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A new law to improve pregnancy outcomes took effect Monday. But how someone can receive timely prenatal care is still unclear.

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Despite presumptive Medicaid eligibility for pregnant women going into effect Monday, it’s still not clear how low-income pregnant women can get the timely prenatal care the law is supposed to make possible.

House Bill 539, which was signed into law by the governor on March 12, allows eligible, low-income pregnant women to receive immediate care covered by Medicaid while they wait for their application to be officially approved by the Division of Medicaid. Applications are supposed to take no longer than 45 days to process, though recent data shows nearly a third of applications in Mississippi took longer than that, bringing pregnant women well into their first trimester – when about 80% of miscarriages occur

The policy, which Mississippi lawmakers hope will help mitigate the state’s poor maternal and infant health metrics – some of the worst in the country – exists in 29 other states and Washington D.C. 

Mississippi Today reached out to the Division of Medicaid in late May to request an interview over the next month with an agency official to discuss what the process of presumptive eligibility and timely care for pregnant women would look like once the law went into effect July 1. The reporter continued each week to reach out to spokesperson Matt Westerfield, who on June 10 said the agency was “exploring some options” for the interview.

On June 28, Westerfield said implementation is “complex” and that the agency would only communicate through “written exchanges.”

The agency on Tuesday issued a general statement about its commitment to implementing the policy – with no details about any outreach, public education or provider training to date.

“The Mississippi Division of Medicaid will continue to do the necessary due diligence to ensure providers interested in making presumptive eligibility determinations are qualified and trained,” Westerfield said in an email.

Not all providers who accept Medicaid will be automatically able to participate in presumptive eligibility, according to a brief explainer on Medicaid’s website posted at the end of June. 

Doctors and other qualifying providers must complete an application and undergo eligibility determination training, in addition to submitting a memorandum of understanding with the agency once approved. Then, a pregnant woman whose income falls below 194% of the federal poverty level – about $29,000 annually for an individual – can bring proof of income to the doctor and, if approved, receive prenatal care the same day.

Westerfield said in an emailed statement in May that the agency would communicate to the public which locations are participating in the program, but said that they were “still working on what that outreach will look like.”

As of Tuesday, it is still unclear which, if any, providers are participating and whether Medicaid has sent any communication about the steps they must take if they want to participate.

House Medicaid Committee Chairwoman Missy McGee, R-Hattiesburg, Tuesday, Feb. 28, 2023, at the Mississippi Capitol in Jackson. (AP Photo/Rogelio V. Solis)

“Medicaid clearly knows that the intent of the Legislature is for pregnant women to get in to see their doctor as early as possible, and they are working to stand up this program that is now the law,” said House Medicaid Chair and the bill’s author Missy McGee, a Republican from Hattiesburg. “As the author of this legislation, I will be closely monitoring the rollout of this new program and am optimistic that it will be done in a timely manner.”

The Legislature made the bill broad enough that the Division of Medicaid would have the freedom to implement it in whatever way it saw fit, McGee explained.

“ … The Legislature’s job is to create the policy. Now that it is law, it is Medicaid’s job to implement it.”

Mississippi Today reached out to University of Mississippi Medical Center – Mississippi’s largest Medicaid provider – to determine what, if any, communication it has received about how presumptive eligibility will work.

“We are still checking into the process for this, but don’t have any comment at this time,” a hospital spokesperson told Mississippi Today on Tuesday.

In March, the number of Mississippi Medicaid applications that took more than 45 days to be processed was 29%, according to data from the Centers for Medicare and Medicaid Services, due to “unwinding.” State Medicaid divisions across the country began reviewing their rolls last year for the first time in three years after the end of COVID-19 restrictions that prevented them from unenrolling beneficiaries, and Mississippi at times had a significant application backlog.

Without presumptive eligibility, pregnant women are forced to pay out of pocket or go without care in this interim period. 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 – and preterm births, in which Mississippi leads the nation.

The state received more than $2 million of federal funds and an additional $602,000 in state money to implement the program, according to the 2024 Medicaid appropriation bill

Advocates of the policy have said the program pays for itself when compared to how much it costs the state to care for 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. 

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 a soon as they find out they’re pregnant by showing proof of monthly income to a doctor at a qualifying location.

While it’s not known which providers, if any, have chosen to participate so far, Mississippi Today will continue to monitor the Division of Medicaid’s implementation of the policy and report on qualifying providers as they sign up.

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 1997

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mississippitoday.org – Jerry Mitchell – 2024-12-22 07:00:00

Dec. 22, 1997

Myrlie Evers and Reena Evers-Everette cheer the jury verdict of Feb. 5, 1994, when Byron De La Beckwith was found guilty of the 1963 murder of Mississippi NAACP leader Medgar Evers. Credit: AP/Rogelio Solis

The Mississippi Supreme Court upheld the conviction of white supremacist Byron De La Beckwith for the 1963 murder of Medgar Evers. 

In the court’s 4–2 decision, Justice Mike Mills praised efforts “to squeeze justice out of the harm caused by a furtive explosion which erupted from dark bushes on a June night in Jackson, Mississippi.” 

He wrote that Beckwith’s constitutional right to a speedy trial had not been denied. His “complicity with the Sovereignty Commission’s involvement in the prior trials contributed to the delay.” 

