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Can a Mississippi governor expand Medicaid on his own? Depends on who you ask.

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Editor’s note: Mississippi Today interviewed two Deep South governors about why they chose to champion and pass Medicaid expansion in their states and what the outcomes have been. Those articles will publish on August 24.

Brandon Presley, the Democratic nominee for governor, has at times spoken of expanding Medicaid through executive action without approval of the Republican-controlled Mississippi Legislature should he win the November general election.

“Day 1, I’m going to expand Medicaid so that 220,000 working Mississippians can get access to affordable healthcare,” Presley wrote on social media in July.

At other times, perhaps recognizing the obstacles such a solo effort to expand Medicaid might face, Presley has indicated he would work with the Legislature, which he has said he believes would be amenable to Medicaid expansion.

As nearly half of the state’s rural hospitals are at risk of closing and hospitals across the state are laying off staff or cutting services because of budget problems, Medicaid expansion has become a key campaign issue in 2023.

Forty states and the District of Columbia have expanded Medicaid, a federal opt-in program that provides health care coverage to poor Americans who can’t otherwise afford it themselves. Two of Mississippi’s neighbors, Arkansas and Louisiana, have expanded Medicaid with great success and improved outcomes.

But leaders in Mississippi, the poorest state in America with one of the nation’s highest percentages of uninsured residents, have resisted expansion for more than 10 years — despite the fact that it would bring more than $1 billion per year in new funds to the state and directly help hospitals.

READ MORE: FAQ: What is Medicaid expansion, really?

In some states, such as Louisiana, expansion was done through executive orders instead of by approval of the Legislature. But there are questions about whether a governor in Mississippi could expand Medicaid without legislative approval.

Republican Gov. Tate Reeves, who is seeking reelection and faces Presley in the November general election, has long opposed expanding Medicaid.

The Division of Medicaid, which is under the statutory direction and purview of the governor, takes the position that Medicaid expansion requires legislative approval.

“State law defines who can be eligible for Medicaid in Mississippi. Our understanding is that a governor is not authorized to unilaterally establish a new Medicaid coverage group through an executive order or a federal demonstration waiver,” said Matt Westerfield, a spokesperson for the state’s Division of Medicaid.

State Sen. Kevin Blackwell, R-Southaven, who chairs the Senate’s Medicaid Committee, referred questions about whether a governor could expand Medicaid on his or her own to the Division of Medicaid. His House counterpart, Joey Hood, R-Ackerman, could not be reached for comment.

Former state Rep. Steve Holland, who for years was considered one of the leading authorities in the Legislature on Medicaid issues as the longtime chair of Public Health Committee, said the governor has considerable authority over the Medicaid program. After all, Medicaid is a division within the governor’s office.

Still, Holland said, “We have the most codified Medicaid program in the country. We have put all the eligibility requirements in law … I know Brandon (Presley) as well as anyone. If he is fortunate enough to be elected governor, he is smooth enough and prepared enough to begin immediately to expand Medicaid. And I think he can work with the Legislature to do that.”

READ MORE: Nearly half of rural hospitals at risk of closure in Mississippi, new data shows

The Presley campaign has cited the ability of the Division of Medicaid — hence the governor — to seek a federal waiver to alter the state Medicaid program. A campaign spokesperson said the governor would have authority to seek the waiver under state law, though waivers are granted for only five years and they normally are granted in coordination with the Legislature, which often must provide funding to pay for the waiver.

Holland said state law provides the Division of Medicaid under the governor significant flexibility to seek waivers from the federal government to enact programs that are not codified in state law.

The bottom line is that if there was an effort to expand Medicaid through the waiver program, an appropriation by the Legislature to fund the program most likely still would be needed. But if a governor did expand Medicaid and figure out a way to pay for the program without the Legislature, it likely would result in litigation and be left to the state courts to determine whether it was legal.

Specific sections of state law define who is eligible for Medicaid based on income levels and health issues. In general terms, in Mississippi only poor pregnant women, poor children, the disabled, certain groups of the elderly and some groups who fall into extreme poverty categories and are providing care for family members on Medicaid are eligible for Medicaid coverage.

