Mississippi speaker’s Holmes County background colors his views on Medicaid expansion

There is a reason first-term House Speaker Jason White has been more out front in his support of Medicaid expansion than perhaps any other Mississippi Republican leader.

Granted, Lt. Gov. Delbert Hosemann for years has talked favorably about Medicaid expansion, but he was slow to act – primarily because he knew getting a bill out of his conservative Senate would be difficult.

But even before White was officially selected as the Republican nominee to serve as speaker during the current 2024-2028 term, he made it clear that Medicaid expansion would be seriously debated and considered during his first year as the House’s presiding officer. White’s commitment was stunning since other leaders in his party, such as his predecessor, former Speaker Philip Gunn, and Gov. Tate Reeves, had publicly opposed Medicaid expansion and even blocked debate on the issue.

But true to his word, a bill to expand Medicaid to provide health care for the working poor was one of the first measures passed by the House – by an overwhelming 99-20 margin with a vast majority of White’s Republican caucus voting for the legislation.

The proposal later died during the final days of the 2024 session when the House and Senate could not reach consensus on what would have been a landmark measure.

But both White and Hosemann have said they expect Medicaid expansion again will be on the table in the 2025 legislative session.

Late in the 2024 session White was asked why he was a supporter of Medicaid expansion.

White smiled and shrugged before saying “I don’t know, Maybe I see it differently. Maybe it is because my wife is in the health care industry. She is a nurse practitioner. She sees patients in Holmes and Carroll counties where there is a lot to be desired. They do a great job, but it is tough. So you see that.”

White went on to say he has seen the negative impact of possible hospital closures in some of the communities in his district.

In addition, he said he is a small town lawyer who has served in various capacities, such as youth court judge.

“You get a great cross section of Mississippi in those environments,” he said.

“I would like to tell you it is because I am brave, but it comes more from voters and constituents saying it is time to do this,” White continued.

While most of the recent Republican leaders hail from the more affluent suburbs of the metro Jackson area, White is from rural Holmes County, one of the poorest areas of the country on the edge of the Mississippi Delta. District 48 that he represents is a large rural area of central Mississippi.

Make no mistake about it – White is conservative, Republican, and proud of it.

The House under White’s leadership passed legislation touted by Republicans to restrict trans people from using the bathroom of the sex they identify with on college and high school campuses and to prevent citizens from gathering signatures to place on the ballot proposals to ease Mississippi’s near total abortion ban.

He said he supports school vouchers, which are the holy grail to many Republicans. But he adds the Republican-dominated House as a whole is not as supportive of sending public funds to private schools as he is.

White points out he got almost 80% of the vote in the 2023 party primary election.

But White also could be described as a bridge between the so-called rural white Democrats who controlled the Mississippi House for decades and the modern-day Republicans who currently have more than a two-thirds majority in the House.

There are some similarities between the Republicans and those rural white Democrats. Many of the Mississippi Democrats who controlled the House before Republicans wrestled control away were social conservatives – opposed to abortion rights and in favor of gun rights. But through decades, those rural white Democrats expanded the state’s role in health care by growing the state’s original Medicaid program because they saw the money the federal government was willing to offer to the state for a more robust Medicaid program as good for Mississippi and its people.

In 2011, rural white Democrats were making a last stand to maintain control of the House. The 2011 election is the only election in the state’s history where it was uncertain which party would end up controlling the Mississippi House.

White ran for election that year as one of those rural white Democrats.

Republicans won a narrow majority in 2011 – taking over the House for the first time since the 1800s. White also won and before his first year in the House was completed, he switched to the Republican majority.

But some of the principals of those conservative rural Democrats might remain in his political DNA.

This analysis was produced by Mississippi Today, a nonprofit news organization that covers state government, public policy, politics and culture. Bobby Harrison is Mississippi Today’s senior Capitol reporter.