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‘Very problematic’: Medicaid drops another 22,000 Mississippians, mostly for paperwork issues

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The Mississippi Division of removed another 22,000 from its rolls in July in the second wave of disenrollments after the end of pandemic-era protections.

That brings the agency up to 51,967 disenrollments total during the unwinding process, with those numbers set to increase.

Beginning in March 2020, federal law prohibited divisions of Medicaid from removing people from their rolls due to the public health emergency.

The emergency ended in May, and now agencies are reviewing the eligibility of their beneficiaries for the first time in more than three years.

According to one expert, Mississippi’s total number of disenrollments is not the most concerning statistic: It’s the fact that 80% of the people dropped so far have been disenrolled because of issues with their paperwork, which could mean many of them were still eligible.

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“It’s very high,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families. “Yeah, that’s very problematic.”

Many of the people who have been procedurally disenrolled could be children. Kids in low-income families make up more than half of Mississippi’s overall Medicaid beneficiaries.

According to Mississippi Medicaid’s enrollment reports, 18,710 children have lost Medicaid coverage from June of this year to July. It’s unclear how many children have been dropped since — the agency has not yet updated its August numbers.

Mississippi is one of only three states that does not have Medicaid online accounts as of January 2023, according to the Kaiser Family Foundation, though people do have the option to complete their renewal online.

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According to a July press release, Mississippi Medicaid enrollment increased by 187,894 people, or 26%, from March 2020 to June 2023, bringing Mississippi’s Medicaid rolls over 900,000 people for the first time in the agency’s history.

In June, Mississippi Medicaid was set to examine the of 67,695 Mississippians whose coverage was up for review.

It found that a little under half of those, or 29,460, were no longer eligible. According to the agency, about 60% of the people who were removed had remained insured during the pandemic because of the extended eligibility rules.

The latest data release shows that of the 75,110 Mississippians who had their eligibility evaluated in July, 22,507, or 30%, were unenrolled.

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The majority of those were terminated because of “procedural reasons,” meaning they lost coverage for not returning paperwork or related reasons.

That means many of the people dropped so far could be people who are still eligible.

Alker said Mississippi’s ex-parte rate was “relatively low” — ex-parte renewals are automatic renewals, and the best case scenario during unwinding. Mississippi Medicaid spokesman Matt Westerfield said that the agency is focused on increasing those ex-parte approval rates. 

“If individuals qualify for Medicaid coverage, we’d rather make that determination without to mail a form that they have to fill out and that a Medicaid specialist then has to process,” he said.

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Combined with the high rate of procedural terminations — only 11 states have higher percentages, according to Alker’s organization — it’s cause for concern, she said, enough that she suggested Gov. Tate Reeves should step in.

“The governor should absolutely pause these procedural terminations and figure out what’s going on,” Alker said.

According to Westerfield, the Division requested permission from the Centers for Medicare and Medicaid Services on Aug. 7 for “four additional flexibilities that could help reduce procedural disenrollments while increasing ex-parte renewals.”

A letter provided to Mississippi by the Division shows that those “flexibilities” included permitting managed care plans to help beneficiaries submit renewal forms, renewing coverage for people whose information “is not returned or is not returned within a reasonable amount of time” and reinstating eligibility for people who were previously unenrolled more quickly. These allowances have not yet been approved, but Westerfield said the agency anticipates that soon.

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People who were dropped because they didn’t submit the needed information can be reconsidered without a new application if they submit that information within 120 days of the disenrollment.

Though Mississippi Medicaid launched the “Stay Covered” outreach campaign that included postcard mailing, flyers and text and email blasts to make people aware of the unwinding process, the leader of a local health advocacy organization that has partnered with the agency previously told Mississippi Today that he doesn’t believe Mississippi Medicaid is doing enough to inform beneficiaries. Additionally, it’s not clear how many emails or letters have been disseminated — Westerfield previously did not respond to that question.

Westerfield did say the Division did not process renewals for a few months for beneficiaries in the Delta affected by tornadoes this spring, though it’s not clear if the agency is doing anything in particular to reach those people — who may be displaced — now.

The new data also reveals a growing backlog in Mississippi.

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In June, about 5,000 renewals that were up for review were not completed. The new numbers show that an additional 15,000 reviews went uncompleted last month. Westerfield blamed it on the larger review group in the July period compared to June.

Alker says the backlog isn’t uncommon, and it’s neither good nor bad .

“We want states to take their time, and they still have a lot of time,” she said. States have until May 2024 to complete the unwinding process.

“But it speaks to the backlog and the system, and the fact that they don’t have enough staff to begin with in many states, including Mississippi,” Alker said. “The backlog will keep getting bigger, and that’s going to be a problem.”

