Gov. Tate Reeves, running for a second term this year, is traveling the state vowing he'll continue to block Medicaid expansion, a policy that would provide health coverage to at least 200,000 working Mississippians and bring at least $1 billion in new annual revenue to the state.

A powerful fellow Mississippi Republican Party leader appears to have had enough of his defiance.

Presumptive new Speaker of the House Jason White told Mississippi Today last week that Medicaid expansion would be on the table in the 2024 legislative session. White's remarks sparked an earth-rattling flash in a state that has resisted expansion for more than 10 years.

In just one interview, the likely new House speaker bucked his party's leader in a prolific way. But the candor of White's statement was telling in itself. He acknowledged that his own party was being rightfully criticized for not being willing to even discuss expansion. It was a brutally honest, almost self-deprecating statement, the likes of which are rarely seen in modern politics.

And it was a clear contrast in how Reeves has long discussed and handled the issue.

“I think we as Republicans have probably earned a little bit of the bad rap we get on health care in Mississippi,” White said in a Thursday interview with Mississippi Today. “Part of that is that we haven't had a full-blown airing or discussion of Medicaid expansion. We've just said, ‘No.'

“Now, I'm not out here on the curb pushing Medicaid expansion, but we are going to have full discussions on that and on all facets of health care in Mississippi,” White said. “… Right or wrong, we have been wearing the yoke of, ‘Y'all haven't even considered this or dug down into the numbers.' And that's true.”

There's all sorts of political cover for any Mississippi leader to float expansion. Public polling this year suggests anywhere between 65% and 80% of Mississippians — and well over 50% of Republicans — support it. Voters broadly want Medicaid expansion, and they're letting candidates hear it.

White, for what it's worth, knows this sentiment better than anyone. The past few months, he's been coordinating political efforts to keep the House GOP supermajority intact in this November's elections. Many of his partymates are facing challenges from Democrats, who have for years advocated for Medicaid expansion and have recently coordinated a concise pro-expansion message. Several Republican candidates across the state are no doubt having a hard time justifying their party's inaction to voters.

Beyond just the politics, the facts are impossible to ignore. The federal expansion program would provide Mississippi, the poorest and unhealthiest state in America, billions in new revenue and create tens of thousands of new jobs. It would provide health care to at least 200,000 Mississippians who live in what's called the “coverage gap” — people who have jobs but do not make enough money to afford health insurance plans on their own and are not offered coverage from their employers. And it would be a major financial shot in the arm for struggling hospitals.

READ MORE: Nearly half of rural hospitals at risk of closure in Mississippi, new data shows

But Tate Reeves doesn't want it. He plays politics, calling it “Obamacare” and likening it to “welfare.” When the governor gave his State of the State address earlier this year, he issued a direct appeal to lawmakers to resist it.

“Don't simply cave under the pressure of Democrats and their allies in the media who are pushing for the expansion of Obamacare, welfare, and socialized medicine,” Reeves said in that speech. “You have my word that if you stand up to the left's push for endless government-run healthcare, I will stand with you.”

White, who sat a few feet from the governor's podium that evening, apparently doesn't care if the governor is standing with him or not.

For the first time since the Affordable Care Act was passed, the top two leaders of the Legislature may be on the same page about having a conversation, at least, about expanding Medicaid. Lt. Gov. Delbert Hosemann, a shoo-in to be reelected for another four-year term, has expressed openness to some version of Medicaid expansion in the past. 

While there has never been an earnest debate of expansion under the Capitol dome, most GOP lawmakers have clearly been awaiting leadership from a party leader. In the 2023 legislative session, Mississippi Today spent weeks surveying lawmakers about the issue. A voting majority in the House and just shy of a voting majority in the Senate said they either supported expansion or were still undecided. Only a small handful of lawmakers in either chamber said they outright opposed it.

White, apparently, is the leader they've been waiting on. And on this issue, he may just take his fellow Republicans along with him and leave his governor behind.

READ MORE: Why so many top candidates are ignoring Mississippi's worsening hospital crisis

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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