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Will Gov. Tate Reeves have to flip position on Medicaid expansion to keep pace with Trump?

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Republican Gov. Tate Reeves may have to do a flipflop on Medicaid expansion to remain in sync with former President Donald Trump, his political hero.

Reeves has proudly hitched his political wagon to Trump, who endorsed both of his successful gubernatorial campaigns. Nowhere has Reeves strived to be more hand-in-glove with the former president than on the issue of opposing the Affordable Care Act, better known by some as Obamacare.

As Reeves has argued against Mississippi expanding Medicaid as is allowed under the ACA to provide health care coverage for the working poor, the governor has often pointed out that he opposed Obamacare just like Trump.

During the heated debate about Medicaid expansion in the 2024 legislative session, Reeves kept his arguments for not expanding Medicaid simple, eschewing the debate of health care policy and whether Medicaid expansion might help get Mississippi off the bottom of virtually every health care list in the nation. Instead, he simply reposted a social media post where Trump proclaimed in November 2023, “Obamacare sucks!!!”

That argument prevailed. The Legislature adjourned unable to agree on a bill to expand Medicaid.

But now Trump, campaigning desperately for a second term as president, appears to be doing his own political flipflop.

With polls showing the ACA as highly popular, Trump more recently on social media said, “I am not running to replace the ACA as crooked Joe Biden says all over the place…We’re going to make the ACA much better than it is right now and much less expensive that it is right now.” The former president has posted similar comments multiple times.

During his four years as president, when part of the time he had a Republican House and Senate to pass his agenda, Trump tried unsuccessfully to repeal and replace the ACA, though he never revealed what his replacement would be.

At one point, he said his replacement plan would provide more people with health care coverage than did the ACA, though it is hard to fathom how he would have accomplished that goal without some form of government-subsidized health care. Presumably, the reason so many Republicans like Reeves oppose the ACA is because it is government subsidized.

But now fewer people are opposed to the ACA. The ACA is viewed as favorable by 62% and unfavorably by 37%, according to the latest polling from KFF, a national health advocacy non-profit. Both former President Trump and President Joe Biden would love to have those poll numbers.

Medicaid has been expanded as is allowed under the ACA in 40 states, and a record number of Americans (20 million) have health insurance through another component of the ACA, the marketplace exchange. An estimated 250,000 Mississippians have health insurance — most receiving federal financial help — through the ACA marketplace exchange.

And the Mississippi Legislature has taken steps to embrace the exchange by passing a bill to create a state exchange that will still depend on federal subsidies to operate and adhere to federal regulations and guidelines. Former Gov. Phil Bryant blocked earlier efforts to create the state exchange as is allowed by the ACA. But in the 2024 session, the Legislature passed a bill to create the ACA’s state exchange.

The bill became law during the 2024 session without Reeves’ signature.

One thing is certain ahead of the 2024 election: Tate Reeves is just about the only politician left crowing that Obamacare sucks.

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