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Q&A: Why Arkansas could be a model for Mississippi Medicaid expansion

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As leaders from the House and Senate will soon begin meeting to find common ground on their dueling Medicaid expansion proposals, some people have pointed to Arkansas as a model that could prove successful in Mississippi.

Arkansas, a red state that shares many demographic similarities with Mississippi, implemented its expansion plan, now called Arkansas Health and Opportunity for Me (ARHOME), in 2014. The program provides health coverage to about 250,000 Arkansans. It has cut the state’s uninsured rate in half, and it has helped struggling hospitals stay open.

The expansion program in Arkansas has been so successful that it’s been renewed each year since 2014 by a supermajority of the state’s Republican-controlled legislature.

READ MORE: ‘A no-brainer’: Why former Arkansas Gov. Mike Beebe successfully pushed Medicaid expansion

Mississippi Today invited Dr. Joe Thompson, who was Arkansas’ surgeon general under Republican Gov. Mike Huckabee and Democratic Gov. Mike Beebe, to explain how Arkansas’ expansion program has worked. Thompson now serves as president and CEO of the Arkansas Center for Health Improvement.


Mississippi Today: Arkansas implemented a pretty unique Medicaid expansion model. How does your state’s program work?

Dr. Joe Thompson: Instead of enrolling uninsured people in the state-run Medicaid program, Arkansas obtained permission from the federal government to use federal Medicaid funds for “premium assistance” — an historically available but rarely used strategy by states. Arkansas purchases private health insurance plans offered on the health insurance marketplace to provide adult Arkansans earning up to 138% of the federal poverty level insurance coverage — with 90% of the costs coming from the federal government.

Newly covered individuals effectively get private coverage and the healthcare access they need; providers get paid commercial insurance rates far higher than Medicaid rates; and insurers benefit because the state is a large, guaranteed purchaser in an otherwise risky individual insurance market.

Governors and legislators have made changes to the program over the years, including a work requirement that was implemented in 2018 and blocked by a federal judge the following year, but the basic structure has remained the same.

MT: How has the program impacted Arkansas?

Thompson: For starters, it cut our adult uninsured rate, which had been among the highest in the nation, by half. Newly insured Arkansans gained access to treatment for chronic conditions that had gone untreated for years, as well as preventive care that allowed them to avoid other health problems and associated costs.

The newly insured also became able to pay for hospital visits, reducing uncompensated care costs at Arkansas hospitals by more than half. Since 2012, no rural Arkansas hospital has closed without being reopened or replaced, while 59 rural hospitals have closed in the six states surrounding Arkansas, including five hospitals in Mississippi.

MT: Some Mississippians are concerned about being able to afford the state match to draw down federal dollars. How has that gone in Arkansas?

Thompson: The federal government pays 90% of expansion costs, but even so, opponents of Medicaid expansion warned that Arkansas’ obligation to pay the remaining 10% would break the budget. In 2016, however, a consultant hired by the Republican legislative leadership analyzed the economic impact of Medicaid expansion and found it would have a net positive impact of $757 million on the state budget between 2017 and 2021 through reduced state expenditures and increased tax revenues.

It’s important to note that the residents of Mississippi and the other holdout states have not been spared from paying for Medicaid expansion. They have been helping to fund it for over a decade through their federal tax dollars, but the money has been flowing into states like Arkansas and Louisiana instead of benefiting the working poor, hospitals, and economies of their home states.

MT: There’s been some concern expressed about how expansion would affect insurers in Mississippi. How has the Arkansas model addressed similar concerns there?

Thompson: Some benefits Arkansas has received from Medicaid expansion are tied to unique aspects of the state’s program. Medicaid expansion is a huge decision for states — they can focus on the expansion decision alone or, as Arkansas did, use expansion to shape both the private and public health insurance systems.

