Presley announces health care plan, takes shot at Medicaid chief

Democratic gubernatorial candidate Brandon Presley re-upped his commitment to Medicaid expansion this week while taking aim at Medicaid Executive Director Drew Snyder who he called a “career political hack.” Presley, 45, has held elected office for the last 22 years.

On Monday, Democratic gubernatorial candidate Brandon Presley formally rolled out his health care plan for Mississippi. Drum roll: it’s Medicaid expansion.

Following the reannouncement of his months-long support for expansion, Presley took to Twitter saying he would implement the policy on “Day 1” if elected. Presumably, the Democratic candidate understands that the supermajority Republican Legislature would have a say in the matter.

Presley also used Twitter to launch a missile at Division of Medicaid Executive Director Drew Snyder. The would-be governor called the sitting Medicaid chief a “career political hack.”

Presley, 45, has held elected office for the last 22 years.

It is unclear what, if anything, provoked the shot on Snyder. Conservative leaders, including Snyder’s boss and Presley’s political opponent–incumbent Governor Tate Reeves, a Republican– have resisted pressure to expand the taxpayer-funded welfare program. Snyder, to his credit, has never taken a public position in favor or opposition to the policy.

Medicaid expansion first came into play under the Affordable Care Act, sometimes referred to as “Obamacare.” Critics of expansion, like former Trump White House Health Care Adviser Brian Blase, frequently cite concerns over the scope and cost of expansion, along with doubt over whether it really solves the problems identified by proponents of the policy.

READ MORE: Brian Blase – Lawmakers Should Reject Calls to Expand Medicaid

Blase says Medicaid expansion states “experienced much greater enrollment and spending than they projected.”

He also argues that the results are less than promising. “Medicaid enrollees typically have worse health outcomes than those with private insurance or the uninsured, even after controlling for a variety of other factors that affect health.”

Nearly One-Third of Mississippians Already on Medicaid

Even without formal expansion, Mississippi’s Medicaid rolls are quite large. In June, there were over 900,000 Mississippians enrolled with some form of Medicaid benefits. That is roughly one-third of the state’s population.

As first reported by Magnolia Tribune, Mississippi’s Medicaid population ballooned by over 187,000 over the last three years. The de facto expansion was a byproduct of a federal prohibition on checking income eligibility during the declared COVID public health emergency. Total Medicaid expenditures in Mississippi, which include both state and federal funds, increased nearly $1.3 billion, from $5.92 billion in Fiscal Year 2019 to an estimated $7.2 billion in Fiscal Year 2023.

For the Hospitals

Presley has argued that expansion would result in 220,000 more Mississippians being added to the taxpayer-funded program, and that it would help struggling rural hospitals across the state. A cavalcade of Democratic Party officials, sympathetic media outlets, and a now deeply fractured Mississippi Hospital Association have joined in bolstering the claims.

RELATED: More Hospitals Drop Out of Mississippi Hospital Association

The truth about the causes of the current hospital dilemma, and the likelihood that expansion would solve the dilemma, is more nuanced and frequently minimized. Proponents often overlook changing dynamics in communities served by hospitals, including large population losses in certain parts of the state and the shift of health care delivery away from in-patient care.

According to a recent report from the Center for Healthcare Quality and Payment Reform (CHQPR), Mississippi has 27 rural hospitals that are labeled “at-risk.” This marks a 29 percent decline from the number reported as recently as October of 2022, and puts Mississippi in 37^th place nationally for the percentage of at-risk rural hospitals.

RELATED: Number of At-Risk Mississippi Hospitals Falls by 29 Percent

States in worse shape–with higher percentages of rural hospitals in danger–include Medicaid expansion states Arkansas, Connecticut, Hawaii, Massachusetts, Nevada, New York, Oklahoma, and Vermont. To put a fine point on it: among the 13 states performing worse than Mississippi, eight of them have expanded Medicaid.

Lt. Governor Delbert Hosemann, a Republican who has come under fire from primary challenger State Senator Chris McDaniel for allegedly supporting Medicaid expansion, said in a recent interview with WJTV that expansion would not solve every funding problem in Mississippi hospitals, adding that it is “not the answer.”

“Not one hospital administrator I’ve talked to said that expansion would cover all my problems. Not one, and I’ve been just about everywhere in Mississippi. And so, that’s not the answer. The answer is to start with what we need and fund to that,” Hosemann said. “I haven’t had a hospital administrator yet say it would, it may help them, but it wouldn’t be the answer. Not the long-term answer. And what’ll happen is we’ll be right back here five years from now having poured more money in it and not have an answer.”

Taking Aim at the Medicaid Chief

Presley said if elected governor, he will remove Snyder, who he called a “career political hack.”

“One of the easiest things I’ll do to improve healthcare in Mississippi is to appoint a Director of Medicaid that is an actual career healthcare professional and not a career political hack,” Presley tweeted, adding, “Tate Reeves wants his pals in top jobs and I want professionals.”

Lost in the politics is the fact that the Executive Director of the Division of Medicaid is not a job that requires the ability to treat medical maladies. It is, first, an administrative job that requires management and business skills.

Snyder brings to bear a law degree from the University of Virginia, a business administration degree from the University of Mississippi, private sector health care law experience, and public policy experience under both then-Secretary of State Delbert Hosemann and former Governor Phil Bryant.

During Snyder’s tenure under two governors, the Division of Medicaid has gone from regularly operating with deficits to consistent balanced budgets.

Governor Reeves’ Deputy Chief of Staff for External Affairs, Cory Custer, told Magnolia Tribune on Tuesday that Snyder is doing a great job.

“Drew is doing a great job and we are grateful for his service to Mississippi,” Custer said. “Thankfully, Brandon Presley will never be governor, so this is really a non-issue.”