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And as unwinding continues and a mounting number of Mississippians are potentially without health care coverage, stress continues to mount on Mississippi’s health care infrastructure.

As Reeves and other Republican state leaders continue to oppose expanding Medicaid to the working poor, one puts almost half of the state’s rural hospitals at risk of closure, and data from Alker’s organization shows that rural populations will be the ones most affected by unwinding.

“If there’s a big unwinding problem, it’s going to be really devastating for these rural communities,” she said.

CMS sent letters to all state Medicaid division directors last week, including Mississippi’s director Drew Snyder. Because Mississippi started disenrollments in June, CMS did not have comments about Mississippi’s procedural termination rate — they analyzed states’ May numbers in their letters.

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However, the letter indicated they would continue to keep an eye on deficiencies in individual states’ unwinding processes.

“I think what was important about the letters is that CMS, this is the first time that they’ve done something publicly like this,” Alker said. “I took it as a sign that they’re stepping up their enforcement.”

As of August, almost 5 million people have been disenrolled from Medicaid nationwide, according to the Kaiser Family Foundation. The organization says up to 24 million people could end up losing coverage during the unwinding.

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

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Mississippi Today

On this day in 1955

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mississippitoday.org – Jerry Mitchell – 2024-09-21 07:00:00

Sept. 21, 1955

Moses Wright points at J.W. Milam as one of the kidnappers of his great-nephew, Emmett Till. Ernest Withers defied a judge’s orders and took this . Credit: Wikipedia

Moses Wright took the witness stand and identified the who kidnapped and killed his great-nephew, Emmett Till. 

“It was the first time in my I had the courage to accuse a white man of a , let alone something terrible as killing a boy,” Wright said later. “I just wanted to see justice done.” 

He worked as a sharecropper and was also a minister, whom the locals called “Preacher.” The two white men who abducted Till — J.W. Milam and his half-brother, Roy Bryant — threatened to kill Wright if he said anything. 

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“How old are you, Preacher?” Milam asked. Wright replied 64. “If you make any trouble, you’ll never to be 65,” Milam said. When the teen’s body was recovered from the Tallahatchie , Wright identified Till. Despite threats, Wright still took the witness stand. When the prosecutor asked him to point out Till’s abductors, he stood up, pointed his weathered finger at Milam and said, “There he is. That’s the man.” 

He testified that Bryant identified himself as “Mr. Bryant.” It may have been the first murder trial in Mississippi where a Black man testified against a white man. Even after the trial, the threats continued, and Wright left to join his in Chicago, where he had already sent them.

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

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Mississippi River mayors agree to unify ports from the Corn Belt to the coast 

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mississippitoday.org – Delaney Dryfoos, The Lens and Elise Plunk, Louisiana Illuminator – 2024-09-20 16:19:36

BATON ROUGE, La. — Mayors from 10 states along the Mississippi convened in Louisiana’s capital this to announce a cooperative agreement between the working river’s ports. 

In town for the annual Mississippi River Cities & Towns Initiative meeting, the mayors also called upon the next U.S. president to prioritize several federal policy changes to the 105 cities represented by the initiative. 

On Wednesday, mayors from the Midwestern Corn Belt joined mayors from Louisiana to sign the Mississippi River Ports Cooperative Endeavor Agreement. The agreement is the first to ensure cooperation between the inland ports in the heart of the corn belt and the coastal ports of Louisiana that export 60% of the nation’s agricultural products.

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Vicksburg, Mississippi, George Flaggs praised the move in a statement on Friday, adding that he and the other mayors there were paying particular attention to environmental issues along the river such as the ongoing drought.

“This agreement ensures that ports from St. Louis to St. Paul will federal designation, a significant step that will bolster commerce and strengthen the economic impact of the entire Mississippi River region,” Flaggs said.

The inland ports between St. Louis and St. Paul were not federally recognized until 2022, said Robert Sinkler, executive coordinating director of the Corn Belt Ports. With the support of the Mississippi River cities initiative, the Corn Belt Ports initiative launched in 2019 to advocate for federal recognition of those ports.

Now, the corn belt and coastal ports will take on commerce-related policy actions together, for the first time in Mississippi River history, said Sinkler. The river moves nearly one trillion dollars in product through its ports annually, according to MRCTI. Maintaining the navigation capability on the river is a key part of the agreement. 

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Drought disrupts commerce and drinking water along the Mississippi River corridor

For the third year in a row, the Midwest is under extreme drought conditions, which have led to low levels that threaten to disrupt barge transports carrying fuel and grain. The 16-month drought spanning from 2022 to 2023 cost the nation $26 billion. The drought of 2012 cost the Mississippi River corridor $35 billion.