Prior to our expansion, insurance carriers could cherry-pick the counties in which they would offer coverage. Arkansas now requires insurers participating in the exchange to offer coverage statewide, creating competition and consumer choice in all areas of the state. Arkansas also enrolled people deemed “medically frail” in traditional Medicaid, creating an expansion population that was relatively young, healthy and low-risk for insurers to cover. In 2014, average marketplace premiums in Arkansas were among the highest in the region, but since 2017 they have been lower than in any of the surrounding states, including Mississippi.

Arkansas’ decision to provide private health coverage has also been advantageous for enrollees. Private coverage does not carry the stigma of Medicaid, and because payment rates are higher for commercially insured patients than for Medicaid patients, Medicaid expansion enrollees in Arkansas have been less likely to encounter barriers to care than traditional Medicaid enrollees.

MT: How many people are actually enrolled in Arkansas, and should Mississippians worry about costs if more people enroll as time goes on?

Thompson: Some opponents of Medicaid expansion have accused Arkansas’ program of out-of-control growth, pointing out that enrollment was projected at the program’s inception to be about 250,000 but grew to more than 340,000 in 2022. In fact, enrollment only reached that level because of a now-defunct rule that required states to keep people continuously enrolled in Medicaid programs during the COVID-19 public health emergency. Arkansas resumed eligibility checks for Medicaid programs last April, and by the end of 2023, total enrollment in ARHOME was just under 252,000 — very close to original projections.

Medicaid expansion’s slow journey toward nationwide adoption is reminiscent of the original federal-state Medicaid partnership, which was enacted by Congress in 1965 but not adopted by every state until 1982, when the last holdout, Arizona, came on board. Change can be hard, but polls show that voters, including Mississippi voters, favor Medicaid expansion. It’s no wonder that the number of holdout states keeps dwindling.

READ MORE: Negotiations begin: Where do House, Senate, governor stand on Medicaid expansion? Is there room for compromise?

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

Mississippi Today

Crystal Springs commercial painter says police damaged his eyesight

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mississippitoday.org – Mina Corpuz – 2024-11-22 12:21:00

CRYSTAL SPRINGS – Roger Horton has worked decades as a commercial painter, a skill he’s kept up with even with the challenge of having what his wife has called “one good eye.” 

It hasn’t stopped him from being able to complete detailed paint jobs and create straight lines without the help of tape. But last year following a head injury, he and others said people have been pointing out a change in his work. Horton says the sight in his right eye is clouded, like he is looking underwater.

Affected vision, short term memory and periods of irritability – potential symptoms of concussion – followed after he was arrested last September. During an encounter with several police officers, Horton alleges more than one slammed his head into a cruiser and placed handcuffs on so tight that he started to bleed. 

“(The officer) was kind of rough with me and all, and he takes my head and I said, ‘What’d I do?’” he recalled recently. 

Horton ended up being convicted of two misdemeanor charges and has paid off the fines, but a year later he still has questions about the arrest and treatment by the police. 

To date, he has not seen a doctor to evaluate his eye and check for vision or cognitive issues. Horton and his wife Rhonda don’t have a car, and transportation to doctor’s appointments in the Jackson area remains a challenge. 

The Hortons have lived in Crystal Springs all their lives, and they have lived in the home the past five years that belonged to Rhonda’s mother. 

More than a quarter of all people in Crystal Springs live below the poverty line, and that includes the couple. Rhonda Horton said it’s hard to make a living because there aren’t a lot of jobs, but they support themselves as painters. 

That’s how they met Yvonne Florczak-Seeman, who lived in Illinois and purchased her first historical property in Crystal Springs in 2019. She splits her time between the two states. 

“We painted that porch bar and the rest is history,” Rhonda Horton said, adding that they went on to complete detailed work on mantles, kitchen cabinets and a cigar room at Florczak-Seeman’s North Jackson Street residence. 

Over the years, the couple built a relationship with Florczak-Seeman, who is seeking to open a women’s empowerment center called the Butterfly Garden, in the building next to city hall. 

