Analysis: Bryant's Medicaid remarks change tone

May 13, 2013 10:03:26 AM



JACKSON -- Sometimes, someone veers from the script. 


That seemed to be the case last week when Gov. Phil Bryant said he would try to run Medicaid even if the Legislature failed to pass bills reauthorizing or funding the program. Beyond the cloudy legality of the Republican's claim, it turns away from the clear-as-glass GOP strategy of blaming Democrats for voting against the program and causing a calamity where 640,000 Mississippians wouldn't have health care coverage come July 1. 


Those GOP positions, repeated over the last two months, appeared aimed at ratcheting up pressure on members of the House Democratic minority. The idea is that some would give in and vote to reauthorize the state-federal health insurance program for the poor without insisting on expanding Medicaid to cover additional people. The plan appeared to be to build the pressure into June and then for Bryant to call lawmakers back for a special session, with the threat of the program's imminent collapse teetering over Democrats' heads. 


But if it's Bryant's position that he can keep Medicaid going even if the Legislature doesn't act, why say it out loud? It's likely to encourage some Democrats to keep fighting. 


In any case, an attempt to keep the agency alive by executive fiat is almost certain to be tested in court. 


Yes, Haley Barbour managed to keep the Department of Human Services alive in 2004 when lawmakers couldn't agree on reauthorizing the agency. To make it a little more legal, Attorney General Jim Hood got a Hinds County Chancery Court judge to appoint Barbour as the agency's receiver. It still seems curious, though, to say that a governor or judge can countermand a law that says an agency will pass out of existence on a certain day. 


Also left unsaid in Bryant's strategy is how the state will pay for Medicaid. 


The hospital tax that Mississippi uses to raise funds to match federal Medicaid money also expires on June 30. Can a judge or Bryant countermand that expiration too? And even if the tax continues to be collected, without an appropriations bill, what authority will Bryant have to spend the money? 


There's another aspect to this standoff that's hard to understand. Democrats had enough votes in the House to block the bill extending Medicaid and the bill paying for it. But despite whispers of Republican defections, Democrats don't appear to have a House majority to expand Medicaid by 288,000 to 300,000 people. 


It's even more unlikely that they have the 60 percent supermajority that was required for the reauthorization bill during the regular session. The bill needed extra votes under the state Constitution because it would have reauthorized the hospital tax. 


And while Republican Lt. Gov. Tate Reeves has seemed willing to keep options open, that's not the same as saying the Senate will support Medicaid expansion. 


So why not give Democrats their expansion debate if they agree to reauthorize the program if their effort fails? 


Maybe Republicans really don't think they can hold their members in line. It could also be that House Speaker Phillip Gunn, R-Clinton, is trying to shield supporters from taking a tough vote. One of the unwritten jobs of a speaker is to protect members from unnecessary votes that can be used against them in re-election campaigns. 


With Bryant's pronouncement that he can keep things going without lawmaker action, maybe no tough vote will be necessary. 


Or maybe the governor will get back on script and resume pressuring Democrats.