One year ago, Gov. Tate Reeves continued his years of steadfast defiance against Medicaid expansion and delivered a plea to his fellow Republican legislative leaders.

“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 his January 2023 State of the State address. “You have my word that if you stand up to the left’s push for endless government-run healthcare, I will stand with you.”

Later today, Reeves will again deliver his annual State of the State address. But this year, he will be standing mostly alone in that fight. It very well could be his final stand.

Much to the governor’s chagrin, the very GOP legislative leaders he pleaded with last year are well underway this year in their push to pass Medicaid expansion — a policy that would have a profound effect on countless Mississippians, their families and their communities. Yes, there are a handful of anti-expansion Republicans in both the House and Senate, but whether Reeves can whip anywhere close to the number of votes needed to block it is in real question.

Medicaid expansion, which Republican Lt. Gov. Delbert Hosemann and Republican House Speaker Jason White are ushering this session, would provide health coverage to between 200,000 and 250,000 poor, working Mississippians and bring in more than $1 billion in additional federal funds to the state each year.

Proponents say the policy would save the lives and livelihoods of countless Mississippians and provide hospitals with a cash boon that could help them keep their doors open. Opponents such as Reeves have decried the policy as “welfare expansion” and, despite dozens of economic studies that say otherwise, maintain the state cannot afford the state match.

Last week, the two legislative leaders — and the Medicaid committee chairs they appointed — remained unmoved by Reeves’ criticism about their pursuit of the policy.

“My position’s been pretty clear on the fact that we were going to explore and look at Medicaid as it affects hard-working, low-income Mississippians,” House Speaker Jason White told Mississippi Today. “My ideas and thoughts about that haven’t changed. He’s the duly elected governor and he’s certainly entitled to his opinions on that matter. I don’t hold any of those against him. We just maybe here in the House have a different view of it.”

No matter how hard Reeves fights back, the GOP legislative leaders pushing an expansion plan this year are not caving to Democrats or the media. They are seeking to help Mississippians of all backgrounds who have long struggled to keep their families healthy. They are responding to small town hospital leaders and business owners who are begging for a life-saving shot in the arm. They are trying to create solutions for our state’s dismal labor participation rate. They are modeling the success of 40 others states — including many GOP-controlled — where Medicaid expansion has unequivocally saved lives.

And, without question, many of the lawmakers know Medicaid expansion is a wildly popular public policy.

The vast majority of Mississippians want it. Business leaders want it, mayors want it, and hospital leaders want it. Republican voters want it, and Democratic voters want it. Big-time Republican donors want it. Health care organizations like the Mississippi State Medical Association, Mississippi Hospital Association, American Cancer Society, and the American Heart Association want it. A majority of legislative Republicans want it, and all legislative Democrats want it. The Republican lieutenant governor wants it, and the Republican speaker wants it.

But Tate Reeves doesn’t. And his last-stand defiance could define his legacy.

The governor has more policy staffers inside the Capitol this year than in his first term, and whether they can convince enough GOP lawmakers to stand with the governor could become the biggest question of the 2024 legislative session.

If legislative leaders do advance and pass an expansion proposal as expected, Reeves could veto the bill. To override his veto would require a two-thirds vote of both the House and the Senate chambers. The mad scramble to whip and wrangle votes during those few days would be unmatched by any legislative moment of Reeves’ governorship.

Many Capitol observers will be listening intently to the governor’s State of the State speech Monday evening. Hosemann and White will be sitting closely behind the governor’s podium, and how they respond to any renewed pleas or perhaps even attacks on their work will be very telling about the days and weeks to come.

To be sure, Reeves doesn’t seem to have much support right now where it matters most. Tonight, at least in his opposition to Medicaid expansion, he’ll be standing mostly alone.

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