Mississippi Today
As Congress moves toward potential Medicaid cuts, expansion grows more unlikely in Mississippi
As Congress moves toward potential Medicaid cuts, expansion grows more unlikely in Mississippi
Hundreds of thousands of poor, disabled or pregnant Mississippians could lose health care coverage if Congress slashes funding for Medicaid.
Although President Donald Trump has vowed Medicaid won’t be “touched,” the U.S. House of Representatives passed a budget resolution Tuesday that instructs the committee that oversees Medicaid and Medicare to cut $880 billion over 10 years. The cuts will help pay for Trump’s agenda on tax cuts and border reform.
The talk of such dramatic changes to the federal-state program has Mississippi lawmakers concerned – and hesitant to push expansion this year.
Proposals for Medicaid budget cuts nationwide include lowering the rate at which states are reimbursed for Medicaid services, capping the amount of money states can get per enrollee, and imposing block grants – meaning states would receive a fixed dollar amount for the program, regardless of need.
Mississippi, the poorest state in the nation, could suffer the most under some of these proposals, according to health policy experts.
Despite the state having some of the strictest eligibility requirements in the nation, pervasive poverty and poor social health determinants mean that more than 650,000 Mississippians – about half of whom are children – rely on the program for basic health care. More than half of births in Mississippi are funded by Medicaid.
“Mississippi has a relatively small population, with the lowest per capita annual income in the country, rates of chronic conditions that are consistently higher than the national average, and with around 60% of Mississippians living with multiple chronic conditions,” explained John Dillon Harris, a health care systems and policy consultant at the Center for Mississippi Health Policy. “… The result is a large Medicaid population that is very expensive to treat.”
Democratic lawmakers are also sounding the alarm about deep cuts to Medicaid. Rep. Omeria Scott, D-Laurel, said it’s something Mississippians “ought to really be afraid of.”
“If they are talking about cutting $880 billion out of the budget, Mississippi is going to be on its knees,” she said at the Democrats’ legislative press conference Tuesday.
However, since Mississippi is one of only 10 states not to expand Medicaid and draw down billions in additional federal funds, some proposed cuts wouldn’t directly affect the state’s current budget – though they would affect future enrollment.
“Mississippi isn’t drawing down as much, so that’s not going to be a direct cut to your current budget, but it’s an opportunity cost,” said Joan Alker, Medicaid expert and executive director of Georgetown University’s Center for Children and Families.
Threats to slash Medicaid spending have already scared away Mississippi lawmakers from attempting expansion this year – though they have passed “dummy bills,” void of details, to keep the issue alive “should something transpire,” House Speaker Jason White said.
After a decade of squelching any debate on the issue, Mississippi House GOP leaders in 2024 pushed for legislation that would expand Medicaid to 200,000 low-income adults, as 40 other states have done. While the bills died after a saga of partisan politics, advocates were hopeful that the historic session created enough momentum to get the policy through the finish line in 2025.
Now, lawmakers fear they may have bigger problems on their hands.
“Unfortunately, we’re hearing more about what may be cuts or block grants to the Medicaid program in general that we will have to deal with as a state because there’s no denying we have a large Medicaid population – so I don’t know the chances,” White said when asked about the likelihood Medicaid expansion would be brought up this year.
Others are more certain the issue is dead this year.
“In a most practical sense, I’d say we probably won’t be doing anything this year,” Senate Medicaid Chairman Kevin Blackwell told Mississippi Today, though he added that if anything changes, lawmakers could suspend the legislative rules and bring a bill back to life late in the session.
Click the dropdown to learn more about the specific proposals that would reduce Medicaid funding:
Reducing the federal match rate
The federal government could reduce the federal matching rate, or FMAP, which determines the percentage of Medicaid costs the federal government pays to each state. How much this would affect Mississippi would depend on the language of the proposed cut.
Mississippi currently has the highest FMAP in the country at 76.9% – meaning the federal government pays for nearly 80% of Mississippians’ Medicaid coverage, while the state makes up the rest – because of the state’s high poverty rate.
