The two candidates running for Mississippi lieutenant governor engaged in a civil discussion about Medicaid expansion and other issues during a televised statewide debate.

The 30-minute forum Thursday evening will probably be the only chance for many voters to do a side-by-side comparison of the nominees. Democrat Jay Hughes of Oxford is a first-term state representative, and Republican Delbert Hosemann of Jackson is in his third term as secretary of state.

The winner of the Nov. 5 general election will succeed Republican Tate Reeves, who is limited to two terms as lieutenant governor and is facing Democratic Attorney General Jim Hood and two other candidates in the governor’s race.

During the debate at the WJTV studio in Jackson, Hughes and Hosemann were asked whether they think Mississippi should expand Medicaid to low-income working people. Under the federal health overhaul that then-President Barack Obama signed into law in 2010, states have the option of expanding coverage to people who earn up to 138 percent of the federal poverty level. Mississippi is among the 14 states that have not taken the expansion option.

Hughes said unequivocally that he supports a plan proposed by the Mississippi Hospital Association, called Mississippi Cares. Hosemann praised the hospitals but warned that Mississippi should be cautious.

Mississippi Cares envisions that low-income people who become Medicaid recipients would pay something for their coverage, and hospitals would also pay into the program to cover other costs. Tim Moore, president and CEO of the Mississippi Hospital Association, said when he unveiled the proposal in May that if 300,000 people paid $20 a month, that would generate up to $72 million a year. However, he also said people in deep poverty would probably pay less. Moore said hospitals would pay the other $78 million.

Medicaid is an insurance program paid by federal and state money, with the federal government paying a larger portion of the costs in poorer states. Because Mississippi is perpetually poor, the federal government pays about 75 percent of Medicaid costs in the state.

Under Medicaid expansion, the federal government pays 90 percent of the costs for the new Medicaid recipients — a rate that applies in all expansion states.

The Kaiser Family Foundation estimates 163,000 Mississippians would be covered if the state expanded Medicaid. The hospital association estimates 300,000 people would be covered under its proposal.

Hughes said the Mississippi Cares plan makes good economic sense.

“It’ll bring in a billion dollars a year — a billion — and create between 16,000 and 20,000 good-paying jobs,” Hughes said. “In these communities … the health care-related positions are some of the best-paying jobs they have there.”

Hosemann said Mississippi needs to look at other states that have expanded Medicaid to avoid the types of problems they’ve had.

“Hospitals — I want to applaud them for taking this step forward,” Hosemann said. “I am for looking at the areas that we can to make sure our people are covered by insurance, particularly those that are working. … I want to make sure that we do it right the first time.”

Republican Gov. Phil Bryant, Reeves and other top Republican elected officials have opposed Medicaid expansion, saying they don’t want to put more people on government-funded health insurance. Critics of that position, including Hood, say that Mississippi is losing out on billions of dollars, even as some rural hospitals are struggling to stay open.

The lieutenant governor presides over the 52-member state Senate, appoints the Senate committee leaders and assigns bills to committees for consideration. That means that the next lieutenant governor, regardless of party, will have great influence over the types of public policy that advance at the Mississippi Capitol.

Emily Wagster Pettus has covered Mississippi government and politics since 1994. Follow her on Twitter: http://twitter.com/EWagsterPettus.