Q&A: Rev. Charlton Johnson on seeing Medicaid expansion not as a financial issue, but a moral necessity

Rev. Charlton Johnson only joined Together for Hope as leader of its Delta region in September, but he began thinking about Medicaid expansion long before that. 

Together for Hope, an organization that works with people in the poorest counties in the country, has ramped up its efforts advocating for Medicaid expansion in Mississippi. The nonprofit hosts summits all over the states to bring together faith leaders, medical experts and health care advocates to raise awareness about Medicaid expansion. The policy, which would provide health insurance for an additional 200,000 to 300,000 Mississippians, would greatly improve health care access for the communities they work with, according to the organization.

But Gov. Tate Reeves remains steadfast in his opposition, despite support from a majority of Mississippians, and has derisively referred to Medicaid expansion as adding more people to “welfare rolls.”

Mississippi is one of only 10 states that has not expanded Medicaid. Over its first few years of implementation, research shows expansion would bring in billions of dollars to Mississippi and help the state’s struggling hospitals.

Johnson, who was born in Greenville and who has worked as a chaplain for hospitals in Memphis and Jackson, acknowledges its financial benefits. But expansion is about more than that, according to Johnson — it’s really about helping your neighbor.

Johnson spoke with Mississippi Today about the need for Medicaid expansion, and what the Governor’s refusal to consider the policy says about morality in Mississippi. 

This interview has been edited for clarity and length. 

Mississippi Today: Talk to me a little bit about what Together for Hope is and what it does for people who have not heard of it.

Rev. Charlton Johnson: It is a coalition with its focus on fighting rural, persistent poverty. Persistent poverty is defined as an area that has been under the federal threshold for poverty for consistently 30 years, and in Mississippi alone, we have 53 counties that meet that definition of persistent poverty. We are a national group, so I’m serving what we call the Delta region, which comprises the poorest counties in Mississippi, in Arkansas and Missouri; some parishes in Louisiana; Illinois — basically along the Mississippi River.

MT: Can you explain a little more in detail what the organization does, specifically?

Johnson: We serve as a bridge for grassroots organizations and what we call grass-top organizations that are trying to find ways to make an impact on the ground. For instance, there is this group that we partner with out of the Delta called Hands for Hope. They have tried to intervene with the food scarcity in that area because they don’t have a lot of grocery stores and fresh foods. Most people do their grocery shopping at Family Dollar or Dollar General. Now, they have a space where they receive fresh foods, like a distribution. Our job is making that connection between the community and that organization. A lot of grassroots organizations have a mission or idea of how they want to help the community, but they don’t always have the resources to turn something around.

MT: What kind of work does Together for Hope do around Medicaid expansion?

Johnson: It’s largely advocacy, with hosting the summit. Expansion has not been framed the right way. That was even mentioned in our last staff meeting, that we almost need to just pull it back from saying Medicaid expansion versus just starting to meet those who are in the gap. There are so many people who are in that void of not being able to receive health care. 

As a chaplain in hospitals, I’ve seen people use the emergency room as their primary care physicians, or they can’t go to the doctor and get sick enough they end up in the ER. That’s because people don’t have insurance. Seeing that was an awakening moment for me — it was when I began to recognize that people are not just running in here because they’re sick. It’s because the hospital has become their only option.

MT: I’m sure you were hearing about expansion long before starting this job. How do you think we have been talking about expansion, and how do you think we should be talking about it?

Johnson: Before coming into this role, I heard conversations about the need to expand Medicaid, which came while President Obama was in office. But there was so much resistance from red states to support that kind of initiative. People were trying to do their best to tear it apart. And Mississippi, of course, being the red state that it has long been, did not accept monies to help make this program more robust in Mississippi. So to hear Governor Reeves saying that he still isn’t interested in expanding Medicaid, to me it is just continuing the talking point that I heard from people who share his political ideology. When I heard that this organization Together for Hope was out there trying to help people better understand how it helps, not just people but the community as a whole and to also fight poverty, I wanted to be on the front lines.

MT: I’m wondering how you, as a pastor, square red states that are really religious with this resistance to helping some of the most vulnerable people in the state?

Johnson: I have a hard time. As a person of faith, it’s so hypocritical to me, because when you look at the 10 commandments, Jesus teaches that all of those commandments can be boiled down to two. The first is loving God, but the second one is loving your neighbor as yourself. And if I love my neighbor, then I recognize that we have a mutual interest in each other doing well. 

That’s not something that I readily see in a hospitality state like Mississippi. So that’s hard for me to square for myself personally, but I also recognize that we’re all at different places in our walk of faith. I think if you’re Christian, you walk the walk of Christ long enough at some point, it changes your heart, and it begins to alter the way you see those around you, so I have hope that one day they’ll see that change. 

But until that day, it just means that those of us who do see the need for change, need to not only be vocal, but need to be out front with doing those acts of compassion, of grace and mercy.

MT: If you were to explain what Medicaid expansion is to someone who wasn’t familiar with it, or someone who opposes it, what would you say about the policy and its significance? 

Johnson: I’ve been holding on to a passage in Psalms 23 which says that “though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me.” It’s not that we don’t have something to fear, but Christ is with us. Christ is with the hurting. And to say that we are Christ’s followers means that we need to follow Christ to where those who are hurting to help, to offer grace, to offer support.

And I see access to health care as a means of offering grace to people, or expanding Medicaid, bridging the gap — whatever phrase people want to put to it. 

MT: Together for Hope advocates for expansion because of their work in communities of poverty, as I understand it, so can you talk a little bit about the connection between poverty and poor health outcomes?

Johnson: If people are not getting the medical care they need, the health disparities are going off the charts. People are dying unnecessarily because they don’t even have the option of going to the doctor when they need it. When they get sick, they have to just muster through it and hope that they’ll be okay. And I don’t think that’s what it means to live in a community. 

MT: If Mississippi continues to forgo expansion, what are the consequences for the communities you work with?

Johnson: Those health outcomes will continue to get worse and worse is the short answer. But I don’t think that robs compassionate people of ingenuity. We’re going to find a way to help people. 

Expansion seems the most logical way that it can be done, but if we have to find an I’ll-climb-the-mountain-side way of helping people with health care access, we will. 

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