Over 150,000 Mississippians have lost health care coverage in the year after the Medicaid “unwinding” process began. 

Many are kids, who account for about half of the state's total Medicaid recipients. In June of 2023, the number of covered children peaked at 456,314. By May, the rolls fell by more than 110,000 to 344,517. 

The state began the process of reviewing each Medicaid recipient's eligibility in April of 2023 as pandemic provisions requiring states not to terminate people's health care coverage ended after three years. 

Though this represents a significant decline in children covered, it's more than were covered before continuous enrollment began. In March 2020, 342,043 children were covered by Medicaid – 2,000 fewer than in May 2024. 

“When state Medicaid programs are directed to return to pre-pandemic enrollment rules, it's not surprising to see Mississippi's Medicaid enrollment returning to around pre-pandemic enrollment levels,” Matt Westerfield, spokesperson for the Mississippi Division of Medicaid, said in an email to Mississippi Today.

He said 45,000 of the people disenrolled were children when the pandemic began but have since aged out of the program, which covers individuals up to 19 years old. 

Khaylah Scott, program manager for the Mississippi Health Advocacy Program, noted that because children are often healthy, changes in coverage have caught some families as a surprise. The Mississippi Health Advocacy Program works to improve health policies and practices in the state for underserved and poor communities. 

“When it's time to get a back-to-school visit or vaccination or physical exam, they may show up to the doctor and that's when they'll find out that they no longer have their health care coverage,” she said. 

Scott said the ramifications of children missing out on visits to the pediatrician are broad. “We know that when kids don't have the care that they need they sometimes miss out on the services that support healthy development,” she said.

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The state has seen an increase in enrollment in the Children's Health Insurance Program (CHIP), a program that provides free or low-cost health insurance to children that are not eligible for Medicaid but have an annual income under $31,200 for a family of four. CHIP enrollment in Mississippi has grown from about 42,000 children at the start of the unwinding process a year ago to over 50,000 in May. 

This change – 8,000 additional children covered – makes only a small dent in the 110,000 young people who lost Medicaid coverage in the past year. 

When children are deemed ineligible for Medicaid coverage in Mississippi, they are automatically enrolled in CHIP when they meet eligibility requirements. 

Adults, too, are impacted

To date, about 74.5% of completed reviews for adults have resulted in a renewal.

Most were completed by recipients filling out a renewal form. The other 31% were ex parte renewals, or automated decisions the agency made using existing information.

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Of Mississippians who have lost coverage during the unwinding process, 26.2% were deemed ineligible. The remaining 73.8% were dropped for procedural reasons, or for reasons other than being determined ineligible. This may mean they did not return, complete or receive required paperwork.

The state does not report how many procedural disenrollments were children. 

At the start of the unwinding process, the rate of procedural disenrollments neared 80% for enrollees who lost coverage. In April, procedural reasons accounted for 72.4% of terminations. 

This is slightly higher than the nation's average of 69% for procedural disenrollments, according to KFF.

Scott said she is concerned by the state's high rates of procedural disenrollment. 

“We're seeing [them] go down over time, but they're not where we would like them to be,” she noted. “… We don't want kids to be caught up in the red tape issues of this unwinding process.”

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The Centers for Medicare and Medicaid Services (CMS) introduced waivers, or opportunities for increased flexibility in making determinations, to states last year in response to high procedural disenrollment rates and to ensure that eligible people nationwide maintained coverage. 

Mississippi has since adopted six waivers to increase ex parte renewal rates, support enrollees with renewal form submissions and ensure the department has access to accurate contact information. 

Westerfield said the waivers have had a “positive impact” on the disenrollment process. 

He said that the department has also instituted monthly text blasts to families with information about when and how to return renewal forms and launched a self-service portal to make it easier to complete renewals online. 

Nationwide, most people disenrolled from Medicaid have been able to regain coverage, though they may have experienced a temporary lapse. 

According to a KFF survey, 47% report that they were able to re-enroll in Medicaid, 28% acquired other health care and about 23% remain uninsured. 

Mississippi, along with 39 other states, is projected to complete the unwinding process this month, as reported by CMS. The state has 2,000 cases left to review out of 750,000 total cases, according to Westerfield.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Lt. Gov. Delbert Hosemann announced the creation of two Senate study committees – one new group and the other task force reinstituted from 2022.

Hosemann, who presides over the Senate, announced a Labor Force Participation Study Group. That committee, chaired by second term Sen. Daniel Sparks, R-Belmont, will look at the issue of Mississippi continuing to have a lower percentage of people 16 and older in the workforce than any state in the nation.

Hosemann and others, including state Economist Corey Miller, have repeatedly said that the low workforce participation rate is a primary reason Mississippi lags the rest of the nation economically.

Hosemann also announced he is re-starting the Study Group on Women, Children, and Families.  It again will be chaired by second-term Sen. Nicole Boyd, R-Oxford.

The group was formed by the lieutenant governor in part due to the 2022 ruling overturning Roe V. Wade, which guaranteed a national right to abortions. Mississippi had laws in place when Roe was overturned banning most abortions in Mississippi.

It was estimated that with the abortion ban there would be an additional 5,000 births annually in Mississippi. That increase, based on an analysis of early data, has not occurred. But the decline in births in Mississippi since 2007 has slowed and more unwanted pregnancies have been reported, according to research by the Institute of Labor Economics. Experts surmised that women were traveling out of state for abortions or were receiving abortion-inducing medication via the mail.

READ MORE: ‘We're 50th by a mile.' Experts tell lawmakers where Mississippi stands with health of mothers, children

Researchers stressed it is too soon after the overturning of Roe to reach definitive conclusions.

