Mississippi Today
New law allows low-income pregnant women to receive prenatal care earlier
Low-income pregnant women can access timely prenatal care regardless of their Medicaid application status thanks to legislation passed by lawmakers this year.
The change brings Mississippi in line with 29 other states and Washington, D.C. The American College of Obstetricians and Gynecologists has long championed the practice for its ability to improve maternal health outcomes.
“Presumptive eligibility simply removes some of the red tape so that individuals can have immediate access to this coverage, especially women of color who are disproportionately affected by coverage disruptions,” explained Taylor Platt, senior manager of health policy at the American College of Obstetricians and Gynecologists.
The law, which will be effective July 1, allows pregnant women whose household income is at or below 194% of the federal poverty level – about $29,000 annually for an individual – to be presumed eligible for Medicaid and receive 60 days of coverage for outpatient care while their applications for Medicaid coverage are being processed.
Without presumptive eligibility, Medicaid-eligible pregnant women are forced to go without care or pay out of pocket during this interim period.
Pregnancy presumptive eligibility makes the largest difference in states that have not expanded Medicaid, explained Usha Ranji, the associate director of women’s policy at KFF. That’s because in states with expansion, the majority of income-eligible women are already on Medicaid and aren’t subject to this no-coverage interim period.
“There are a lot of people who are uninsured (in Mississippi) and who will only qualify for Medicaid once they become pregnant,” Ranji said. “Not surprisingly, people in expansion states tend to have had coverage for a longer period before the pregnancy.”
Before passing House Bill 539, Mississippi was one of only three states with neither pregnancy presumptive eligibility or Medicaid expansion.
Medicaid eligibility is restrictive in Mississippi. In addition to falling below an income threshold, Mississippians must belong to one of three categories to qualify for Medicaid: parenting, pregnant or disabled. After months of negotiations, a bill that would expand Medicaid in Mississippi died late in the session this year.
First-time mothers only become eligible for Medicaid once they become pregnant, meaning their application processing time can cut well into their first trimester. Applications for pregnancy Medicaid can take up to 45 days to be approved, according to the Division of Medicaid.
Medicaid funds more than two-thirds of births in Mississippi, the state with the second highest rate of births financed by Medicaid in the country.
If everyone eligible for presumptive eligibility took advantage of it, the policy could affect tens of thousands of pregnant women.
“Medicaid is an important player in the state’s maternal health infrastructure,” Ranji said. “… Presumptive eligibility could really help a lot of people in the state.”
Early prenatal care has been proven to mitigate a number of pregnancy-related problems including hypertension – the leading cause of maternal mortality in Mississippi and across the country.
“You may miss infections that could be easily treated early but now have gone untreated, that can lead to increased complications during your pregnancy, or you may have health conditions that need to be addressed early,” explained Dr. Charlene Collier, a member of the Mississippi Maternal Mortality Review Committee and a Jackson-area OB-GYN. “Even more dangerous, there could be an ectopic pregnancy or an abnormal pregnancy that can lead to serious risk to yourself.”
Last year, the Legislature passed a bill to guarantee Mississippi mothers care for 12 months postpartum. Now, along with presumptive eligibility, low-income pregnant women should receive care from the start of their pregnancy through one year postpartum. Experts hope these policies will not only help maternal and infant mortality rates but also health disparities.
People of color are disproportionately subject to discontinuous coverage, according to a 2020 study published in Obstetrics and Gynecology, with nearly half of all Black women experiencing disruptions in insurance coverage from pre-pregnancy to postpartum.
House Medicaid Chair Missy McGee, a Republican from Hattiesburg, authored the bill. She said the policy is a no-brainer in a state boasting some of the highest maternal and infant mortality rates in the country.
The Division of Medicaid estimates that presumptive eligibility will cost the state $567,000 annually, which McGee says is “a minimal investment for a tremendous benefit to women in our state.”
That cost includes medical services and overhead for women initially presumed eligible but later determined ineligible. Doctors will be reimbursed for any prenatal care they provide to pregnant women who they deem eligible for Medicaid according to income.
Not all doctors will choose to participate, explained Matt Westerfield, spokesperson for the Division, but those who do will receive training from the agency to help them make eligibility determinations.
Providing presumptive eligibility for the thousands of pregnant women on Medicaid in the state will cost roughly half as much as it costs the state to pay for just one infant’s prolonged stay in a neonatal intensive care unit – which can easily top $1 million, according to a study published in the American Medical Association Journal of Ethics.
Mississippi has the highest rate of preterm births in the country.
It’s an example of how fronting a small amount of money for preventative care can save the state millions of dollars in the long run, explained Dr. Anita Henderson, a Hattiesburg pediatrician and former president of the state pediatric association.
“The return on investment is going to be great,” Henderson said. “Because if we can prevent even just one premature baby that might cost the state a million dollars, then the program pays for itself. So the healthier we can get that mom, the healthier we can get that baby.”
How to know if you qualify
Anyone who is pregnant and makes at or below 194% of the federal poverty level qualifies for Medicaid and for presumptive eligibility. These individuals can start receiving care as soon as they find out they’re pregnant by showing proof of monthly income to a doctor at a qualifying location. A spokesperson from the Division of Medicaid told Mississippi Today that the agency will communicate to the public which locations are participating in presumptive eligibility, but said that they “are still working on what that outreach will look like.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1954
Sept. 7, 1954
In compliance with the recent Brown v. Board of Education decision, schools in Baltimore and Washington, D.C., were desegregated. Baltimore was one of the first school systems to desegregate below the Mason-Dixon line.