Yvonne Florczak-Seeman poses for a portrait at her business, The Butterfly Garden, in Crystal Springs, Miss., Tuesday, Oct. 1, 2024. Credit: Eric Shelton/Mississippi Today

Florczak-Seeman has supported the couple numerous times, including helping them pay a late water bill and offering them work. She called them talented painters and hired them again to paint the interior of the future center, located at East Railroad Avenue. 

In pieces, Rhonda Horton told Florczak-Seeman about her husband’s arrest and later the injuries she said he sustained from it. Florczak-Seeman had questions about the encounter and other potential injustices at play, so she offered to help. 

“I just want them to pay for what they’ve done not just to him, but everybody,” Rhonda Horton said. “That’s what I want, justice.” 

The Arrest

On Sept. 24, 2023, Horton was walking home from a friend’s house when officers approached him. One grabbed his arms to handcuff him, and he remembers them cutting his wrist and causing it to bleed.

Then, he said, a second officer slammed his head into the top of the police car, followed by another officer who slammed his head again. During the encounter, a bag of marijuana that Horton said he found fell out of his pocket onto the ground. 

An officer put Horton in the back of the cruiser and took him to the station where Horton asked to speak to the police chief and call his wife. He said the police took his phone and clothes.

Afterward, he was taken to the Copiah County Detention Center in Gallman. 

Police Chief Tony Hemphill disputed Horton’s allegation of mistreatment, saying he did not sustain any injuries that required hospitalization. He said Horton’s wrist was cut while he resisted arrest. 

“He was not brutalized and targeted,” Hemphill said. “If he had just complied, he wouldn’t have had to come up there (to jail) that night.”

Two police reports from the night of the September 2023 arrest detail how officers had responded to a possible assault and were given the description of a white man. While in the area, they encountered Horton — the only person who fit that description. 

Hemphill said a mother called police after her daughter told her she was assaulted. He said officers approached Horton on the street and tried to talk with him to rule him out as a suspect. 

That’s when Horton began “fighting, pulling away, and kicking against (the officer’s) patrol vehicle, trying to run,” according to a police report from the night and Hemphill. Horton denies doing any of that. 

The next day police took Horton from the county jail to the Crystal Springs police station. There, police informed him a teenage girl reported being assaulted. After learning about the assault allegation, Horton remembered feeling shocked and saying it couldn’t be true because he was not on the street where the alleged incident took place. 

Hemphill confirmed the police investigated the assault allegation and found it not credible, meaning Horton wouldn’t face any related charges. He said he communicated this to Horton and his wife early on and since then, which the couple disputes. 

As Horton was being arrested and detained, his wife grew worried because she had just spoken with him on the phone and expected him to arrive home shortly. Rhonda Horton and her adult son started calling Roger’s phone, each not getting an answer. 

Then during one of the calls by her son, someone who did not identify himself answered Roger’s phone and said, ‘Your daddy’s dead’ and then hung up, Rhonda Horton said. 

She was starting to assume the worst had happened. Rhonda Horton wouldn’t have confirmation her husband was alive until he called from the county jail in the early morning. 

The next morning as she talked with the police chief, Rhonda Horton asked the chief about who answered the phone and told her son that Roger was dead. The chief told her the person who answered must have been from the county. 

Hemphill later told Mississippi Today that he did not know about the call and that type of behavior by his staff “is not going to be tolerated.” Similarly, Copiah County Sheriff Byron Swilley said he had not heard about it and could not say whether a member of his department made the comment to Rhonda and Roger Horton’s son. 

A Sept. 25, 2023, citation signed by Hemphill, shared with Mississippi Today, summoned Roger Horton to municipal court for the misdemeanor charges of possession of marijuana and resisting arrest and directed him not to have contact with the alleged victim in the assault case. No contact orders are typically for cases such as domestic violence and sexual assault and they are set by a judge.

LaKiedra Kangar, who works in municipal court services, said the no contact order was put in place because of the assault allegation. She confirmed Horton was not charged with the offense following the police department’s investigation of the allegation. 