One of the proposals would take away the FMAP floor. As it stands, all states receive at least a 50% FMAP, even if they “should” be receiving less, according to the per capita income formula. If that floor was removed, richer states would be affected, as their FMAP would drop below 50%. Mississippi would likely not suffer from this proposal.
Another proposal would remove the increased federal match rate of 90% that the federal government offered to newly-expanded states in the last few years. Without the increased match rate, expansion would not hold the financial favor that has made it politically palatable to Republicans in the state.
Capping benefits per enrollee
The feds could also impose what’s called a “per capita cap,” limiting the amount a state could spend on Medicaid per person. If the caps were implemented, Medicaid would only receive a certain amount of money from the federal government to cover the care of a beneficiary – regardless of his or her medical needs. States would be locked into a fixed amount based on what they have historically spent.
The fact that Mississippi has one of the lowest per person Medicaid spending would count against the state – locking it into a lower fixed budget.
Alker, the Medicaid expert from Georgetown University, says pushing expansion legislation through this year could make Mississippi more likely to receive a higher per capita budget – though it’s no guarantee.
“I’ve seen proposals that look at taking away the American Rescue Plan Act incentives, which is extra funding for states that newly come to expansion … I have seen some chatter about how one proposal is to take away those incentives, but to not take them away from states that were counting on them,” explained Alker.
“In other words, sort of grandfathering in North Carolina and South Dakota (states that expanded Medicaid in the past two years). So, if anything, it might be smart for Mississippi to do the expansion this session and lock that in.”
Imposing a block grant
Imposing block grants would be similar to per capita caps, but arguably more punishing for states since funding wouldn’t change based on enrollment growth.
Block grants would limit states’ abilities to respond to emergencies, and would especially hurt rural areas, research says.
Limiting provider tax
Mississippi is currently almost maxed out on the tax it’s allowed to impose on hospitals, which helps the state pay for its share of Medicaid spending. One option being discussed in Congress is to lower the limit of or eliminate the tax, which would mean hospitals would be reimbursed at a lower rate and there would be less state money to fund the Medicaid program.
The proposal is less likely to garner support, explained Harris, the policy consultant at the Center for Mississippi Health Policy.
“It’ll be difficult to move this particular reform through Congress since such a large number of states, both red and blue, rely on this tax to pay for their programs,” he said.
But if it did go into effect, the impact would be profound.
“The state would have to get really creative in figuring out what to tax and how in order to maintain the current level of support hospitals receive through these supplemental payments,” Harris said.
Imposing work requirements
Work requirements have long been discussed as a means of making Medicaid expansion more palatable to conservatives who view the program as “welfare.” Now, Congress may decide to impose work requirements on the regular Medicaid population.
As it stands, Mississippi has one of the country’s strictest income requirements for Medicaid. Childless adults don’t qualify, and parents must make less than 28% of the federal poverty level, a mere $7,000 annually for a family of three, to qualify. More times than not, that means that working a full-time job counts against an individual.
If the state were to keep its strict income requirements while also imposing a work requirement, it would be difficult for Mississippians to qualify for the health care program.
The red tape that a work requirement would create would also likely deter eligible Mississippians from enrolling or staying on the program.
Lt. Gov. Delbert Hosemann said Mississippi lawmakers have “a leg up” since the state’s former Medicaid director recently landed a spot in Washington leading the federal Medicaid division under Trump. Hosemann has yet to say what, if anything, Snyder has told lawmakers so far, but said he expects to have “a direct commentary into the area of Medicaid” through Snyder.
Regardless of what action the federal government decides to take, cuts of this magnitude would affect millions of low-income people across the country, not just in Mississippi.
“States will be forced to deeply cut eligibility, benefits and reduce provider rates,” Alker said in a statement published online in response to the House budget resolution outlining Medicaid costs. “These cuts will especially harm rural communities who are more reliant on Medicaid, and where hospitals are already operating on tighter margins.”
Taylor Vance, Geoff Pender and Michael Goldberg contributed to this report.
