“Among the flawed arguments made by opponents of Medicaid expansion in Mississippi is this one: Because Medicaid generally does not compensate hospitals enough for what it takes to provide the care, they could actually end up doing worse financially if the state expands the program to cover the working poor.”
That led off a remarkable editorial by the Greenwood Commonwealth which called an example of the above argument by Douglas Carswell, president and CEO of the Mississippi Center for Public Policy, “intellectually dishonest.”
“Every time a rural hospital treats someone on Medicaid, the hospital normally loses money,” Carswell wrote in an article he distributed. “How would expanding such a loss-making system improve the financial position of rural hospitals? It wouldn’t.”
The Commonwealth editorial pointed out that, yes, hospitals often do not recoup costs from Medicaid, but they lose far more by not collecting much of anything from those whom Medicaid expansion would cover.
The Emergency Medical Treatment and Labor Act (EMTALA) adopted by Congress in 1986 requires hospital emergency rooms to accept and triage patients “regardless of ability to pay.” Federal funds were provided to help hospitals offset those losses until the Affordable Care Act which passed in 2010. ACA replaced those subsidies with Medicaid expansion. Mississippi did not expand Medicaid, so uncompensated care losses skyrocketed in Mississippi hospitals.
Evidence is clear that Medicaid expansion would greatly reduce those losses to levels most hospitals could manage. The Commonwealth editorial cited a case study regarding Ascension Health Hospitals provided by Russ Latino, now CEO of the Magnolia Tribune.
No doubt the Greenwood newspaper reacted so strongly to Carswell’s cavalier and deceptive argument because of the plight of its own hospital. Greenwood Leflore Hospital is on its last legs financially. Other Mississippi hospitals are not far from that status.
So who is this Carswell guy? In announcing his arrival as head of the Mississippi Center for Public Policy in January 2021 he cited as his background “twelve years as a Member of the British Parliament, and co-founder of Vote Leave, the official campaign that won the Brexit referendum.”
Since taking over the policy center, Carswell has become a loud voice for the libertarian “economic freedom” ideology promoted by the infamous Koch brothers. Perhaps that is why a number of policy nerds deemed the center as “the center for public propaganda.”
Intellectual dishonesty pervades the world of propaganda. Carswell’s piece on Medicaid expansion suggests the policy nerds may be on target.
“And you shall know the truth” – John 8:32.
Crawford is a syndicated columnist from Jackson.