A month after a dozen Black students began attending what had been an all-white school, demonstrations took place, one of them turning violent when 800 whites attacked four Black students. White parents began pulling their children out of the schools, and by 1960, the district was majority Black.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
USM admin say program cuts are necessary to afford future pay raises for faculty, staff
The University of Southern Mississippi will look at cutting under-enrolled programs even though administrators say it is not facing a financial crisis.
The budget is balanced, despite a four-year period of decreasing revenue and increasing costs, and USM has adequate cash reserves.
The move is necessary, top leaders said at last month’s convocation, so the research institution in Hattiesburg can survive the increasingly competitive future facing higher education in Mississippi by becoming a “unicorn” among its peers, offering programs students want and the state needs.
“Colleagues, this is plain and simply the reality of where we are in higher education today, and progressive institutions all across the landscape are doing the same,” President Joe Paul told faculty on Aug. 19, according to a video the university has since taken off YouTube after faculty and staff had a chance to watch it. “We can no longer simply kick the can down the road and hope things can get better. We will instead take charge of our future and crease a uniquely positioned, distinctive public research universty of which we can all be proud and feel ownership.”
Paul added that cuts are also one of the few ways the university can afford more pay raises for its faculty and staff, some of whom will receive merit raises this fall for the first time in eight years. (After protesting, minimum wage workers at USM won a pay raise two years ago.)
“My goal for us is not to go another eight years before offering raises again, that accomplishes little,” Paul said. “If we are to develop a true salary increase plan that is competitive and sustainable, we simply must continue to do two things with discipline and consistency. One, we must all continue to grow the enrollment through recruitment and retention … while also continuing to find efficiencies and decrease spending as an institution.”
USM was able to afford the raises, which total about $4.4 million, through what Paul described as two years of systematic reductions in administrative spending. The university cut 22 unfilled and six filled positions at its Hattiesburg and Gulf Park campuses.
An increase in state appropriations also helped support the raise, but USM isn’t able to say how much because “the raises come from the university’s operating budget and the amount is not broken down by revenue source,” Nicole Ruhnke, a spokesperson, wrote in an email.
The raises addressed a significant concern for faculty at USM who held a protest for fair pay earlier this year.
Low salaries are an issue across Mississippi’s higher education system, which has struggled to attract and retain talented faculty. In recent years, the governing board of Mississippi’s eight universities has repeatedly heard how Mississippi’s faculty and staff are paid well below the average salary of other Southern states.
In an effort to fix that, the Institutions of Higher Learning Board of Trustees asked the Legislature to provide $53 million in funding this year so that each university could afford a 6.4% raise.
IHL’s spokesperson John Sewell wrote in an email that the system ultimately received $27 million in unrestricted new funding, not enough for 6.4% increase.
That funding also needed to cover other inflationary costs facing the institutions, like PERS and health insurance, Sewell wrote.
Therefore, IHL left the final decision on raises up to the institutions, so Sewell could not say how much each university spent. Plus, the system’s final appropriation bill, which IHL negotiates on behalf of the eight institutions, did not include specific language regarding raises.
“IHL did not prescribe a fixed amount of new funding to be dedicated to raises as the individual institutions needed the flexibility to balance the increased costs for PERS and health insurance along with other inflationary costs before considering the amount for possible raises,” Sewell wrote.
Those costs are also driving USM administrators’ review of under-enrolled programs, which comprise a minority of USM’s programs.
Lance Nail, the provost, is leading that effort. In response to questions from Mississippi Today, Nail and Paul did not participate in an interview but provided statements.
Nail wrote that details about the program review will be worked out in the coming weeks in consultation with faculty, staff and administration.
“We will look at each under-enrolled academic program individually in collaboration with the deans, school directors and faculty, and determine what has led to low enrollment, student and market demand, as well as other contributions the program provides within the academy.” Nail noted. “These include the program’s contributions to the general education core, pre-major requirements, research and service.”
Last fall, USM deleted three degrees after IHL’s academic productivity review, which is triggered when a program is deemed to have too few graduates in a three-year period. Those degrees were a bachelors in international studies, and doctoral degrees in music education and criminal justice.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Richard Lake joins Mississippi Today as audience engagement specialist
Mississippi Today is pleased to announce that Richard Lake has joined the Mississippi Today team as Audience Engagement Specialist.
In this role, Lake will work directly with journalists, editors and readers to ensure Mississippi Today’s Pulitzer Prize-winning journalism reaches every corner of the state and beyond.
“Richard has developed into a respected member of the journalism community here in Mississippi,” said managing editor Michael Guidry. “He brings such an invaluable variety of skills to our newsroom that will help us further enhance how we engage with our members and growing audience.”
Born in San Antonio, Texas, Lake graduated from Mississippi State University in 2022, earning a bachelor’s degree in journalism and a minor in political science. Richard comes to Mississippi Today after over two years as WJTV Channel 12 News‘ Senior Political Correspondent. A former Mississippi Today intern, Lake previously worked on the audience team. He also completed an internship with MSNBC’s Andrea Mitchell Reports, working as a production assistant.
While at WJTV, Lake was named a finalist for TV Rookie of the Year at the 2023 Mississippi Association of Broadcasters Awards. Lake was also a part of WJTV’s award winning reporting on Mississippi’s 2023 gubernatorial election.
“Finding creative ways to provide our audience with the journalism they expect and deserve is more important now than ever,” said Lake. “I’m excited to apply innovative strategies and work alongside this incredible team in furthering the impact of our reporting.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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