Belinda Constant, mayor of Gretna, Louisiana, said that droughts often cost more than floods, but do not qualify as “major disasters” worthy of relief from the Federal Emergency Management Agency. 

“We still are not able to capture federal disaster declarations for drought or intense heat,” Constant said. 

While drought is not considered a “major disaster” by FEMA, the president can declare one. President Joe Biden declared a federal emergency last September in Louisiana when the effects of drought caused salt water to intrude up the Mississippi River and threaten drinking water.

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FEMA is not set up to provide relief for intense droughts or extreme heat, which are expected to become more extreme, according to the Fifth National Climate Assessment. The federal does offer support through other agencies, such as farm losses through the U.S. Department of Agriculture. 

Constant asked the next U.S. president to update FEMA regulations to include droughts and extreme heat. Earlier this summer, dozens of labor and environmental groups filed a petition to push FEMA to declare extreme heat and wildfire smoke as “major disasters,” on par with other natural disasters such as floods and tornadoes. 

Constant said the next administration should also create a mechanism to incentivize or compensate manufacturers and farmers who recycle water or reduce water usage during dry periods. 

Louisiana is again dealing with drought. As of Sept. 13, 2024, the saltwater wedge had reached river mile 45, corroding drinking water infrastructure below Port Sulphur and inching toward Pointe a la Hache, Louisiana. Earlier this week, the U.S. Army Corps of Engineers began construction on an underwater sill near Myrtle Grove to slow the creep of saltwater intrusion for the third summer in a row.

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But the drought impacts all communities along the Mississippi River, not just those in southern Louisiana. And 50 cities with a total population of 20 million people depend on the Mississippi River for their drinking water.

“Memphis depends on the of the corridor to power our international port and fuel our multi-billion-dollar outdoor recreation and tourism industry,” said Paul Young, mayor of Memphis, Tennessee. The tournament fishing industry is worth billions in revenue. 

“It is vital we work to safeguard the Mississippi River together,” he added.

Tugboats maneuver barges south along the Mississippi River in Vicksburg, Thursday, Oct. 27, 2022. Near record low water levels are affecting shipping and tourism. Credit: Vickie D. King/Mississippi Today

Advocating for the Mississippi River corridor as a whole

The 105 cities represented by inititiuave also called on the next U.S. president to advocate for the corridor both at home and internationally. “We are asking the next president to please work with us to enact a federal Mississippi River program through which we can deploy infrastructure spending at a multi-state scale,” said Hollies J. Winston, mayor of Brooklyn Park, Minnesota. 

On the global stage, the initiative has advocated for the Mississippi River corridor at five United Nations climate meetings. Bob Gallagher, mayor of Bettendorf, Iowa, called on the next President to ensure that the nation remains a part of the Paris Agreement to sustain the corridor’s $500 billion in revenue.

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“Serving as a past co-chair of MRCTI along with being from an agricultural state, I know firsthand that U.S. participation in the Paris Accord helps us compete and move our commodities and goods across the world to other markets,” said Gallagher. 

Pulling out of the Paris Agreement could trigger tariffs for goods coming from a non-signatory nation. Leaving the international climate accord would place farmers and manufacturers at a potential disadvantage in the global market, said Gallagher.

In 2017, President Donald Trump announced that the U.S. would withdraw from the Paris Climate Accord. In 2021, on President Biden’s first day in office, the U.S. rejoined the international agreement to limit temperature increases.

“We can’t afford to make any policy decisions that will jeopardize the $164 billion in agricultural commodities the Mississippi River makes possible every year,” said Gallagher. 

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Mitch Reynolds, mayor of La Crosse, Wisconsin, and the initiative’s co-chair, said that the advocacy work of the initiative is paramount to defending the health of the river and its communities. 

The Mississippi River Ports Cooperative Endeavor Agreement unites the communities along the corridor in a shared commitment to protect, restore and manage the river’s resources sustainably, said Sharon Weston Broome, mayor of Baton Rouge, Louisiana, and host of the initiative’s 13th annual meeting.

“We urge the next administration to increase its focus on the river, its impact on the national economy and its continued need for stewardship,” said Broome.

This story is a product of the Mississippi River Basin Ag & Water Desk, an independent reporting network based at the University of Missouri in partnership with Report for America, with major funding from the Walton Foundation. MRCTI is also a Walton grantee. 

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Mississippi Today environmental reporter Alex Rozier contributed to this report.