Mississippi Today receives grant support from The Bower Foundation, as does the Center for Mississippi Health Policy. Donors do not in any way influence our newsroom’s editorial decisions. For more on that policy or to view a list of our donors, click here.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Ties that bind, not lines that divide, at the heart of “Little Women” are what make Louisa May Alcott’s beloved novel such an enduring classic. More than a century and a half since its 1868 publication, the March sisters’ coming-of-age tale continues to resonate in fresh approaches, say cast and crew in a musical version opening this week at New Stage Theatre in Jackson, Mississippi.
“Little Women, The Broadway Musical” adds songs to Alcott’s story of the four distinct March sisters — traditional, lovely Meg, spirited tomboy and writer Jo, quiet and gentle Beth, and artistic, pampered Amy. They are growing into young women under the watchful eye of mother Marmee as their father serves as an Army chaplain in the Civil War. “Little Women, The Broadway Musical” performances run March 25 through April 6 at New Stage Theatre.
In a serendipitous move, the production coincides with Women’s History Month in March, and has a female director at the helm — Malaika Quarterman, in her New Stage Theatre directing debut. Logistics and scheduling preferences landed the musical in March, to catch school matinees with the American classic.
The novel has inspired myriad adaptations in film, TV, stage and opera, plus literary retellings by other authors. This musical version debuted on Broadway in 2005, with music by Jason Howland, lyrics by Mindi Dickstein and book (script) by Allan Knee.
“The music in this show brings out the heart of the characters in a way that a movie or a straight play, or even the book, can’t do,” said Cameron Vipperman, whose play-within-a-play role helps illustrate the writer Jo’s growth in the story. She read the book at age 10, and now embraces how the musical dramatizes, speeds up and reconstructs the timeline for more interest and engagement.
“What a great way to introduce kids that haven’t read the book,” director Quarterman said, hitting the highlights and sending them to the pages for a deeper dive on characters they fell in love with over the two-and-a-half-hour run time.
Joy, familial warmth, love, courage, loss, grief and resilience are all threads in a story that has captivated generations and continues to find new audiences and fresh acclaim (the 2019 film adaptation by Greta Gerwig earned six Academy Award nominations).
In current contentious times, when diversity, equity and inclusion programs are being ripped out or rolled back, the poignant, women-centered narrative maintains a power to reach deep and unite.
“Stories where females support each other, instead of rip each other apart to get to the finish line — which would be the goal of getting the man or something — are very few and far between sometimes,” Quarterman said. “It’s so special because it was written so long ago, with the writer being such a strong dreamer, and dreaming big for women.
“For us to actualize it, where a female artistic producer chooses this show and believes in a brand new female director and then this person gets to empower these great, local, awesome artists — It’s just really been special to see this story and its impact ripple through generations of dreamers.” For Quarterman, a 14-year drama teacher with Jackson Public Schools active in community theater and professional regional theater, “To be able to tell this story here, for New Stage, is pretty epic for me.”
Alcott’s story is often a touchstone for young girls, and this cast of grown women finds much in the source material that they still hold dear, and that resonates in new ways.
“I relate to Jo more than any other fictional character that exists,” Kristina Swearingen said of her character, the central figure Jo March. “At different parts of my life, I have related to her in different parts of hers.”
The Alabama native, more recently of New York, recalled her “energetic, crazy, running-around-having-a-grand-old-time” youth in high school and college, then a career-driven purpose that led her, like Jo, to move to New York.
Swearingen first did this show in college, before the loss of grandparents and a major move. Now, “I know what it’s like to grieve the loss of a loved one, and to live so far away from home, and wanting to go home and be with your family but also wanting to be in a place where your career can take off. .. It hits a lot closer to home.”
As one of four sisters in real life, Frannie Dean of Flora draws on a wealth of memories in playing Beth — including her own family position as next to the youngest of the girls. She and siblings read the story together in their homeschooled childhood, assigning each other roles.
“Omigosh, this is my life,” she said, chuckling. “We would play pretend all day. … ‘Little Women’ is really sweet in that aspect, to really be able to carry my own experience with my family and bring it into the show. … It’s timeless in its nature, its warmth and what it brings to people.”
