Wading through the complexities of Medicaid eligibility in order to secure health insurance for yourself or your family member in Mississippi can be a nightmare. It might even feel impossible.

But if you happen to go to church with a state legislator, you may be in luck.

“Please have someone check on the Medicaid app on (patient),” Rep. Jody Steverson, R-Ripley, wrote to Mississippi Division of Medicaid Director Drew Snyder last summer. “(Patient) has cerebral palsy and I attend church with his grandparents.”

Snyder forwarded the message to Tracy Buchanan, Medicaid’s director of long term services and supports. “Will do,” she responded.

In roughly the last year, Snyder asked Buchanan to follow up on requests from at least eight lawmakers, all white Republican men, according to text messages obtained by Mississippi Today.*

“Being a lawmaker, you can go to the head of the department and start there,” said Rep. Price Wallace, R-Mendenhall, who called and texted Snyder about a Medicaid application in January. “When you can call the top brass and let them know, then the problem seems to get worked out a lot quicker than starting at the bottom and trying to go up the ladder.”

In the texts, the politicians ask for special attention, sometimes explaining the heartbreaking circumstances and the roadblocks that specific beneficiaries faced in attempting to access Medicaid – the public health insurance program reserved for the poorest and most medically fragile citizens.

READ MORE: ‘You’re not in line’: Family battles politics, indifference, and suspected fraud in federal health care program

Medicaid is one of the largest arms of the nation’s social safety net, a maze of taxpayer-funded assistance that ideally exists to level the playing field for needy Americans, if not just simply help them survive.

Mississippi lawmakers – as well as Gov. Tate Reeves, who reappointed Snyder from the previous Gov. Phil Bryant administration – have resisted expanding Medicaid to cover the poor and uninsured. They’ve opted instead for punitive policies that target beneficiaries for suspected fraud, such as the HOPE Act, which they refused to repeal even after recent pleas from the Reeves-appointed welfare director.

Yet they can tap into the programs for those they personally deem worthy.

“Thank you for again helping me,” House Appropriations Chairman Rep. John Read, R-Gautier, texted Snyder in early 2022. “The family at this time can not express how great they feel.”

Looking at it one way, the requests demonstrate the lawmaker’s accessibility, their resourcefulness, tangible constituent representation.

But the texts also reflect the potential influence lawmakers have over the agency, not just in relation to its state budget, but in determining who successfully ends up on the Medicaid rolls in the poorest state in the nation.

“Legislators often reach out to the Division with questions or concerns raised by their constituents, and we take those questions and concerns seriously,” Medicaid said in a written response to Mississippi Today. “However, we strongly disagree with your assertion that these communications demonstrate a pattern of legislative influence on who gets served and how quickly.”

While some of Snyder’s inquiries to Buchanan over the last year came from other connected people, the majority originated from lawmakers. Snyder, who came to Medicaid after working as a deputy chief of staff and policy advisor in Bryant’s office, has an incentive to make lawmakers happy, since they determine his state budget.

“I think it does help, you know, when a lawmaker makes the phone call. It puts a little bit hotter fire under their bottom,” Wallace said. “… When I talked back with Drew, he was like, ‘Yeah, we got everything handled.’ So it was taken care of.”

“That’s what we’re here for,” Wallace said. “In all honesty, that’s why I ran for this job, to help my constituents. That’s where I get the most satisfaction of being a representative for the state of Mississippi District 77 is when one of my constituents calls me with a problem and I’m able to help them resolve that problem.”

Mississippi Today recently published a story about the struggles that a couple in north Mississippi have had navigating a special Medicaid program, called the Medicaid IDD waiver, for their 23-year-old son, who has severe autism.

The couple, Natalie and Jamie Gunnells, sought help from their local lawmaker Sen. Chad McMahan, R-Guntown, which they had supported in his past campaigns. McMahan set up a meeting for the Gunnells with officials from Medicaid, which eventually acquiesced, adopting a temporary policy that allowed Natalie Gunnells to get paid for care for her son.

“I know how to work the system for the people I represent,” McMahan told Mississippi Today. “… I have figured out a way to be very successful in helping my constituents get the medical services or the disability services their family needs. And I’m not gonna reveal how I’ve learned it. I’ve learned the system.”

When McMahan found out the Gunnells had expressed support for his upcoming political opponent, a conservative opposed to Medicaid enhancements, the senator called them out, saying it was a “slap in the face” considering all the hours he spent lobbying on their behalf.

Asked if he thinks about helping people access public assistance as a way to secure votes, McMahan said, “That never crosses my mind. There’s never a wrong time to do the right thing.”

(Medicaid later chose not to permanently adopt the policy).

Rep. John Hines, D-Greenville, said when he’s reached out to Medicaid about concerns, current agency leadership has always been responsive to him, explaining why one of his constituents may or may not be eligible for the assistance. They say they want to help, Hines said, but that they have to stay within strict eligibility guidelines.

To Hines, this scenario illuminates a larger point: There wouldn’t be such a need for lawmaker intervention on specific beneficiary cases if those lawmakers put in place equitable policies for all.

“I think the issue in the whole Medicaid system is the fact that we did not expand,” Hines said. “And a lot of these conversations, a lot of these situations that are happening here in this state, if we would just expand it, we would not be having. There wouldn’t even be a need for you to do the story that you’re doing.”

Hines continued: “The government’s inability to want to expand Medicaid forces representatives and directors of agencies to have to make uncomfortable decisions and conversations around the safety and the health of constituents, which would automatically be eligible for Medicaid if we would expand it, and they wouldn’t have to be making all these special phone calls.”

Below are the texts between Snyder and Buchanan referencing lawmaker interactions with Steverson, Read, Wallace, Rep. Tracy Arnold, R-Boonville, Rep. Rob Roberson, R-Starkville, Rep. Joey Hood, R-Ackerman, Rep. Bubba Carpenter, R-Burnsville, Rep. Sam Creekmore, R-New Albany, and former House Ways and Means Chair Jeff Smith, R-Columbus. Most of them either declined to comment or did not return texts or calls to Mississippi Today.

*The text messages referenced in this story were sent between Snyder and Buchanan from Dec. 1, 2021, to February 16, 2023. They do not reflect the entirety of communication between state lawmakers and Snyder, just the correspondence he forwarded to Buchanan that was then shared with Mississippi Today to fulfill its records request. 

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