Weeks passed. Roger Horton went to court for the misdemeanor charges, to which he pleaded guilty.  Felony assault charges were not part of the hearing. Municipal Court Judge Matthew Kitchens ordered Roger to pay over $900 in fines for the misdemeanors. 

Horton was able to pay for some of the fine through at least 10 hours worth of court-ordered community service, which he said involved painting buildings for the city. 

Months later after learning about Horton’s arrest and how he said the police treated him, Florczak-Seeman said she wanted to know more. Horton didn’t have access to his arrest documents, so she accompanied him and his wife to the police department to ask for them. 

The first visit, Horton asked but did not receive the arrest report. Florczak-Seeman asked if he had a fine for any of the charges, which police said Horton did even after completing some community service hours. Florczak-Seeman paid for the remaining balance and had him work for her for two days to pay that off. 

This year, they went to the police department a second time so Horton could ask for his arrest paperwork. An officer told him he didn’t need it and that the rape allegation had been investigated and found not to be credible, Horton told Mississippi Today. 

Florczak-Seeman asked why Horton couldn’t receive the report. She said Hemphill asked if she was Horton’s attorney, and Florczak-Seeman clarified she was his representative. 

The chief left for a few minutes and returned with two pieces of paper and handed them to Horton. Hemphill told Mississippi Today he did not recall whether he was the one who handed the report to Horton. 

Florczak-Seeman took the document from Horton and began to read it as they stood in the lobby. She said she was horrified to see the name of the alleged, underage victim and her address in the report.

Hemphill said the victim’s personal information should have been restricted and not doing so was an oversight. 

After reading the report, Florczak-Seeman went down the street to the mayor’s office at city hall to explain what happened, and how she believed the mayor had grounds to fire the police chief because he provided that document to Roger with the alleged victim’s information. 

Crystal Springs Mayor Sally Garland Credit: Crystal Springs website

Mayor Sally Garland confirmed she had a conversation with Florczak-Seeman about the police chief’s employment. 

She said she reviews all complaints about city officials, and Garland said she goes to the department head to get a better understanding of the situation. If she determines there are potential grounds for termination, a hearing would be scheduled with the Board of Aldermen, and the group would vote on that decision.   

Garland did not find grounds for termination, and Hemphill remains police chief. 

A Strange Visit

The Hortons and Florczak-Seeman hadn’t given much thought about the 2023 arrest, until weeks ago when a teenaged girl suddenly showed up in Florczak-Seeman’s yard. 

At the end of September at the North Jackson Street home, Florczak-Seeman heard screaming and found the teenage girl who came onto her property. She asked what was wrong, and the teenager said she was chased by a dog, which Florczak-Seeman and Rhonda Horton did not see. 

The teenager asked for a soda, and Rhonda Horton went inside to get one. Florczak-Seeman asked where the teenager lived, and she gave an answer that Florczak-Seeman said conflicted with what two girls who were standing nearby on the public sidewalk said she told them. 

Then Florczak-Seeman asked the teenager’s name and recognized it as the name of the alleged victim on Horton’s arrest record. Immediately, Florczak-Seeman said she turned to Horton and told him to stay back, and she told the teenager to get off her property, which she did. 

At the moment, they were not able to verify whether the teenager was the alleged victim from the report. Neither the Hortons nor Florczak-Seeman had seen her before, and they only knew her name from the arrest report.

“That didn’t make sense at all,” Rhonda Horton told Mississippi Today. 

Florczak-Seeman called 911 to report the situation and ask for police to come, which they did not. Hemphill told Mississippi Today a dispatcher informed him about the call with Florczak-Seeman, including details with the teenage girl and how she wanted to report the girl for trespassing. 

Florczak-Seeman is one of the people who have noticed a difference in Horton’s vision. It’s clear when comparing the detailed and clean paint job Roger completed at her Jackson Street property in 2019 and the center where he painted last year.

During an interview at the center in October, Florczak-Seeman pointed to the ceiling and noted spots that Horton did not paint. She remembers telling him about them and realized that he couldn’t see them. 

