On Monday, Tim Moore, chief executive officer at the Mississippi Hospital Association, presented the plan, Mississippi Cares to a crowd comprising hospital administrators. Moore stated that state leaders are not in touch with Mississippians, who support Medicaid expansion. Moore stated, “If you look across Mississippi and you see the support that is in this room, it’s time for (expansion).” “I believe our administration and our leadership need to realize that there’s a lot support in Mississippi for a plan such as this.” Since the Affordable Care Act was launched in late 2013, 37 states have expanded Medicaid access to adults earning less than 138 per cent of the federal poverty line. Many people fall within what is known as the “coverage gap”, meaning that they are too poor to be eligible for federal Medicaid or too rich to receive a subsidy under the law. Mississippi does not have Medicaid expansion, despite being eligible for a federal match rate of 90 percent, which is the highest in the nation. According to the Kaiser Family Foundation, more than 350,000 Mississippians don’t currently have health insurance. Mississippi hospitals are now required by federal law to treat all patients who come to their emergency departments, regardless of ability to pay. They receive $600 million annually in uncompensated care. Moore stated that last year, the hospital association met Bryant and Division of Medicaid officials in order to discuss expanding Medicaid in Mississippi. Moore claimed that the governor requested a proposal, but did not respond to it after it was submitted. “I have not heard from the governor on this since November. He was interested in knowing more and asked for a proposal. The proposal was accepted. After that, I don’t know what his thoughts were. I probably won’t be able to say anything more. Moore stated that he was not allowed to speak about the matter after that meeting. Moore said that the governor’s office didn’t immediately respond to a request to comment on this story. Mississippi Today reported in December that Gov. Bryant was quietly in discussions about a type of Medicaid expansion similar to that which Vice President Mike Pence had introduced when he was governor of Indiana. Bryant’s administration officials and supporters dismissed the report as unfounded. They later stated that Medicaid expansion wouldn’t be part of the governor’s 2019 legislative agenda. Moore spoke Monday and compared Mississippi Cares to Bryant’s November proposal. He stressed that it was not Medicaid expansion. “We’re using “Medicaid reform,” Moore stated. Moore’s description of Mississippi Cares is not accurate. It is actually Medicaid expansion. This was made possible by federal Medicaid reforms under the Affordable Care Act. Like Healthy Indiana, Mississippi Cares would pay a portion of the state’s 10% share of costs, which is estimated to amount to around $117million a year. Participants would be charged a limited fee, in this instance a $20 monthly premium, and $100 for each non-emergency emergency visit to an emergency room. The rest would be paid by the state to the hospitals that are included in the plan. The implementation of the plan would also be similar to Indiana’s. While most states expanded Medicaid through legislative action, only a few, including Indiana applied through a federal waiver program. Mississippi Cares would depend on this waiver, which only Division of Medicaid can seek. Bryant is the Division of Medicaid’s controller, so he would have to approve the application. The Hospital Association hopes that Bryant will support the plan. Moore stated that “We need the public support for it.” Mississippi Cares also revived Mississippi True, which would be the insurer for all enrollees. Moore estimates that there could be up to 300,000. Mississippi True, an insurance company run by providers and many member hospitals of the Hospital Association, was not able to secure a contract in 2017 to provide coverage for current Medicaid beneficiaries. After lobbying hard, the hospital association lost the battle to get a contract to insure current Medicaid recipients in 2017. Moore stated that Mississippi Cares was not just about saving Mississippi True, which its member hospitals had spent tens to millions of dollars on creating. Moore stated that this is an insurance policy that’s funded by hospitals for this particular population. This is a population that cannot afford insurance. No matter what the current administration does in 2019, Medicaid expansion is a hot topic in campaigning for Bryant’s job in 2019. Not only is this the case for Jim Hood, the Democratic front-runner, but it also includes two Republicans who are vying for the gubernatorial nomination. One of those two Republicans, Bill Waller Jr., a retired Chief Justice on the Supreme Court, supported the Mississippi Cares plan shortly after Moore announced it. Lt. Governor is the current Republican front-runner. Tate Reeves didn’t respond to a request for comments, but he has consistently opposed any form of Medicaid expansion. “There are 31 hospitals in Mississippi that are at risk of closing.” Waller stated in an email that he supports conservative principles in reforming our health system, just as Vice President Mike Pence did in Indiana as Governor. “The Mississippi Cares plan proposed will address these issues in a similar way by increasing access to care while not putting taxpayers at high risk,” Waller said.