Although Delbert Hosemann stated during his successful 2019 campaign to be lieutenant governor, that he was open to considering the issue, he hasn’t – at least publicly- spent much political capital to put Medicaid expansion front burner during his first term as Senate’s presider. This is not surprising, as Medicaid expansion doesn’t seem likely at this stage with Gov. Opposition was voiced by Tate Reeves, House Speaker Philip Gunn and House Speaker Philip Gunn. The issue is rarely discussed during legislative sessions because it is perceived that advocating for Medicaid expansion feels almost like trying to tilt at windmills. The issue was brought up at a recent meeting by the Senate Public Health Committee, where a federal suit that could lead to the takeover state’s mental healthcare system was being discussed. The executive director of the Department of Mental Health Diana Mikula was explaining to members of the Senate Committee that 14 community mental hospitals, which are crucial in resolving this federal lawsuit, are funded largely through Medicaid payments. She explained that if someone receiving services at a community mental hospital center isn’t on Medicaid or doesn’t have private insurance, the state usually pays the cost of treatment. Nearly thinking out loud, Senator David Blount (D-Jackson) suggested that Medicaid could help the state save money by covering more of the nearly 120,000 people who are treated in community mental health centers throughout the state. That could happen if the state expanded Medicaid, a federal-state program that provides health care. While the state currently pays 100 percent of the costs for treatment in community mental health centers, the federal government would cover 90 percent of the cost of treatment. The expansion could mean that the state would pay 10 percent instead of the current 100 percent. Blount stated that he would like to determine how many people are currently being paid by the state to access treatment at community mental health centers. This information could be used to expand the Medicaid program. The traditional Medicaid program covers poor children, pregnant women, and certain groups of the elderly, as well as the disabled. Medicaid expansion will allow people to qualify for Medicaid if they earn up to 138 per cent of the federal poverty line ($17,609 for an adult or $36,156 for four). Medicaid expansion is part the federal Patient Protection and Affordable Care Act, or Obamacare. If the state expanded Medicaid, it is reasonable to suppose that Medicaid would cover some community mental health centers for people who are unable to pay. Blount stated, “I want to know exact numbers.” Some believe that Medicaid expansion is beneficial in areas such as community mental health centers and help for them. Mississippi is one of fifteen states that has not expanded Medicaid. Gunn and Reeves have stated that the state cannot afford Medicaid expansion. They also argued that the state should not expand its welfare system as Medicaid expansion would. Reeves has also stated that if Medicaid expansion was available, people would switch to Medicaid if they didn’t have the more expensive private insurance. Reeves said that this was a bad thing. The Senate Public Health hearing discussed Medicaid expansion. However, it was not the focus of the hearing. It was there to discuss the lawsuit alleging that the state violates federal law by failing to provide adequate treatment in communities for people with mental health problems. U.S. District Judge Carlton Reeves of Southern District of Mississippi found that care provided by the 14 community mental healthcare centers is inconsistent. It might be adequate in some cases, or even exceptional in others, but it isn’t always adequate. Hob Bryan (D-Amory), Senate Public Heath Chair, stated that he believes there will continue to be efforts to provide additional state funding to community mental health centers as a result of the federal lawsuit. The current state funding for community mental health centers is $44.4 million per year. This does not include the money they receive for the patients they treat under the traditional Medicaid program. It is likely that the federal government will pay more for the funding of these centers as a result of Medicaid expansion. Perhaps this is something the state leaders would like to learn more about. Blount stated that he would. Blount said he would. But maybe it would be like trying to tilt at windmills.