At the beginning of the 2023 legislative session, Lt. Gov. Delbert Hosemann announced a plan to save Mississippi’s failing rural hospitals.

The first-term Senate leader proposed a hodgepodge of grants and programs including four bills costing upwards of $100 million that would grant extra money to hospitals, remove legal barriers to consolidating small hospitals and incentivize the retention of nurses and doctors.

Months later, all four of those bills have passed. Three are waiting on Gov. Reeves’ final approval.

The state of Mississippi’s rural health care infrastructure is tenuous. A third of the state’s rural hospitals are at risk of closure, and half of those in a few years, according to a report by the Center for Healthcare Quality and Payment Reform. Their closures could spell devastation for the communities they serve, in a state with some of the worst health outcomes in the country.

READ MORE: The death of rural hospitals could leave Mississippians ‘sick, sick, sick’

Hosemann said he spoke with statewide hospital and health care leaders in developing the plan. Notably, he steered away from floating Medicaid expansion, which would draw down more than a billion dollars from the federal government.

But he did voice support for extending postpartum Medicaid coverage and wanted to work with the state Division of Medicaid and Gov. Tate Reeves to increase reimbursements to hospitals. Both those goals were accomplished, with the Legislature extending postpartum coverage to 12 months in February, and reimbursements to hospitals have increased, though only by about $40 million, a far cry from the $230 million health care experts say they need. Much of the difference will be made up by grants from the Legislature, but they’re short in total about $40 million.

On Tuesday, both chambers passed Senate Bill 2372, which establishes the hospital grant program, and House Bill 271, the appropriations bill that funds it. Senate Medicaid Chairman Kevin Blackwell, R-Southaven, told lawmakers that $700,000 would go to the Department of Health to administer the program, and the rest, $103 million, would go to hospitals.

On the Senate floor on Monday, debate about the hospital grants turned into a debate about broader Medicaid expansion and how the proposed grant program doesn’t do enough to help hospitals. Several Democratic senators pointed out the $103 million could be just as easily spent as the state’s match for federal Medicaid dollars under expansion.

READ MORE: Mississippi leaving more than $1 billion per year on table by rejecting Medicaid expansion

“Less than 30 minutes ago, the governor of red North Carolina signed a bill to expand Medicaid,” Sen. David Blount, D-Jackson, said on Monday. “You can put $100 million in this fund for hospitals and have $100 million, or you can put $100 million over here, and have $1 billion for hospitals.”

As lawmakers enter the final few days of the 2023 legislative session, here’s where Hosemann’s legislation stands. Because the state budget hasn’t been finalized as of Tuesday, details about exact amounts are still subject to some change. 

• Senate Bill 2371: Provide between $16 million and $25 million to help with hospital residency and fellowship programs, as well as a nursing/allied health community college grant program. The bill aims to help retain doctors — the majority of doctors remain in the places they do their residencies — and increase Mississippi’s nursing workforce. The bill passed in the Senate on Monday and the House on Tuesday.
• Senate Bill 2372: Establish the Mississippi Hospital Sustainability Grant Program, which would provide extra money to aid the state’s struggling hospitals. The Senate’s bill establishes rules and regulations for the grant program, while House Bill 271 will fund the program. Lawmakers decided Monday that they’d send $104 million to hospitals, up from $80 million the Senate approved earlier in the session. The details of the grant program laid out in the Senate bill were released and passed on Tuesday.
• Senate Bill 2373: Provide $6 million for a nurse loan repayment program, to aid the state’s substantial shortage. Mississippi’s nurse turnover and vacancy rates are at their highest in at least a decade. The bill was passed and signed into law by Gov. Tate Reeves in early March.
• Senate Bill 2323: Amend current laws to allow the consolidation of hospitals. Hosemann previously said the state’s health care system needs to be revamped to be more financially viable. The bill has passed and awaits Reeves’ signature or veto by March 30.

Mississippi Today’s Geoff Pender contributed to this report.