Jennifer Smith of Clinton, as March family matriarch Marmee, found her way in through a song. First introduced to Marmee’s song “Here Alone” a decade ago when starting voice lessons as an adult, she made it her own. “It became an audition piece for me. It became a dream role for me. It’s been pivotal in opening up doors for me.”
She relishes aging into this role, countering a common fear of women in the entertainment field that they may “age out” of desirable parts. “It’s just a full-circle moment for me, and I’m grateful for it.”
Quarterman fell in love with the 1969 film version she watched with her sister when they were little, adoring the family’s playfulness and stability. Amid teenage angst, she identified with the inevitable growth and change that came with siblings growing up and moving on. Being a mom brings a whole different lens.
“Seeing these little people in your life just growing up, being their own unique versions, all going through their own arc — it’s just fun, and I think that’s why you can stay connected” to the story at any life juncture, she said.
Cast member Slade Haney pointed out the rarity of a story set on a Northeastern homestead during the Civil War.
“You’re getting to see what it was like for the women whose husbands were away at war — how moms struggled, how sisters struggled. You had to make your own means. … I think both men and women can see themselves in these characters, in wanting to be independent like Jo, or like Amy wanting to have something of value that belongs to you and not just just feel like you’re passed over all the time, and Meg, to be valuable to someone else, and in Beth, for everyone to be happy and content and love each other,” Haney said.
New Stage Theatre Artistic Director Francine Reynolds drew attention, too, to the rarity of an American classic for the stage offering an abundance of women’s roles that can showcase Jackson metro’s talent pool. “We just always have so many great women,” she said, and classics — “To Kill a Mockingbird” and “Death of a Salesman,” for instance — often offer fewer parts for them, though contemporary dramas are more balanced.
Reynolds sees value in the musical’s timing and storyline. “Of course, we need to celebrate the contributions of women. This was a woman who was trying to be a writer in 1865, ’66, ’67. That’s, to me, a real trailblazing thing.
“It is important to show, this was a real person — Louisa May Alcott, personified as Jo. It’s important to hold these people up as role models for other young girls, to show that you can do this, too. You can dream your dream. You can strive to break boundaries.”
It is a key reminder of advancements that may be threatened. “We’ve made such strides,” Reynolds said, “and had so many great programs to open doors for people, that I feel like those doors are going to start closing, just because of things you are allowed to say and things you aren’t allowed.”
For tickets, $50 (discounts for seniors, students, military), visit www.newstagetheatre.com or the New Stage Theatre box office, or call 601-948-3533.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Tracy Harden stood outside her Chuck’s Dairy Bar in Rolling Fork, teary eyed, remembering not the EF-4 tornado that nearly wiped the town off the map two years before. Instead, she became emotional, “even after all this time,” she said, thinking of the overwhelming help people who’d come from all over selflessly offered.
“We’re back now, she said, smiling. “People have been so kind.”
“I stepped out of that cooler two years ago and saw everything, and I mean, everything was just… gone,” she said, her voice trailing off. “My God, I thought. What are we going to do now? But people came and were so giving. It’s remarkable, and such a blessing.”
“And to have another one come on almost the exact date the first came,” she said, shaking her head. “I got word from these young storm chasers I’d met. He told me they were tracking this one, and it looked like it was coming straight for us in Rolling Fork.”
“I got up and went outside.”
“And there it was!”
“I cannot tell you what went through me seeing that tornado form in the sky.”
The tornado that touched down in Rolling Fork last Sunday did minimal damage and claimed no lives.
Horns honk as people travel along U.S. 61. Harden smiles and waves.
She heads back into her restaurant after chatting with friends to resume grill duties as people, some local, some just passing through town, line up for burgers and ice cream treats.
Rolling Fork is mending, slowly. Although there is evidence of some rebuilding such as new homes under construction, many buildings like the library and post office remain boarded up and closed. A brutal reminder of that fateful evening two years ago.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
George Foreman, surely one of the world’s most intriguing and transformative sports figures of the 20th century, died over the weekend at the age of 76. Please indulge me a few memories.