The decision did more than ensure that Beckwith would stay behind bars. The conviction helped clear the way for other prosecutions of unpunished killings from the Civil Rights Era.

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

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Mississippi Today

Medicaid expansion tracker approaches $1 billion loss for Mississippi

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mississippitoday.org – Bobby Harrison – 2024-12-22 06:00:00

About the time people ring in the new year next week, the digital tracker on Mississippi Today’s homepage tabulating the amount of money the state is losing by not expanding Medicaid will hit $1 billion.

The state has lost $1 billion not since the start of the quickly departing 2024 but since the beginning of the state’s fiscal year on July 1.

Some who oppose Medicaid expansion say the digital tracker is flawed.

During an October news conference, when state Auditor Shad White unveiled details of his $2 million study seeking ways to cut state government spending, he said he did not look at Medicaid expansion as a method to save money or grow state revenue.

“I think that (Mississippi Today) calculator is wrong,” White said. “… I don’t think that takes into account how many people are going to be moved off the federal health care exchange where their health care is paid for fully by the federal government and moved onto Medicaid.”

White is not the only Mississippi politician who has expressed concern that if Medicaid expansion were enacted, thousands of people would lose their insurance on the exchange and be forced to enroll in Medicaid for health care coverage.

Mississippi Today’s projections used for the tracker are based on studies conducted by the Institutions of Higher Learning University Research Center. Granted, there are a lot of variables in the study that are inexact. It is impossible to say, for example, how many people will get sick and need health care, thus increasing the cost of Medicaid expansion. But is reasonable that the projections of the University Research Center are in the ballpark of being accurate and close to other studies conducted by health care experts.

White and others are correct that Mississippi Today’s calculator does not take into account money flowing into the state for people covered on the health care exchange. But that money does not go to the state; it goes to insurance companies that, granted, use that money to reimburse Mississippians for providing health care. But at least a portion of the money goes to out-of-state insurance companies as profits.

Both Medicaid expansion and the health care exchange are part of the Affordable Care Act. Under Medicaid expansion people earning up to $20,120 annually can sign up for Medicaid and the federal government will pay the bulk of the cost. Mississippi is one of 10 states that have not opted into Medicaid expansion.

People making more than $14,580 annually can garner private insurance through the health insurance exchanges, and people below certain income levels can receive help from the federal government in paying for that coverage.

During the COVID-19 pandemic, legislation championed and signed into law by President Joe Biden significantly increased the federal subsidies provided to people receiving insurance on the exchange. Those increased subsidies led to many Mississippians — desperate for health care — turning to the exchange for help.

White, state Insurance Commissioner Mike Chaney, Gov. Tate Reeves and others have expressed concern that those people would lose their private health insurance and be forced to sign up for Medicaid if lawmakers vote to expand Medicaid.

They are correct.

But they do not mention that the enhanced benefits authored by the Biden administration are scheduled to expire in December 2025 unless they are reenacted by Congress. The incoming Donald Trump administration has given no indication it will continue the enhanced subsidies.

As a matter of fact, the Trump administration, led by billionaire Elon Musk, is looking for ways to cut federal spending.

Some have speculated that Medicaid expansion also could be on Musk’s chopping block.

That is possible. But remember congressional action is required to continue the enhanced subsidies. On the flip side, congressional action would most likely be required to end or cut Medicaid expansion.

Would the multiple U.S. senators and House members in the red states that have expanded Medicaid vote to end a program that is providing health care to thousands of their constituents?

If Congress does not continue Biden’s enhanced subsidies, the rates for Mississippians on the exchange will increase on average about $500 per year, according to a study by KFF, a national health advocacy nonprofit. If that occurs, it is likely that many of the 280,000 Mississippians on the exchange will drop their coverage.

The result will be that Mississippi’s rate of uninsured — already one of the highest in the nation – will rise further, putting additional pressure on hospitals and other providers who will be treating patients who have no ability to pay.

In the meantime, the Mississippi Today counter that tracks the amount of money Mississippi is losing by not expanding Medicaid keeps ticking up.

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 1911

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mississippitoday.org – Jerry Mitchell – 2024-12-21 07:00:00

Dec. 21, 1911

A colorized photograph of Josh Gibson, who was playing with the Homestead Grays Credit: Wikipedia

Josh Gibson, the Negro League’s “Home Run King,” was born in Buena Vista, Georgia. 

When the family’s farm suffered, they moved to Pittsburgh, and Gibson tried baseball at age 16. He eventually played for a semi-pro team in Pittsburgh and became known for his towering home runs. 

He was watching the Homestead Grays play on July 25, 1930, when the catcher injured his hand. Team members called for Gibson, sitting in the stands, to join them. He was such a talented catcher that base runners were more reluctant to steal. He hit the baseball so hard and so far (580 feet once at Yankee Stadium) that he became the second-highest paid player in the Negro Leagues behind Satchel Paige, with both of them entering the National Baseball Hame of Fame. 

The Hall estimated that Gibson hit nearly 800 homers in his 17-year career and had a lifetime batting average of .359. Gibson was portrayed in the 1996 TV movie, “Soul of the Game,” by Mykelti Williamson. Blair Underwood played Jackie Robinson, Delroy Lindo portrayed Satchel Paige, and Harvey Williams played “Cat” Mays, the father of the legendary Willie Mays. 

Gibson has now been honored with a statue outside the Washington Nationals’ ballpark.

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

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