association, said all of those steps are needed to increase the financial viability of the state’s hospitals. But according to a Hospital Association chart handed out to senators, expanding Medicaid is the options that would provide the most benefit. Medicaid expansion would provide a financial boost to the hospitals, while improving the state economy, based on multiple studies. It also would benefit Mississippi citizens by providing health care to primarily the working poor.

During the committee hearing, Sen. Brice Wiggins, R-Pascagoula, said Medicaid expansion would not solely fix the problem facing the hospitals. Richard Roberson, vice president for policy with the Mississippi Hospital Association said, “it might not solely fix it, but I would argue it would go a long way.”

Wiggins replied, “It would go a long way because it would provide a revenue stream for hospitals, but 10 years down the road could be another situation.”

But Roberson said in the meantime, people, primarily the working poor, would have access to health care other than a hospital emergency room. Under current law, hospitals are mandated to provide emergency services regardless of a patient’s ability to pay.

Medicaid expansion would cut down on more expensive emergency room care while providing Medicaid expansion beneficiaries the opportunity for preventive care from primary care physicians, Roberson said. In addition, Medicaid expansion would substantially cut down on the amount of uncompensated care – about $600 million a year and increasing – that hospitals currently incur because there would be fewer uninsured patients being treated.

After the meeting, Sen. Dennis DeBar, R-Leakesville, when asked about the possibility of expanding Medicaid in the upcoming 2023 session, responded, “Why are you asking me about that?” DeBar then added it might be pointless for the Senate to try to take up the issue while the House leadership and Gov. Tate Reeves are entrenched in their opposition to Medicaid expansion.

Sen. Kevin Blackwell, R-Southaven, who chairs the Senate Medicaid Committee, said after Monday’s Public Health Committee hearing that he remains opposed to Medicaid expansion. He said Medicaid provides less money to medical providers for the services rendered than private insurance. He said he would prefer other options, such as helping poor people purchase private insurance.

The federal government pays 90% of the health care costs for those covered by Medicaid expansion – those earning up to 138% of the federal poverty level or about $19,000 annually for an individual. Whether the state could develop a Medicaid expansion substitute where the federal government pays the bulk of the cost for private insurance is not known.

At any rate, Blackwell said it probably would be the 2024 session – after 2023 statewide elections – before such options are considered.

In the meantime, Edney pointed out there is a growing area in the state where there is no hospital to deliver babies. He said that only worsens Mississippi’s position as the state with the nation’s highest infant mortality rate.

Edney said the state Department of Health would try to step in as a last resort “safety net” in those areas lacking adequate health care.

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