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Bill to provide prenatal care to low-income women still inaccessible as 2025 legislative session looms

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mississippitoday.org – Sophia Paffenroth – 2024-11-19 12:32:00

Nearly five months after a new law to make prenatal care more accessible to low-income women was supposed to go into effect, its fate remains unclear. 

The state is still in negotiations with the Centers for Medicare and Medicaid Services – the federal agency responsible for approving the state plan – according to Matt Westerfield, spokesperson for the Mississippi Division of Medicaid. CMS is supposed to take no more than 90 days to approve or reject a plan, but that 90-day clock has been suspended indefinitely since issues have been raised with legislation Mississippi lawmakers wrote last session. 

Presumptive eligibility for pregnant women allows temporary and immediate Medicaid coverage for low-income expectant mothers while they wait for their official Medicaid application to be approved – a process that can take months. 

Strict Medicaid eligibility requirements in Mississippi mean that a majority of low-income women are only eligible for Medicaid once they become pregnant. If a woman applies when she finds out she’s pregnant, that means a lengthy application process could cut well into her pregnancy and delay her seeking prenatal care, which is proven to lead to poor outcomes such as preterm birth – in which Mississippi leads the nation

Senators Nicole Boyd, R-Oxford, takes notes during a presentation by Mississippi Department of Child Services Commissioner Andrea Sanders, during a study group on women, children and family, held at the State Capitol, Wednesday, Oct. 2, 2024 in Jackson. Credit: Vickie D. King/Mississippi Today

Nicole Boyd, R-Oxford, who leads the Senate Study Group for Women, Children and Families, has been checking in weekly with Medicaid about the status of the policy. In a committee hearing Monday, Boyd followed up twice with newly appointed Medicaid Executive Director Cindy Bradshaw at the beginning and end of the meeting to try to gain clarity on the status of the policy. 

Boyd asked Bradshaw whether the 2024 legislation could be salvaged or whether lawmakers would need to redo legislation to enact the policy in 2025. Bradshaw said both that she hopes the state and federal agencies can come to an agreement, and also that she’d feel better with new legislation. 

“Well, I think we can come to a reasonable place that we will be able to get it,” Bradshaw said. “Am I 100% comfortable with that? No. I would prefer that we have legislation to shore up the concessions that we’ve had to make.”

It’s not clear what concessions the Mississippi Division of Medicaid has had to make, but it’s likely that CMS is requiring Medicaid to take out a proof of income and proof of requirement lawmakers included in the original bill. 

Federal guidelines state that while the agency may require proof of citizenship or residency, it should not “require verification of the conditions for presumptive eligibility.”

CMS will not comment on ongoing negotiations with individual states.

If 2024 legislation can’t be salvaged, lawmakers would have two options for rewriting the law next session. They could take out the requirements with which CMS has an issue, or they could take their chances hoping a Trump administration would grant a waiver allowing them to keep requirements at odds with federal guidelines – something lawmakers will likely bank on with a Medicaid expansion bill next session, as well. 

Insisting on the proof of pregnancy requirement doesn’t serve much of a purpose, since it wouldn’t be possible for a woman to fake a pregnancy and receive prenatal care, such as ultrasounds. As for the proof of income requirement, it can be cumbersome on low-income women already facing socioeconomic hurdles, explained Tricia Brooks, a research professor at the Center for Children and Families at Georgetown University and the lead author on the KFF Annual Survey on Medicaid and CHIP Eligibility, Enrollment and Renewal Policies.

“I remember when I first got pregnant, I thought I had the flu because I was nauseous for days on end,” Brooks said. “If I go to the doctor and find out that lo and behold maybe I am pregnant, and you want me to get enrolled, but now you’re asking me for paystubs … So now I have to come back in or somehow communicate or transmit proof of income to the provider. That just gives everybody pause of, ‘Oh my god, is this even worth it?’”

In the meantime, the Division of Medicaid is continuing to accept providers who wish to participate in the program and conduct eligibility determination trainings, according to Westerfield. Until CMS approves the state plan, none of the providers that have been approved will be able to provide care under the policy to eligible women.

Below is a list of the 13 providers that have been approved to participate as of Oct. 18: 

  • Physicians & Surgeons Clinic – Amory
  • Mississippi Department of Health, Dr. Renia Dotson – County Health Department (Family Planning Clinic)
  • Family Health Center – Laurel
  • Delta Health Center Inc (Dr. H. Jack Geiger Medical Center) – Mound Bayou
  • G.A. Carmichael Family Health Center Providers – Belzoni, Canton, Yazoo City
  • Coastal Family Health Center Inc. – Biloxi 
  • Delta Health System – Greenville
  • Delta Medical Group – Women’s Specialty Clinic – Greenville
  • Southeast MS Rural Health Initiative Inc. – Women’s Health Center – Hattiesburg
  • University of Mississippi Medical Center – Jackson
  • Jackson Hinds Comprehensive Health Center – Jackson
  • Central MS Health Service – Jackson
  • Northwest MS Regional Medical Center – Clarksdale

An expectant mother would need to fall under the following income levels to qualify for presumptive eligibility:

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

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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