A wide majority of Mississippians across partisan and demographic lines support expanding Medicaid to provide health coverage for the working poor, according to a newly released Mississippi Today/Siena College poll.
The poll showed 80% of respondents — including 70% of Republicans — either strongly agree or somewhat agree the state should “accept federal funds to expand Medicaid.”
The numbers appear to show a continued shift of voter sentiment in what has long been a partisan battle. Mississippi’s elected Republican governors and other leaders for the last decade have blocked Medicaid expansion via the Affordable Care Act and the billions in federal dollars that would have come with it. This resistance continues even as struggling hospitals and more citizens in the poorest, unhealthiest state cry for help.
“Yes, I support it,” said Joy Cevera, 60, a Republican voter from Oxford who said she generally supports Gov. Tate Reeves but disagrees with him on Medicaid expansion. Several poll respondents agreed to talk with Mississippi Today about their responses.
For Cevera, a disability-retired cook, the issue is personal.
“I used to be one of the working poor,” she said. “I watched my son suffer because I couldn’t afford medical care for him … He’s now 35, and I’m still watching him suffer because he’s one of the working poor. There’s got to be something done. If other states can do it, why can’t we?”
The poll showed large majorities across partisan and demographic lines strongly support the state’s hospitals, large and small, being adequately funded and a majority believe state government has a responsibility to help poor, working people pay for basic healthcare. Vast majorities, including 91% of Republican voters, agree every Mississippian should have access to good health care.
“I think we do have a responsibility as a society to help folks, and sometimes the folks you’re helping aren’t your favorite folks, but too bad,” said Brad Dickey, 58, an engineer from Southaven who said he votes Republican at least 90% of the time. “The right to live is a basic right … They should expand it. We are an unhealthy state … I tell my friends who say they don’t want to give money to people who don’t work or can’t afford insurance, ‘Yes, but they have children.’
“They have got to have something, otherwise what they do is go to the emergency room,” Dickey continued. “It would be much more affordable care if done another way. It stresses the hospitals, and yes, we end up paying for it anyway.”
Editor’s note: Poll methodology and crosstabs can be found at the bottom of this story. Click here to read more about our partnership with Siena College Research Institute.
Mississippi is one of 11 states to refuse expansion. The decision means the state is refusing about $1 billion a year in federal funding meant to help poor states provide healthcare, and leaving up to 300,000 working Mississippians without coverage.
Meanwhile, health officials say 38 rural hospitals are in danger of closure, in large part due to eating the cost of providing care to indigent patients. Some of those hospitals are larger regional care centers, such as Greenwood Leflore Hospital, and even larger metro area hospitals are struggling financially because of uncompensated care costs.
But 14% of voters, including 23% of Republicans, according to the poll, remain opposed to Medicaid expansion. Some of those, such as small business owner Joseph Allen, 42, of Brandon, see it as an issue of fairness and too much of their tax dollars going to social or entitlement programs.
“I pay for my own insurance myself, and it’s a lot of money,” Allen said. “… To me it’s like the same old broken record in America. The more you put in, the more you’re penalized. The harder you work, the more they take.”
Independent voter Michelle Dukes, 52, a homemaker and caregiver in Edwards, said previously working 15 years in the mental health services field showed Medicaid is a flawed program and “the system needs to be fixed before they expand it.”
For some voters, support of Medicaid expansion comes with caveats and limits.
“I support it, but in a very specific way,” said Robby Raymond, 47, a heavy equipment operator who supports Gov. Reeves and is friends with him from their hometown in Florence.
“I do believe we need to do more to help the working poor, or the retired,” Raymond said. “… But for the people who are able to work that don’t and think they need assistance — what they need is a job. That’s our big downfall in this whole country, that we don’t do enough to help the people that need help, and do too much for the people who don’t need it … I’ve been fortunate and always had a good job, made good money and had insurance. But there’s lots of people I know that struggle.
“I do disagree with Tate Reeves (on Medicaid expansion), but I still talk with him a couple of times a year, and I know that he also shares my viewpoint that we should do more to help our retired and our working poor,” Raymond said.
Tim Moore, president of the Mississippi Hospital Association and advocate for Medicaid expansion, said he was not surprised to see widespread support for expansion, but the numbers were a little higher than he would have expected.
“I have for a long time thought it’s at least 65%-70%, simply because of the high numbers we got on our last poll just with Republican voters,” Moore said. “An overwhelming majority of Mississippians support it. I don’t know how our leadership ignores that.”
Moore said MHA participated in polling in 2019, gearing up for a ballot initiative drive for voters to force Medicaid expansion over legislative reluctance. But the state Supreme Court, in a ruling on medical marijuana, invalidated the state’s ballot initiative system and lawmakers have yet to restore that right to voters.
Moore noted that South Dakota, like Mississippi, was long a hold out on Medicaid expansion because of partisan politics. South Dakota voted 56% to 44% last year to expand Medicaid.
“South Dakota is also a very red state,” Moore said. “Their governor made a public statement that she didn’t support it, but if that’s what South Dakotans wanted, she would put it in place.
“I am very encouraged by the numbers this new poll is reflecting,” Moore said. “Mississippi is seeing the need for change.”
State Rep. Tracy Arnold, a conservative Republican from Booneville, said he’s not surprised at the support the poll showed for Medicaid expansion. He recently did some informal polling of his constituents on Facebook, and said he estimates support was 90% to 95%, “As long as you’re talking about the working poor.”
“I’m not surprised, because that’s the only portion of our society that is left out of everything — working people and small business owners,” Arnold said. Arnold said he’s interested in “some sort of hybrid,” expansion, perhaps similar to that enacted by Arkansas.
“Maybe have some buy in, like normal insurance with copay for visits and medicines, or even a voucher to let them buy insurance on the private market,” Arnold said. He said he might also support helping seniors who struggle to pay for supplemental insurance for Medicare.
Arnold said that although the leadership has thwarted voting or debate on Medicaid expansion in recent years, he suspects it will be at least debated when other issues are brought up, such as the Senate’s push to expand postpartum coverage for mothers.
“I think people are a little more open minded about it than they were,” Arnold said. “We have a substantial amount of revenue now. We have to help save our struggling hospitals, and this would not only be giving hospitals more funding, it would hep the struggling taxpaying citizen.
“There’s only a few states left that haven done this, and it appears to be providing some benefit and services where they have,” Arnold said. “… My position is, I will listen to the people I represent.”
The Mississippi Today/Siena College Research Institute poll of 821 registered voters was conducted Jan. 8-12 and has an overall margin of error of +/- 4.6 percentage points. Siena has an A rating in FiveThirtyEight’s analysis of pollsters.
Click here for complete methodology and crosstabs relevant to this story.