Most able-bodied people are not eligible for Medicaid in Mississippi.

With Medicaid expansion, those earning up to 138% of the federal poverty level — or about $18,750 annually — would be eligible for coverage. The intent with Medicaid expansion is to provide health care to primarily the working poor who cannot afford private insurance and who are not provided coverage by their employers.

The most clear cut way to expand Medicaid would be for the Legislature to approve a bill to incorporate the new eligibility requirements in state law.

Whether it would be feasible for the Legislature to agree to such a change in state law is the unknown question. If Presley is elected, Mississippians will find out.

At least in the current Legislature, there is a significant appetite to at least consider the merits of expansion. Last legislative session, Mississippi Today surveyed most of the 174 lawmakers and asked them directly if they supported Medicaid expansion.

In response, voting majority in the House said they either supported Medicaid expansion or remained undecided. One vote shy of a voting majority in the Senate said the same.

Just 21 of the House members surveyed, or 18% of the House, said they outright opposed Medicaid expansion. And just 18 of the Senate members surveyed, or 38% of the Senate, said they outright opposed it.

READ MORE: Few Mississippi lawmakers outright oppose Medicaid expansion

Holland, who served in the Legislature until 2020, says he believes Presley could get Medicaid expansion through the Legislature even with a Republican supermajority.

“Tate Reeves and (House Speaker) Philip Gunn were the two blocking it. Period.” said Holland. Gunn is not seeking re-election this year.

“In my final years in the House I had so many Republicans come to me and say expanding Medicaid is the right thing to do,” Holland said.

Another option would be for the Legislature to reauthorize the ballot initiative program that was ruled unconstitutional in 2021 by the state Supreme Court. Through the initiative process, people can gather signatures to bypass the Legislature and place issues directly on the ballot.

When the initiative process was ruled invalid, there was an effort underway to gather the required number of signatures to place Medicaid expansion on the ballot. The Mississippi Hospital Association was one of the sponsors of the Medicaid expansion initiative proposal and had hoped to have enough signatures to place the proposal on the 2022 ballot.

Multiple polls have indicated strong support among Mississippi voters for Medicaid expansion.

So far, legislative efforts to revive the initiative have been unsuccessful.

READ MORE: Mississippi leaving more than $1 billion per year on table by rejecting Medicaid expansion

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

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Mississippi River flooding Vicksburg, expected to crest on Monday

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April 25, 2025

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mississippitoday.org – @alxrzr – 2025-04-25 16:04:00

by Alex Rozier, Mississippi Today
April 25, 2025

Warren County Emergency Management Director John Elfer said Friday floodwaters from the Mississippi River, which have reached homes in and around Vicksburg, will likely persist until early May. Elfer estimated there areabout 15 to 20 roads underwater in the area.

A truck sits in high water after the owner parked, then boated to his residence on Chickasaw Road in Vicksburg as a rising Mississippi River causes backwater flooding, Friday, April 25, 2025.

“We’re about half a foot (on the river gauge) from a major flood,” he said. “But we don’t think it’s going to be like in 2011, so we can kind of manage this.”

The National Weather projects the river to crest at 49.5 feet on Monday, making it the highest peak at the Vicksburg gauge since 2020. Elfer said some residents in north Vicksburg — including at the Ford Subdivision as well as near Chickasaw Road and Hutson Street — are having to take boats to get home, adding that those who live on the unprotected side of the levee are generally prepared for flooding.

A rising Mississippi River causing backwater flooding near Chickasaw Road in Vicksburg, Friday, April 25, 2025.
Old tires aligned a backyard as a deterrent to rising water north of Vicksburg along U.S. 61, Friday, April 25, 2025.
As the Mississippi River rises, backwater flooding creeps towards a home located on Falk Steel Road in Vicksburg, Friday, April 25, 2025.

“There are a few (inundated homes), but we’ve mitigated a lot of them,” he said. “Some of the structures have been torn down or raised. There are a few people that still live on the wet side of the levee, but they kind of know what to expect. So we’re not too concerned with that.”

The river first reached flood stage in the city — 43 feet — on April 14. State officials closed Highway 465, which connects the Eagle Lake community just north of Vicksburg to Highway 61, last Friday.