“The spots on my ceiling are still not painted, and they’re not painted as a reminder of the injustices that happened in this situation and why I got involved,” Florczak-Seeman said. 

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

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Mississippi Today

Job opening: Jackson Reporter

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mississippitoday.org – Mississippi Today – 2024-11-22 15:00:00

Mississippi Today, a Pulitzer Prize-winning newsroom focused on investigative and accountability journalism, is building a dedicated team of reporters to provide in-depth coverage of Jackson, Mississippi.

As the state’s largest and capital city, Jackson matters greatly to us and all Mississippians. Launched in 2016 as the state’s flagship nonprofit newsroom focused on Mississippi government and policy, Mississippi Today is focusing our lens beyond the statehouse and to the city of Jackson, serving our readers with the watchdog reporting they’ve come to expect from Mississippi Today. Our newsroom, with a proven record of providing impactful government accountability, aims to serve the city more directly with this team.

Our Jackson team will focus on sharp investigative reporting, watchdog accountability journalism and meaningful cultural storytelling. We aim to both elevate the voices of those working for positive change in the community while offering a balanced perspective on the city’s obstacles and triumphs. Our goal is to deliver impactful, honest journalism that will inform, inspire and empower Jackson’s citizens.

The team will be led by Pulitzer Prize winner Anna Wolfe, an investigative reporter with a decade of experience covering Jackson.

Roles and Responsibilities:

  • We are purposefully casting a wide net, hoping to connect with journalists of many different backgrounds who may be uniquely qualified to help us launch this team. If you’re a reporter with any of the following experience or attributes, this team may be for you.
  • Investigative reporting focused on uncovering systemic issues within government and politics. The bigger the impact of your reporting on government leaders or systems, the better.
  • Political reporting covering not only high-profile candidates for offices, but experience delving into issues and ideas that affect a community. We hope to delve deeply into a deep distrust in the city’s institutions.
  • Cultural reporting that highlights the often-overlooked success stories of citizens who are making a positive impact on their communities.
  • Strong understanding of Jackson (or similar large urban centers) and the unique challenges facing the city and its residents.
  • Commitment to the mission of balanced, impactful journalism that centers and respects the voice of the community.
  • Collaborative mindset and ability to work within a team-oriented newsroom.

The starting salary for this position is $58,000. Compensation is commensurate with experience level.

Expectations:

  • Work with a small team of journalists who are focused on social inequities and racial equality in our area.
  • Willingness to collaborate closely with a small team of like-minded journalists.
  • Get people to talk, find willing sources and protect them while telling sensitive and timely stories.
  • Build trust: Many people who have been impacted by inequities in Mississippi have been victims of predatory practices and forces. This will require empathy, patience and savvy.
  • Work with our Audience Team and data and visual journalists to create compelling story presentations.

Qualified candidates should have:

  • Experience working as a reporter in a newsroom.
  • Ability to work quickly, with accuracy and good news judgment.
  • Comfortability in digital or multimedia journalism spaces.
  • Ability to independently develop and cultivate sources.
  • Ability to use social media for research and to engage readers.

What you’ll get:

  • The opportunity to work alongside award-winning journalists and make significant contributions to Mississippi’s top nonprofit, nonpartisan digital news and information sources.
  • Highly competitive salary with medical insurance, and options for vision and dental insurance.
  • Use of appropriate technology and equipment. 
  • 29 days paid time off.
  • Up to 12 weeks of parental family leave, with return-to-work flexibility.
  • Simple IRA with 3 percent company matching. Group-term life insurance provided to employees ($15,000 policy).
  • Support for professional training and attending industry conferences.

How to Apply:

We’re committed to building an inclusive newsroom that represents the people and communities we serve. We especially encourage members of traditionally underrepresented communities to apply for this position, including women, people of color, LGBTQ people and people who are differently abled. Please apply here.

