Gov. Reeves announces 11th-hour plan for Mississippi hospital crisis. Opponents pan it as 'too little, too Tate'

After being criticized for months by his Democratic opponent for not having a plan to address Mississippi's health care crisis, Gov. Tate Reeves on Thursday unveiled what he called "sweeping Medicaid reimbursement reforms."

Reeves' proposal, announced less than two months before the November election, includes pulling more federal dollars to increase Medicaid reimbursement to hospitals — a plan that Reeves' own Medicaid administration advised GOP lawmakers and hospital leaders last year wouldn't work.

Hospitals under the plan would pay an increase in "bed taxes," but this would allow more federal dollars to be drawn down for a net to hospitals of $689 million, Reeves said. His plan also includes a measure to allow speedier prior insurance authorization of drugs or procedures, a measure lawmakers had passed but Reeves vetoed earlier this year.

Reeves' plan does not include Mississippi accepting more than $1 billion a year in federal dollars to expand Medicaid to cover the working poor as 40 other states have done.

The governor's plan was immediately panned on Thursday by supporters of Medicaid expansion and of his opponent, who dubbed his proposal, "too little, too Tate." State political observers speculated Reeves' new plan is a result of polling and of Mississippi's GOP legislative leadership warming to the idea of Medicaid expansion.

Tim Moore, president of the Mississippi Hospital Association, on Thursday said, "Who would have ever thought donating $250,000 to a Democrat would have motivated a Republican so much?" He was referring to MHA's PAC donating to Democratic gubernatorial candidate Brandon Presley.

Moore said he was appreciative of Reeves' proposal, but "surprised by what was presented because they're things we've proposed for years."

"It still does nothing to help the low-wage earners in Mississippi who do not have the disposable income to pay for medical care," Moore said. "What's the difference in taking federal money to do this, and taking federal money to cover working poor people?"

Reeves reiterated his opposition to Medicaid expansion, which he referred to as "welfare," as he gave a press briefing on his new plan, which would have to be approved by the federal Centers for Medicare & Medicaid Services. Reeves said the plan was submitted to CMS on Thursday, and that approval or disapproval could take months.

"This will have a profound impact on the bottom line of hospitals across the state, large and small," Reeves said Thursday. As for Mississippi's highest-in-the-nation rate of people without insurance, Reeves reiterated that they need to get a job or better job.

"We need more people in the workforce," Reeves said. "… I am focused on bringing better and higher paying jobs and providing opportunity for Mississippians to train for the jobs of tomorrow and have their insurance through their employer."

Reeves' proposal on Thursday was immediately blasted by his Democratic opponent Brandon Presley, who has made Medicaid expansion to cover the working poor with federal dollars a major plank in his platform.

"If Tate Reeves really cared about ending the hospital closure crisis he created, he would call a special session and expand Medicaid so working families can get the healthcare they need," Presley said in a statement. "Tate Reeves has had 12 long years to do something about Mississippi's hospital crisis and 47 days before an election is too little, too late for the hospitals that have cut essential services, lost jobs, or are on the brink of closing altogether.

"Today's announcement is nothing more than an election year stunt and just more proof that Tate Reeves is a craven, failed governor who will always look out for himself and his political career ahead of the health of Mississippi families," Presley said.

Mississippi Democratic Chairman Cheikh Taylor (second right), State Rep. Daryl Porter (right) and Democrat supporters gathered at the Sillers Building to protest Gov. Tate Reeves unveiling of a hospital program, Thursday, Sept. 21, 2023. Credit: Vickie D. King/Mississippi Today

Other state Democratic leaders held a small rally outside Reeves' office building after his announcement. They chanted, "Too little, too Tate," and called for Medicaid expansion.

"Tate Reeves does not care about the $1 billion it would bring into our state or the 10,000 jobs it would create," said state Democratic Party chairman and state Rep. Cheikh Taylor. "At the end of the day, Tate Reeves does not care. He cares about what his political position is in the final days of the election."

Reeves proposal, if approved by CMS, would reimburse providers of Medicaid managed care services near the rate at which private insurers pay. It would reimburse hospitals for treating Medicaid fee-for-service patients at the upper level of what Medicare pays, higher than Medicaid's normal rate. Hospitals would pay more in bed taxes to cover the state's share of the higher rates, and lose some federal payments for treating uninsured patients, but would net an estimated $689.5 million, Reeves said.

Republican legislative leaders and the hospital association starting last year pushed a similar proposal to increase Medicaid reimbursements to hospitals, but were told by Reeves' Medicaid administrators that it wouldn't work — and would only bring in about $40 million — because the state's rate of commercial insurance payments are so low.

When asked about this on Thursday, Reeves deferred the question to Medicaid Director Drew Snyder, who cryptically answered that the difference in projections this year versus last year is because, "We got the right people in the room."

Republican Lt. Gov. Delbert Hosemann on Thursday said: "Last year, around this time, our office met with Medicaid and hospitals to discuss hospital payment initiatives, but we were told by Medicaid that these changes were not currently possible. The Legislature then turned to alternatives … We are always happy to discuss long-term solutions to stabilize hospitals in Mississippi and improve access to care."

Gov. Tate Reeves announces his plans for a series of Medicaid reimbursement reforms during a press conference at the Walter Sillers Building in Jackson, Miss., on Thursday, September 21, 2023. Credit: Eric Shelton/Mississippi Today

Reeves presented his plan in a press conference flanked by several executives of the state's largest hospitals. None of them spoke, and they were not made available for media questions in the briefing.

Gary Marchand is interim CEO of Greenwood Leflore Hospital, one of many small rural hospitals in Mississippi teetering on the brink of closure. Reeves, in his presser on Thursday, provided a sheet that showed Greenwood Leflore would receive an extra $10 million a year if his plan gets federal approval.

Marchand, contacted on Thursday, said he's unsure how much of an impact the additional money would make, but he's appreciative of "any efforts to provide additional cash resources in support of our operations." He also added, "We are hopeful for a rapid approval process."

Reeves on Thursday vowed his new plan is "just the beginning."

"Our eyes are set on the future, and we aim to continue ushering in reforms that strengthen Mississippi's healthcare system no matter where you live in the state," Reeves said.

Mississippi Today reporter Devna Bose contributed to this story.

-- Article credit to Geoff Pender of Mississippi Today