The Simmons & Simmons law office sits at the heart of downtown Greenville, where Main Street meets the levee. Family Dollar and Dollar Trees stores and neighborhoods of taped-together houses lie on its outskirts, as well as elegant, pillared old homes shaded by magnolias. The Simmons brothers are trying to revive century-old buildings downtown, but some are crumbling anyway. People with desperate cases who need help or luck or both filter in throughout the day and wait on Naugahyde furniture underneath the massive framed portrait of the brothers standing as mirror images. Derrick, the state senator, wears a bow-tie; Errick, the mayor, wears a straight tie.
The brothers specialize in criminal defense cases. In his public policy work, Derrick Simmons said he prioritizes two things: access to healthcare and education funding—two items that are usually at odds in state budgets. He won his state Senate seat in 2011 and as soon as Obamacare passed in Congress, he set his sights on Medicaid expansion and drafted a bill.
“The Republicans had a supermajority in the Legislature,” Simmons said. “Even before I authored the (expansion) amendment it was known: our Gov. Phil Bryant said he would not support it. Lt. Gov. Tate Reeves said he would not support it. The speaker of the House, Philip Gunn, said he would not even participate.”
Rep. Stephen Holland, a Democratic, said the state Legislature opposes expansion because lawmakers don't understand how Medicaid works.
“The only thing that saves Medicaid among this group is so many of their mothers and grandmothers are in nursing homes funded by Medicaid,” Holland told Modern Healthcare in June. “But they don't understand Medicaid. They talk a big game about how they want to cut back on welfare queens, but they don't do it. It's not right, politically not right, but they don't expend enough energy to understand Medicaid.”
Simmons attributes the opposition to something deeper.
“In Mississippi, we have a dark past, a dark history, and for a lot of people it's subconscious,” he said. “A lot of people, they don't even realize that they use religion when it's convenient. I think some people know that they use it when it is convenient, and I think other people don't. But I believe that as a Christian you would want to help your sister and brother, and I believe that if you are as religious as you purport to be, then Medicaid expansion was it.”
He noted that expansion opponents argue that they don't want to take money and mandates from the federal government.
"But we already take money from the federal government at a rate of 3-to-1," he said. "Look at the farm bill—you don't want to take subsidies, but look at the farm bill and what it does for Mississippi's economy. The only reason you are not critical of that is because of who it's going to.”
The day Derrick Simmons introduced his Medicaid expansion measure in 2013, he walked around the Senate floor asking every single senator to sign on as a co-sponsor. About 15 Republicans told him they wanted to join but said: “You know we can't.”
One big reason, lawmakers and close observers of the Legislature said, was Reeves. The lieutenant governor serves as president of the Senate and can steer legislation. He sent Simmons' bill to two GOP committee chairmen who would kill it on their panels.
Laura Hipp, Reeves' spokesperson, said Reeves was opposed because the state couldn't afford its share of the cost.
“Medicaid in Mississippi accounts for more than $1 billion of the state's $6 billion general fund budget,” she said. “Taxpayers simply could not afford an expansion of Obamacare that would pull limited resources from public schools and public safety and add burdensome regulations on the state's job creators.”