Stand On Principle

Cory T. Wilson is a Madison attorney and Moss Point native. To follow Cory: @CoryWilsonMS or cory@corywilson.ms. Click on the hyperlink to  see the full Medicaid expansion study.

The media are having a joyous holiday, faux-fretting over the GOP’s disarray in Washington.  The Republicans seem to be the first shattered over the side of the fiscal cliff.
Thursday night, Speaker John Boehner pulled his “Plan B” designed to avoid the tax increases set to occur January 1.  Conservatives against any tax increases (and who demand real spending cuts) bucked Boehner, leaving the Speaker with an embarrassing defeat instead of a “least bad option” served up to President Obama and the Democrats.
In the short term, Republicans are divided.  This has been Obama’s main goal in his fiscal cliff “negotiations.”  He wants to break Congressional Republicans, so that his tax-and-spend agenda can continue apace without effective opposition.
Something similar is about to play out in the Mississippi Legislature.  And, Obama will deserve the credit here, too.
This session, the Republican-led legislature must decide whether Mississippi will expand its Medicaid program as part of the implementation of Obamacare.
Governor Phil Bryant has said he is opposed to expanding Medicaid because the state cannot afford it.  He has a point.
Obamacare would expand Medicaid eligibility to Mississippians at or below 138 percent of the poverty level.  That would bring an estimated 300,000 more people into the Medicaid program, raising the total number of Mississippians covered by Medicaid to around a million.  That is a third of the state.
For the first three years, the federal government would pay 100 percent of the expansion cost.  By 2020, the federal share goes down to 90 percent.  According to an October 2012 study prepared by economist Bob Neal, Ph.D., for the University Research Center, the cost to Mississippi for 2014-2025, would run as high as $556 million.
But take heart.  If fewer people participate, it could only cost the state $497 million.
There is a counterpoint to Bryant’s position.  Democrats in the Legislature, and others, are already making it.  In November, I chaired a meeting of the Madison County Business League Health/Wellness and Government Relations Committees, during which Dr. Alton Cobb, retired state health officer, and Dr. Phil Pepper, former state economist, discussed the supposed benefits of Medicaid expansion.
According to Cobb and Pepper, who discussed the findings of the same October study, Mississippi can hardly afford NOT to expand Medicaid.  The reason is that Mississippi would receive billions in “free” federal dollars, which would have a positive economic impact.  They estimate that by 2025, Medicaid expansion would create 9,000 jobs in the state, and actually add to the general revenue tax coffers.
It’s a plausible theory at least.  An influx of billions of dollars could stimulate the economy, unless those dollars are mired in waste-prone government spending.  (Oh, wait, they will be.  See also, Obama’s Stimulus.)
Republicans will be under great pressure to take this deal.  It comes down to the classic siren song of “free money,” if we only expand the welfare state as directed.
Conservative legislators should be mindful: weak knees may not be covered by Obamacare.
Even wise men like Cobb and Pepper concede that the marginal upside is dependent on the federal government covering 90 percent of the cost.  Once the feds run out of other people’s money, much more cost would hit Mississippi.
The economic “benefit” also does not account for the strain on Mississippi’s health care providers.  We already have a shortage of qualified providers.  300,000 more people demanding “free” health care may strain the system to the breaking point.  And, no one really knows how many people will end up on government health care rolls.  Every other federally-bestowed welfare program blew out its cost estimates.  Obamacare’s track record of estimating costs is outright fraud.
Of course, those “free” federal dollars are also not free.  Those billions are taken from taxpayers and removed from somewhere else in the economy.  Any jobs gained here will be lost elsewhere, probably in greater numbers.
When the pressure’s on, Republicans should recall Obama’s first year.  Democrats controlled DC.  Many in the GOP were urging Republicans to change to meet the “new reality.”  A February 2009 issue of Newsweek (remember them?) proclaimed “We Are All Socialists Now.”
A funny thing happened on the way to the re-education camps.  Republicans found their spines, and began to stand on principle.  That’s how they gained the U.S. House majority, and likely the majority in our state House in 2011.
Mississippi Republicans will soon face a choice: “free” federal dollars for bigger government, or standing on principle, which could give Mississippi a future in which we are less dependent upon both.