It's a much debated decision in Mississippi, whether to expand the state's medicaid program or leave it alone.
"It's a huge public health and economic opportunity for our state," Economic Policy Center Director Ed Sivak says.
Sivak highlights a report from the Institutions of Higher Learning that shows expanding the program will cost the state much less than previously estimated. The federal government would cover all costs for the first three years and then funding declines to 90 percent, leaving the state to pay for the rest. Previous estimates put state costs at about $1.6 billion through the year 2020. The IHL estimate puts spending just under $110 million and adds 312,000 mississippians to the medicaid rolls.
"You can't not say that there is some state share of this but if you really look at what the benefits are I think they're well offset," according to Judy Solomon with the Health Policy Center on Budget & Policy Priorities.
Solomon says not expanding comes with impacts as well.
"If the state doesn't expand, I think you'll see impacts on insurance premiums, raising private premiums," she adds.
This discussion on medicaid comes as Governor Phil Bryant travels the state discussing ways to improve healthcare. Bryant does not support a medicaid expansion saying the state can not afford it. Solomon says an expansion is a way to help Bryant actually reach his goal of healthcare reform.
"What I've heard about what the governor is saying is actually very consistent with expanding medicaid in terms of talking about healthcare as a driver of the economy," Solomon says.
Lieutenant Governor Tate Reeves agrees reform is needed, but during a meeting last month said expanding medicaid would break the budget.
"The reality is that the adding, in our state as Obamacare would do, 400,000 to 500,000 Mississippians on to the medicaid rolls, we just don't believe is the right way to do it," Reeves says.
Given Mississippi's health rankings and economic conditions, Sivak says the state could lose out if an expansion isn't taken advantage of.