“It is the Legislature's job to examine how our state laws and appropriations help or hinder Mississippi's opportunities for positive growth and prosperity,” Hosemann said in announcing the task forces. “Both of these topics have tremendous potential to move the needle in terms of economic development, tourism, health outcomes, educational attainment, and other major factors which determine our future trajectory as a state and in our communities.”

As of April, the state's labor force participation rate was 53.75% compared to the national average of 62.75%, Hosemann said.

After the Supreme Court decision overturning Roe, the Senate study group discussed multiple issues that later became law with the stated aim of helping women and children.

Those include:

• Expanding Medicaid coverage from 60 days to a year for women after giving birth
• Providing presumptive Medicaid eligibility for a pregnant woman receiving health care
• Increasing tax credits for people adopting children and for pregnancy crisis centers
• Extending the time a parent can surrender a new born to emergency providers from seven days to 45 days
• Making other changes to adoption and foster care laws

Noteworthy, the state has not expanded Medicaid to provide health care coverage to the working poor and presumably help low income families.

People wanting to make recommendations can do so at LaborStudyGroup@senate.ms.gov or at WCPStudyGroup@senate.ms.gov.

Both study groups will hold public hearings later this year.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

In the latest push to expand broadband access in Mississippi, internet service providers across the state will receive $70.9 million in grants for infrastructure projects.

This first round of grants is expected to expand access to 26,500 homes across 19 counties. More grants will be announced throughout the summer and into the fall. 

“BEAM is working to reach the most homes possible as quickly as possible,” Sally Doty, director of Broadband Expansion and Accessibility of Mississippi, said in an email. “With this first round of funding reaching 26,500 (homes), I would estimate that the total reach of the Capital Projects Fund will be 35,000 – 40,000 homes.”

The money is part of the $152 million in Mississippi Capital Projects Funds awarded to the state by the U.S. Department of the Treasury through the American Rescue Plan Act, signed into law in 2021.

Since BEAM was established in 2022, it has received a windfall of federal dollars aimed at increasing access to broadband internet service in Mississippi, which consistently ranks among the last nationwide for broadband availability, infrastructure and subscription rate. 

Broadband, or high-speed internet connection, is the modern standard for internet service. Its availability enables individuals to get the most out of the internet. According to the Federal Communications Commission, broadband service is defined as internet connection with at least 100 Mbps – megabits per second –  download speed and 20 Mbps upload speed. 

Uplink Internet, one of the grant recipients, has been providing internet access to people in the rural Mississippi Delta for more than a decade. What began as a group of farmers attempting to bring internet access to their homes in the country blossomed into a business after it became clear the demand was there. 

“These grants are really helping us meet the needs of people who have been requesting it (internet service) for a long time,” Scott Litwiller, chief operating officer of Uplink, said.“It's very gratifying to be able to get these rural communities the internet they've been wanting for a long time.”

Litwiller said that demand skyrocketed during the pandemic, which is when Uplink decided to take the leap and apply for the grants. Most of Uplink's clients are people who have not had internet access before or were dissatisfied with their current service. Nationwide, the pandemic brought into focus how essential broadband internet access was as everything, from work to school, shifted online. 

“It does a lot for people — access to the digital economy, being able to get goods cheaper through the internet, and being able to work from home,” he said. “We have a lot of single parent families that have a hard time working a job and providing childcare. With being a parent, having the ability to work from home anywhere in the world is helpful.” 

Many use high speed internet service to take advantage of online degree programs. 

“I talked to a customer the other day who got her bachelor's degree from her house. She wouldn't have been able to do that if she had to go to a physical classroom because she's at a stage in her life where she can't quit work and go back to school,” he said. “My wife got two nursing degrees from home using the internet. It does impact people in ways you don't even think of. It's a very powerful tool.”

Uplink currently serves Coahoma and parts of Bolivar counties in the Mississippi Delta, and is expanding service into Tunica and Quitman counties. 

BEAM received over $550 million in applications for the $152 million of funding. According to Doty, a rubric was used to determine which projects would receive the funding. 

“A scoring rubric was used that was made available to all applicants prior to opening of the application portal,” Doty said. “Scoring took into consideration the number of locations to be served, matching funds to be provided, cost per passing, and all federal and state requirements.”

Other factors considered in the merit review process included affordability and the ability to complete the project by the end of the year in 2026 — the point when the Treasury Department stipulates that all funds are to be spent. 

In the Mississippi Delta, where concerns were raised that BEAM was not doing enough to meet the area's needs, projects are underway. 

“There are many providers in the Delta who are actively building out using private funding and also through current grant funding. Delta Electric's broadband subsidiary DE Lightspeed is actively building,” Doty said. 

“USDA and the FCC have provided funding to Uplink, Arriva, Tech Info, Belzoni Cable, Franklin Telephone, and other Delta providers. The upcoming BEAD funding will fill in the gaps for coverage in the Delta through grants to many of those same providers,” she said, referring to the Broadband Equity, Access and Deployment program.

Of the most recent grants announced, the Mississippi Delta counties of Coahoma, DeSoto, Sunflower, Quitman and Tunica will be receiving service. In Tunica County, broadband expansion is being used to address health and safety concerns that the BEAM office was made aware of during a community engagement event. 

“There had been a recent incident where they could not call for an ambulance when needed,” Doty said. “BEAM left with an understanding of the seriousness of the situation. Within six months we were able to announce reprogramming of some grant funding to reach this area.”
BEAM recently completed projects associated with money received through the CARES Act, and is in the process of accessing $1.2 billion from the Broadband Equity Access and Deployment program. Other major funding in recent years includes $32.7 million from the Broadband Infrastructure program and $10.7 million for the state's Digital Skills and Accessibility Program, which will be used to increase digital skills in Mississippi.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.