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

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Central, south Mississippi voters will decide judicial runoffs on Tuesday

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mississippitoday.org – Taylor Vance – 2024-11-22 11:16:00

Some Mississippi voters head to the polls Tuesday to decide who should represent them on the state’s highest courts. 

Polls will be open from 7 a.m. to 7 p.m. on Tuesday. Absentee voting has begun, and in-person absentee voting at county circuit clerk’s offices ends at noon on Saturday. 

In the Jackson Metro area and parts of central Mississippi, incumbent Supreme Court Justice Jim Kitchens will compete against Republican state Sen. Jenifer Branning of Neshoba County. In areas on the Gulf Coast, Jennifer Schloegel and Amy St. Pé will face each other for an open seat on the Court of Appeals. 

Candidates for judicial offices in Mississippi are technically nonpartisan, but political parties and trade associations often contribute money to candidates and cut ads for them, which has increasingly made  them almost as partisan as other campaigns. 

In the Central District Supreme Court race, GOP forces are working to oust Kitchens, one of the dwindling number of centrist jurists on the high Court. Conservative leaders also realize Kitchens is next in line to lead the court as chief justice should current Chief Justice Mike Randolph step down.

Kitchens is one of two centrist members of the high court and is widely viewed as the preferred candidate of Democrats, though the Democratic Party has not endorsed his candidacy. 

Kitchens, first elected to the court in 2008, is a former district attorney and private-practice lawyer. On the campaign trail, he has pointed to his experience as an attorney and judge, particularly his years prosecuting criminals and his rulings on criminal cases. 

In an interview on Mississippi Today’s ‘The Other Side’ podcast, Kitchens said his opponent, who primarily practices real estate law, would be at a “significant disadvantage” because the state Supreme Court often reviews criminal cases and major civil lawsuits that are sent to them on appeal. 

“I’m sure she has an academic knowledge about the circuit courts that she perhaps learned in law school or perhaps has been to some seminars, but she does not have the hands-on trial experience that I have,” Kitchens said. “And that’s so important to the work that I do.” 

Branning, a private-practice attorney, was first elected to the Legislature in 2015. She has led the Senate Elections and Transportation committees. During her time at the Capitol, she has been one of the more conservative members of the Senate leadership, voting against changing the state flag to remove the Confederate battle emblem, voting against expanding Medicaid to the working poor and supporting mandatory and increased minimum sentences for crime.

While campaigning for the judicial seat, she has pledged to ensure that “conservative values” are always represented in the judiciary, but she has stopped short of endorsing policy positions — which Mississippi judicial candidates are prohibited from doing. 

Branning declined an invitation to appear on Mississippi Today’s podcast. 

“Mississippians need and deserve Supreme Court justices that are constitutionally conservative in nature,” Branning said in a recent interview with radio station SuperTalk Mississippi. “And by that, I mean justices that simply follow the law. They do not add or take away.”

The two candidates have collectively raised around $187,00 and spent $182,00 during the final stretch of the campaign, according to campaign finance reports filed with the Secretary of State’s office. 

Since she initially qualified in January, Branning has raised the most amount of money at $879,871, with $250,000 of that money coming from a loan she gave her campaign. She spent around $730,000 of that money. Several third party groups have supported her campaign. 

Kitchens has raised around $514,00 since he qualified for reelection. He’s spent roughly $436,000 of that money, and some of his top contributors have been trial attorneys. 

For the open Court of Appeals seat, Schloegel and St Pe, two influential names on the Gulf Coast, are working to turn out their voters in a close election. 

Schloegel is a Chancery Court judge in Harrison, Hancock and Stone counties. St. Pé  is an attorney in private practice, a municipal court judge in Gautier, and a city attorney for Moss Point. 

Schloegel has raised roughly $214,000 since she qualified, and has spent almost that same amount of money this election cycle. St. Pé has raised around $480,000 this year and spent approximately $438,067 during that timeframe. 

Whoever wins the race, it ensures that a woman will fill the open seat. After the election, half of the judges on the 10-member appellate court will be women, the most number of women who have served on the court at one time. 

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

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