Flood waters along Kings Point Road in Vicksburg, Friday, April 25, 2025.

Elfer said the areas impacted are mostly residential and he didn’t believe any businesses have been affected, emphasizing that downtown Vicksburg is still safe for visitors. He said Warren County has worked with the U.S. Army Corps of Engineers and the Mississippi Emergency Management Agency to secure pumps and barriers.

“Everybody thus far has been very cooperative,” he said. “We continue to tell people stay out of the flood areas, don’t drive around barricades and don’t drive around road close signs. Not only is it illegal, it’s dangerous.”

NWS projects the river to stay at flood stage in Vicksburg until May 6. The river reached its record crest of 57.1 feet in 2011.

The boat launch area is closed and shored up on Levee Street in Vicksburg as the Mississippi River rises, Friday, April 25, 2025.
The boat launch area (right) is closed and under water on Levee Street in Vicksburg as the Mississippi River rises, Friday, April 25, 2025.
City of Vicksburg workers shore up the bank along Levee Street as the Mississippi River rises, Friday, April 25, 2025.
The old pedestrian bridge spanning the Mississippi River in Vicksburg, Friday, April 25, 2025.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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With domestic violence law, victims ‘will be a number with a purpose,’ mother says

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9 hours ago

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April 25, 2025

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mississippitoday.org – @MSTODAYnews – 2025-04-25 15:07:00

by Mina Corpuz, Mississippi Today
April 25, 2025

Joslin Napier. Carlos Collins. Bailey Mae Reed. 

They are among Mississippi domestic violence homicide victims whose family members carried their photos as the governor signed a bill that will establish a board to study such deaths and how to prevent them. 

Tara Gandy, who lost her daughter Napier in Waynesboro in 2022, said it’s a moment she plans to tell her 5-year-old grandson about when he is old enough. Napier’s presence, in spirit, at the bill signing can be another way for her grandson to feel proud of his mother. 

“(The board) will allow for my daughter and those who have already lost their lives to domestic violence … to no longer be just a number,” Gandy said. “They will be a number with a purpose.” 

Family members at the April 15 private bill signing included Ashla Hudson, whose son Collins, died last year in Jackson. Grandparents Mary and Charles Reed and brother Colby Kernell attended the event in honor of Bailey Mae Reed, who died in Oxford in 2023. 

Joining them were staff and board members from the Mississippi Coalition Against Domestic Violence, the statewide group that supports shelters and advocated for the passage of Senate Bill 2886 to form a Domestic Violence Facility Review Board. 

The law will go into effect July 1, and the coalition hopes to partner with elected officials who will make recommendations for members to serve on the board. The coalition wants to see appointees who have frontline experience with domestic violence survivors, said Luis Montgomery, public policy specialist for the coalition. 

A spokesperson from Gov. Tate Reeves’ office did not respond to a request for comment Friday.

Establishment of the board would make Mississippi the 45th state to review domestic violence fatalities. 

Montgomery has worked on passing a review board bill since December 2023. After an unsuccessful effort in 2024, the coalition worked to build support and educate people about the need for such a board. 

In the recent legislative session, there were House and Senate versions of the bill that unanimously passed their respective chambers. Authors of the bills are from both political parties. 

The review board is tasked with reviewing a variety of documents to learn about the lead up and circumstances in which people died in domestic violence-related fatalities, near fatalities and suicides – records that can include police records, court documents, medical records and more. 

From each review, trends will emerge and that information can be used for the board to make recommendations to lawmakers about how to prevent domestic violence deaths. 

“This is coming at a really great time because we can really get proactive,” Montgomery said. 

Without a board and data collection, advocates say it is difficult to know how many people have died or been injured in domestic-violence related incidents.

A Mississippi Today analysis found at least 300 people, including victims, abusers and collateral victims, died from domestic violence between 2020 and 2024. That analysis came from reviewing local news stories, the Gun Violence Archive, the National Gun Violence Memorial, law enforcement reports and court documents. 

Some recent cases the board could review are the deaths of Collins, Napier and Reed. 

