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By Emily Wagster Pettus/The Associated Press

Republican Gov. Phil Bryant wants to create more health care jobs in Mississippi, one of the poorest and most medically under-served states in the nation.

He also opposes putting more Mississippi residents on Medicaid under the federal health care law that Democratic President Barack Obama signed in 2010, even with the federal government paying most of the cost.

Are these two positions contradictory?

Bryant says they’re not.

Yet, even the toughest fiscal conservatives in the Legislature could start feeling pressure from health care providers who see Medicaid expansion as a way to pump money into the state to support their livelihoods and improve people’s well-being.

“I absolutely think the state should proceed with expanding Medicaid,” Chris Anderson, CEO of the Pascagoula-based Singing River Health System, said at the Capitol last week after he and administrators of other hospitals appeared before a Senate Public Health panel.

“If we do not expand, we are taking taxpayer dollars from the state of Mississippi, and we’re giving it to other states,” Anderson said.

Health care as economic development — just what the governor says he wants. But Bryant has dug in so strongly against Medicaid expansion that turnabout is practically unthinkable.

A new study shows that for every $1 Mississippi would spend on Medicaid expansion, the federal government would spend $14 in the state, on everything from colonoscopies to blood pressure medication to nursing home care. The study was conducted by the Urban Institute for the nonpartisan Kaiser Commission on Medicaid and the Uninsured.

Rachel L. Garfield, senior researcher and associate director of the Kaiser Commission, discussed the findings last week in Jackson at a breakfast hosted by the Mississippi Health Advocacy Program.

The study estimates about 288,000 newly eligible people could be expected to enroll in Medicaid if Mississippi does an expansion. More than 600,000 are enrolled now, in a state just shy of 3 million. The study says another 57,000 who are eligible for Medicaid under current standards could be expected to sign up.

The study estimates that with expansion, Mississippi would pay about $1.2 billion more for Medicaid, stretched over 10 years and would collect more than $15 billion in federal money.

Medicaid eligibility is based on income, and each state sets its own threshold. The federal poverty level is around $11,000 a year. In Mississippi, an adult’s income must be less than half of that to qualify — one of the lowest levels in the nation.

Federal law says states have the option of expanding Medicaid eligibility to 138 percent of the federal poverty level, or about $15,000.

“There’s a very large body of research that shows that having health insurance makes a big difference in how people interact with the health care system,” Garfield said. “When they have coverage, they are more likely to seek preventive care, they are more likely to catch a diagnosis of a serious illness early on.”

Rep. David Baria, D-Bay St. Louis, called the Kaiser numbers “eye popping.”

“I don’t know how we can say no to this,” Baria said.

Bryant spokesman Mick Bullock said the governor’s staff hadn’t seen the Kaiser study. Bryant relies on research from the Milliman firm, which shows larger potential enrollment and substantially larger state expenses.

“The federal and state costs associated with the health mandate come from the same place — taxpayers’ pockets,” Bullock said. “Gov. Bryant does not support a huge tax increase, which a Medicaid expansion would necessitate, or directing additional state resources to the program that could otherwise be spent on core government functions like public safety and economic development.”

Emily Wagster Pettus is a writer for The Associated Press.

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