Mississippians are split when it comes to Medicaid expansion or reform. About a third say they would be more likely to vote for a candidate who supported expanding the program. About a third say they would be less likely to vote for someone who supported it. And about a third don’t really care.

That’s odd considering how many Mississippians would benefit from some sort of Medicaid expansion or reform.

Uncompensated care costs in Mississippi are more than $600,000 million annually, according to the Mississippi Hospital Association. The state also ranks among the highest in medical debt.

Those factors alone make expansion or reform attractive. But that’s not the only benefit to adding more residents to Medicaid roles.

Rural hospitals, many of which are struggling to remain open, would benefit from more Medicaid patients.

“When the Affordable Care Act went into effect, hospitals faced tremendous decreases in reimbursement with the promise of getting a big chunk of it back through Medicaid expansion,” King’s Daughters Medical Center CEO Alvin Hoover said. “In Mississippi, with no expansion, we have not had the opportunity to make up the difference, our bad debt is rising, and many hospitals are in financial trouble because of it.”

The Mississippi Hospital Association has created a proposal for “reforming” Medicaid. Mississippi Cares is a proposed partnership between the State of Mississippi, Mississippi hospitals, Mississippi True and its plan members. Mississippi True is a hospital-owned health plan.

Residents who want to join the plan would have to be employed or working toward it. They would also have to pay a small amount for their health insurance premiums — $20 per month.

Hospitals would cover the rest of the state’s financial obligation to qualify for the federal funds expansion would bring.

“Mississippi Cares is MHA’s proposal to add coverage for the working poor. It is not more Medicaid, it is Medicaid reform because it requires the new recipients to have a job and pay a premium,” Hoover said. “The state of Mississippi will not have to pay a single dollar to draw down the federal dollars to support Mississippi Cares. Hospitals across the state will put up the state match to establish and maintain this program.  Mississippi Cares is a good deal for every hospital and every community across the state.”

We agree with Hoover. Something must change or more hospitals will struggle to remain open. Mississippi Cares is a good option that lawmakers and the state’s next governor should consider.