In court records, prosecutors wrote that Napier, 24, faced increased violence after ending a relationship with Chance Fabian Jones. She took action, including purchasing a firearm and filing for a protective order against Jones.

Jones’s trial is set for May 12 in Wayne County. His indictment for capital murder came on the first anniversary of her death, according to court records. 

Collins, 25, worked as a nurse and was from Yazoo City. His ex-boyfriend Marcus Johnson has been indicted for capital murder and shooting into Collins’ apartment. Family members say Collins had filed several restraining orders against Johnson. 

Johnson was denied bond and remains in jail. His trial is scheduled for July 28 in Hinds County.  

He was a Jackson police officer for eight months in 2013. Johnson was separated from the department pending disciplinary action leading up to immediate termination, but he resigned before he was fired, Jackson police confirmed to local media. 

Reed, 21, was born and raised in Michigan and moved to Water Valley to live with her grandparents and help care for her cousin, according to her obituary. 

Kylan Jacques Phillips was charged with first degree murder for beating Reed, according to court records. In February, the court ordered him to undergo a mental evaluation to determine if he is competent to stand trial, according to court documents. 

At the bill signing, Gandy said it was bittersweet and an honor to meet the families of other domestic violence homicide victims.

“We were there knowing we are not alone, we can travel this road together and hopefully find ways to prevent and bring more awareness about domestic violence,” she said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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Court to rule on DeSoto County Senate districts with special elections looming

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9 hours ago

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April 25, 2025

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mississippitoday.org – @MSTODAYnews – 2025-04-25 15:06:00

by Taylor Vance, Mississippi Today
April 25, 2025

A federal three-judge panel will rule in coming days on how political power in northwest Mississippi will be allocated in the state Senate and whether any incumbents in the DeSoto County area might have to campaign against each other in November special elections.  

The panel, comprised of all George W. Bush-appointed judges, ordered state officials last week to, again, craft a new Senate map for the area in the suburbs of Memphis. The panel has held that none of the state’s prior maps gave Black voters a realistic chance to elect candidates of their choice. 

The latest map proposed by the all-Republican State Board of Election Commissioners tweaked only four Senate districts in northwest Mississippi and does not pit any incumbent senators against each other. 

The state’s proposal would keep the Senate districts currently held by Sen. Michael McLendon, a Republican from Hernando and Sen. Kevin Blackwell, a Republican from Southaven, in majority-white districts. 

But it makes Sen. David Parker’s district a slightly majority-Black district. Parker, a white Republican from Olive Branch, would run in a district with a 50.1% black voting-age population, according to court documents. 

The proposal also maintains the district held by Sen. Reginald Jackson, a Democrat from Marks, as a majority-Black district, although it reduces the Black voting age population from 61% to 53%.  

Gov. Tate Reeves, Secretary of State Michael Watson, and Attorney General Lynn Fitch comprise the State Board of Election Commissioners. Reeves and Watson voted to approve the plan. But Watson, according to meeting documents, expressed a wish that the state had more time to consider different proposals. 

Fitch did not attend the meeting, but Deputy Attorney General Whitney Lipscomb attended in her place. Lipscomb voted against the map, although it is unclear why. Fitch’s office declined to comment on why she voted against the map because it involves pending litigation. 

The reason for redrawing the districts is that the state chapter of the NAACP and Black voters in the state sued Mississippi officials for drawing legislative districts in a way that dilutes Black voting power. 

The plaintiffs, represented by the ACLU, are likely to object to the state’s newest proposal, and they have until April 29 to file an objection with the court

The plaintiffs have put forward two alternative proposals for the area in the event the judges rule against the state’s plans. 

The first option would place McLendon and Blackwell in the same district, and the other would place McLendon and Jackson in the same district. 

It is unclear when the panel of judges will issue a ruling on the state’s plan, but they will not issue a ruling until the plaintiffs file their remaining court documents next week. 

While the November election is roughly six months away, changing legislative districts across counties and precincts is technical work, and local election officials need time to prepare for the races. 

The judges have not yet ruled on the full elections calendar, but U.S. Fifth Circuit Court of Appeals Judge Leslie Southwick said at a hearing earlier this month that the panel was committed have the elections in November. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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