As I began the last President’s Stew, the 2024 Legislative Session was just getting underway. Well, it is now in full swing and, needless to say, the session has surely given us multiple ingredients to add to the stew pot and on top of that, some of the ingredients are still simmering (developing). More on that as we move through the journey. Early in the session, MSMA leaders were able to meet with both chambers’ leadership and highlight our legislative major points of focus for the session. Both the Lt. Governor and Speaker were attentive and engaging and the meetings were encouraging, in that healthcare was going to be a major focus this session. Like preparing your favorite stew, you really don’t know how tasty, or not, it is going to be until the stew is complete - and the stew is not complete just yet. There are still some savory ingredients out there, that hopefully will be fruitful and available, to be added to the stew in the near future.

Because this legislative session follows an election year, it is 125-days, as compared to the traditional 90-day session of other years. As expected it got off to a somewhat slow start allowing the newly elected officials time to get accustomed to the legislative processes. There were the typical meetings and hearings during the early weeks of the session, but as bills began to be formed and discussed, it was easy to see that this was going to be one of the more intense and healthcare-oriented sessions of recent memory. There are always scope bills introduced, but this session had more than its share. These bills necessitated much of the early attention of the MSMA team. The newly modified prior authorization bill and the Medicaid presumptive eligibility bills passed through both chambers without major challenges. Then, given the rhetoric during the 2023 campaigns related to Medicaid expansion, this session had the hints that something was going to transpire during the session. And we knew that if it did, it was going to require much time and political capital, if it were to be successful. The good news was that at least we felt for the first time since the enactment of the Affordable Care Act in 2010, that it was, at a minimum, going to finally be debated openly in the legislature. And true to form, Medicaid expansion was brought forward and has been keenly debated during the session.

Claude Brunson, David Roberts, and Sara Hartzog spend many hours reviewing and monitoring the thousands of bills that originate annually during the legislative session. Most of these bills never make their way to committees or out of committees, if they get that far. But those that do move forward take active monitoring and engagement to sort through and find the favorable bills vs. those that may be detrimental to healthcare and/or our patients. Like my stew, a stew may start off savory only to have some bad ingredients added, which can make for a bad stew, or a bad bill. In some cases, a bad bill or stew can be made good with the right ingredients added, so all require attention. Your MSMA leadership stands ready to move in the appropriate direction at a moment’s notice because of the changing landscape of these bills. In many of these cases a call to action, for all the membership, will go out. Please, please, take these calls to action seriously and act accordingly. Because, often passage of a bill or defeating of a bill, lies within a small vote margin. You never know whose vote is going to make the difference in success or failure, so let your legislative leaders know your preferences. I hear time and time again from legislators about how important it is to their decision to have one-on-one conversations with leaders in their communities. We, as physicians, need to do a better job of letting our voices be heard. They also reiterate how few times their physicians reach out to them. I can’t over emphasize the importance of the engagement with your legislative leaders is.

Claude, David and Sara are there on the front line for us, but they need all of us to amplify their voices. Numbers are important. If you ever have any doubt or curiosity as to what your MSMA is doing for you, just simply come to the Capitol and spend the day, especially this time of year. Go ahead and plan to sign up for Doctor of the Day at the Capitol next year.

We have had many successes this session, like early passage of the prior authorization bill to address the administrative burden for our physicians and patients, improvements and strengthening public health, and the passage of a Medicaid presumptive eligibility bill to allow for earlier intervention in pregnancy. However, the many successes in defeating unwanted or outright dangerous bills to healthcare probably get the least fanfare or publicity, but are some of the most important works and successes annually.

MSMA has for several years pushed for expansion for healthcare access, coming short of using the words, “Medicaid Expansion”, but now the cat is out of the bag. Medicaid expansion is being mentioned openly and often. Business leaders, hospital leaders, and faith-based leaders have joined with healthcare providers to advocate for healthcare access expansion, and they too are now promoting Medicaid expansion for both the access and economic benefits it affords Mississippi. The Speaker and the House membership acted quickly and passed legislation with a veto-proof majority. This was certainly an important and necessary action if a bill of this nature would have a chance to become law. The Senate was less responsive, but through the process, a version of the House bill eventually ended up in conference between the two chambers. As the old saying goes, there is more than one way to skin a cat, but it still amazes me at how the two chambers can have such differing views at times. At any rate, at the time of this writing the two chambers are still engaged in “horse trading” so to speak. So, the outcome is yet to be known but it is looking more like there will be a compromise and Mississippi could see some version of Medicaid expansion before it is all said and done.

Back to the President’s Stew, the happenings during this session have made the session memorable. The happenings have added a tremendous number of spices available to the stew, but for now the flavor is still undetermined. But as your MSMA President, I feel assured that this is going to be one of the more tasty stews (sessions). Some even say that if the Medicaid expansion bill proceeds and the two chambers agree to a compromise, and the bill is eventually passed, it will be the most transformative healthcare legislation since tort reform. Without a question, even if the House and Senate pass a Medicaid expansion bill, the stew will still not be complete at that point.

With the session scheduled to end May 5th, we are down to crunch time. By all accounts it will likely be vetoed by the Governor, thus it will take a 2/3 majority vote in both chambers to override a veto, should one occur. So, one can see that we still have many ingredients to add to our stew before we know it’s true flavor.

Your MSMA staff and leadership have been hard at work defending bills, defeating bills, and in some cases promoting bills. Keep your calls and emails coming when called upon. And stay tuned, the stew tasting is just around the corner and I predict it is going to be the best, most savory stew that you have ever tasted.

In closing, this time of the year emphasizes the importance of legislative contacts and further emphasizes the critical nature of participating in MMPAC. Your voice and your input are critical to the care and safety of our patients and our physician’s future. I look forward to continuing my travels across the state, meeting with you and your component societies, and hearing your suggestions. If you are not a member of MSMA, become one, if you are a member, find a way to engage and be more active, we need all of us working together.

Best wishes, joy, and peace.

John Mitchell, MD
MSMA President