This was back when professional boxing was in its heyday. Muhammad Ali was heavyweight champion of the world for a second time. The lower weight divisions featured such skilled champions and future champs as Alex Arugello, Roberto “Hands of Stone” Duran, Tommy “Hit Man” Hearns and Sugar Ray Leonard.
Boxing was front page news all over the globe. Indeed, Ali was said to be the most famous person in the world and had stunned the boxing world by stopping the previously undefeated Foreman in an eighth round knockout in Kinshasa, Zaire, in October of 1974. Foreman, once an Olympic gold medalist at age 19, had won his previous 40 professional fights and few had lasted past the second round. Big George, as he was known, packed a fearsome punch.
My dealings with Foreman began in January of 1977, roughly 27 months after his Ali debacle with Foreman in the middle of a boxing comeback. At the time, I was the sports editor of my hometown newspaper in Hattiesburg when the news came that Foreman was going to fight a Puerto Rican professional named Pedro Agosto in Pensacola, just three hours away.
Right away, I applied for press credentials and was rewarded with a ringside seats at the Pensacola Civic Center. I thought I was going to cover a boxing match. It turned out more like an execution.
The mismatch was evident from the pre-fight introductions. Foreman towered over the 5-foot, 11-inch Agosto. Foreman had muscles on top of muscles, Agosto not so much. When they announced Agosto weighed 205 pounds, the New York sports writer next to me wise-cracked, “Yeah, well what is he going to weigh without his head?”
It looked entirely possible we might learn.
Foreman toyed with the smaller man for three rounds, almost like a full-grown German shepherd dealing with a tiny, yapping Shih Tzu. By the fourth round, Big George had tired of the yapping. With punches that landed like claps of thunder, Foreman knocked Agosto down three times. Twice, Agosto struggled to his feet after the referee counted to nine. Nearly half a century later I have no idea why Agosto got up. Nobody present– or the national TV audience – would have blamed him for playing possum. But, no, he got up the second time and stumbled over into the corner of the ring right in front of me. And that’s where he was when Foreman hit him with an evil right uppercut to the jaw that lifted the smaller man a foot off the canvas and sprayed me and everyone in the vicinity with Agosto’s blood, sweat and snot – thankfully, no brains. That’s when the ref ended it.
It remains the only time in my sports writing career I had to buy a T-shirt at the event to wear home.
So, now, let’s move ahead 18 years to July of 1995. Foreman had long since completed his comeback by winning back the heavyweight championship. He had become a preacher. He also had become a pitch man for a an indoor grill that bore his name and would sell more than 100 million units. He was a millionaire many times over. He made far more for hawking that grill than he ever made as a fighter. He had become a beloved figure, known for his warm smile and his soothing voice. And now he was coming to Jackson to sign his biography. His publishing company called my office to ask if I’d like an interview. I said I surely would.
One day at the office, I answered my phone and the familiar voice on the other end said, “This is George Foreman and I heard you wanted to talk to me.”
I told him I wanted to talk to him about his book but first I wanted to tell him he owed me a shirt.
“A shirt?” he said. “How’s that?”
I asked him if remembered a guy named Pedro Agosto. He said he did. “Man, I really hit that poor guy,” he said.
I thought you had killed him, I said, and I then told him about all the blood and snot that ruined my shirt.
“Man, I’m sorry about that,” he said. “I’d never hit a guy like that now. I was an angry, angry man back then.”
We had a nice conversation. He told me about finding his Lord. He told me about his 12 children, including five boys, all of whom he named George.
I asked him why he would give five boys the same name.
“I never met my father until late in his life,” Big George told me. “My father never gave me nothing. So I decided I was going to give all my boys something to remember me by. I gave them all my name.”
Yes, and he named one of his girls Georgette.
We did get around to talking about his book, and you will not be surprised by its title: “By George.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
://mississippitoday.org”>Mississippi Today.
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