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

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Jerry Mitchell: Why Medgar Evers should represent Mississippi in U.S. Capitol Statuary Hall

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mississippitoday.org – Jerry Mitchell – 2024-09-20 11:32:07

Editor’s note: Mississippi Today and the Mississippi Humanities Council cosponsored an event – “Reimagining Statuary Hall” – on Sept. 18 at The Station in Fondren. Several speakers suggested accomplished to represent the state in Statuary Hall at the U.S. Capitol. Currently, statues of staunch segregationists Jefferson Davis and J..Z. George represent Mississippi. What follows is Mississippi Today investigative reporter Jerry Mitchell’s pitch from the event.


Medgar Evers Credit: National Park Service

Medgar Evers dove onto the sand at Normandy. In the weeks following the D-Day invasion of June 6, 1944. He joined a million soldiers fighting to expand the beachhead. The Luftwaffe strafed and bombed them, hoping to push them back into the sea.

He was also part of the Red Ball Express, which provided fuel, food and other critical supplies as Allied troops pushed back the German forces.

As Allied forces freed more of France from Nazi occupation, Evers enjoyed life without the color line. He could eat in any restaurant he desired. He even fell in love with a French girl.

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After battling the Nazis, he returned to Mississippi and fought racism all over again in the form of Jim Crow, which barred Black Americans from restaurants, restrooms and booths. When he tried to vote in his hometown of Decatur, Mississippi, he and other Black war were turned away by an armed white mob.

After graduating from Alcorn College, he worked for his mentor, Dr. T.R.M. , and was involved in passing out bumper stickers across the Delta that read, “Don’t Buy Gas Where You Can’t Use the Restroom.”

In January 1954, he tried to enroll at the of Mississippi School of — only to be turned away. NAACP officials considered taking up his case but were so impressed with him they decided instead to hire him as the first field secretary for the Mississippi NAACP.

He investigated violence against African Americans, including the 1955 assassinations of the Rev. George Lee and Lamar Smith, who were killed because they helped Black Mississippians register to vote.

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He worked with Dr. Howard on the lynching of Emmett Till and helped find new witnesses.

The economic threats and violence became so great that Dr. Howard and others left Mississippi, but Medgar Evers stayed.

He helped James Meredith enroll at , and he logged 40,000 miles a year traveling the roads, sometimes flooring it past 100 to escape those hell-bent on harming him. 

His telephone rang at all hours with threats. Some were short and emphatic: “We’re going to kill you, N-word.” Others described how they planned to torture him.

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Evers told a CBS reporter, “They say I’m going to be dead soon, that they’re going to blow up my house, that they’re going to blow my head off. If I die, it will be a good cause. I’m fighting for America just as much as the soldiers in Vietnam.”

After the white mayor of Jackson chastised the movement in Mississippi in spring 1963, Evers won his FCC bid for “equal time” to respond. He talked on television about the mistreatment of Black Mississippians and in so doing he became even more of a target. The Evers’ home was firebombed.

Hours after President Kennedy told the nation that the grandchildren of those enslaved are “not yet freed from the bonds of injustice,” Evers was shot in the back as he stepped onto his own driveway in Jackson, Mississippi. His wife, Myrlie Evers, heard the shot, ran outside, saw the blood and screamed. When the children heard the scream, they ran outside and saw their father.

“Daddy, get up,” his 8-year-old daughter, Reena, said. “Daddy, get up.”

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He never did.

On Evers’ birthday in 1964, Congress passed the Civil Rights Act

Three decades later, his finally saw his assassin convicted.

“All I want to say is, ‘Yay, Medgar, yay!’” Myrlie Evers declared as she wiped away tears. “My God, I don’t have to say accused assassin anymore. … what he failed to realize was that Medgar was still alive in spirit and through each and every one of us who wanted to see justice done.”

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That justice inspired others. To date, 24 men have been convicted in civil rights cold cases.

A year after Evers’ killer went to prison, Myrlie Evers became chairman of the national NAACP and helped rescue the civil rights organization from the brink of bankruptcy.

She continues to break boundaries. She became the first lay person to deliver the inaugural invocation at Barack Obama’s second inauguration.

She cheered when Mississippi removed the Confederate emblem from the state flag, and she told me the reason we keep repeating its history is we don’t know our history.

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Putting Medgar Evers in Statuary Hall would honor a fallen soldier in the war against hate and would ensure that we know our history so that we don’t repeat it.

Jerry Mitchell on his Statuary Hall pick; Medgar Evers

READ MORE: Other Southern states removed white supremacist statues from Washington. Will Mississippi?

READ MORE: J.Z. George’s descendant advocates for removing the statue of the Confederate icon from the nation’s Capitol

READ MORE: Mississippi’s Jefferson Davis statue has new neighbor in U.S. Capitol: Arkansas civil rights leader

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

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