Mississippi Today
Despite Gov. Reeves’ debate claims, experts say it’s hard to argue that states are ‘better off’ without Medicaid expansion
Gov. Tate Reeves, the state’s most powerful opponent of Medicaid expansion, repeated a familiar claim at Wednesday night’s gubernatorial debate: that the program wouldn’t save the state’s failing hospitals.
But health care experts say that was always clear, that the governor’s argument is missing an understanding of the challenges facing the state’s health care system and that expansion, by potentially insuring about a quarter million Mississippians, would allow hospitals to get paid something for the care they provide to uninsured patients versus getting paid nothing.
The first and only debate between Reeves and Democratic challenger Brandon Presley ahead of the Nov. 7 election opened Wednesday night with questions about Medicaid expansion, which has remained a title issue of the campaign cycle.
Mississippi is one of just 10 states that have not expanded Medicaid. Though most Mississippians support the policy, the governor has remained steadfast in his opposition.
READ MORE: FAQ: What is Medicaid expansion, really?
“Medicaid is not the best policy for rural hospitals, but you don’t have to look very far to prove that,” Reeves said at the debate, before citing data from the Center for Healthcare Quality and Payment Reform’s rural hospital report about Louisiana and Arkansas, two Southern states that have expanded Medicaid.
The center’s most recent version of the report, which was updated last month, shows that Louisiana and Arkansas still have high rates of rural hospitals at risk of closure — 42% and 43%, respectively.
According to the report, 42% of Mississippi’s rural hospitals are at risk of closure.
“Guess what? The difference is… Louisiana and Arkansas have expanded Medicaid,” Reeves continued. “Mississippi has not. (Medicaid expansion) is not the financial windfall that Brandon Presley would have you believe.”
READ MORE: Brandon Presley again vows to expand Medicaid as Gov. Tate Reeves reiterates opposition
The heart of Reeves’ argument misses some major points, experts said.
“To say that other states that expanded have had the same problems is a very true statement,” said Ryan Kelly, executive director of the Mississippi Rural Health Association. “But would they be worse off without (Medicaid expansion) in the current environment? Yes, I think they would be.”
According to the center’s report, the average percentage of rural hospitals at risk of closure in non-expansion states is over 37%, while the percentage in expansion states is much lower at 26%.
“What [Reeves is] saying is true,” said Harold Miller, leader of the Center for Healthcare Quality and Payment Reform. “Those are the numbers.”
However, expansion is about more than just “saving” hospitals, Miller said — it’s about insuring vulnerable people, allowing them to receive regular health care.
While emergency rooms cannot turn down patients regardless of their insurance status, doctor’s offices can, preventing people from receiving preventative and other non-urgent forms of health care.
Somewhere between 200,000 and 300,000 Mississippians would be affected by Medicaid expansion, according to projections. The policy would potentially bring in billions within its first few years of implementation in Mississippi, an influx of cash that the state needs. Just minutes later during the same debate, Reeves touched on Mississippi’s economy, and the “competitive disadvantage” the state’s up against when it comes to economic development.
Miller said hospitals in states that have expanded Medicaid do have greater losses on Medicaid services — Medicaid typically reimburses hospitals at lower rates than commercial insurance for health care services.
Reeves used that argument during the debate.
“The unintended consequence of expanding Medicaid to 300,000 Mississippians is moving individuals off of private insurance,” he said. “That’s bad for rural hospitals as well, because the fact is that when you move them from private insurance, the reimbursement rates… are actually lower when they go on Medicaid.”
But that’s better than not getting paid at all, according to Kelly.
Hospitals report losing about $600 million on uncompensated care annually, or services provided to people who aren’t insured. That number would reduce drastically if Medicaid was expanded.
Experts agree that the hospital crisis, while heightened by the COVID-19 pandemic, has been caused by a multitude of factors. In the same vein, it won’t be solved by one policy.
Kelly cited all of the other challenges hospitals are up against, including timely insurance reimbursements and rising health care costs, but he conceded that expansion would aid hospitals’ uncompensated care losses, an issue that’s fueling the crisis.
“You’re going to have a real hard time finding someone who would say hospitals would be better off without Medicaid expansion,” Kelly said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1875
Nov. 2, 1875
The first Mississippi Plan, which included violence against Black Americans to keep them from voting, resulted in huge victories for white Democrats across the state.
A year earlier, the Republican Party had carried a majority of the votes, and many Black Mississippians had been elected to office. In the wake of those victories, white leagues arose to challenge Republican rule and began to use widespread violence and fraud to recapture control of the state.
Over several days in September 1875, about 50 Black Mississippians were killed along with white supporters, including a school teacher who worked with the Black community in Clinton.
The governor asked President Ulysses Grant to intervene, but he decided against intervening, and the violence and fraud continued. Other Southern states soon copied the Mississippi plan.
John R. Lynch, the last Black congressman for Mississippi until the 1986 election of Mike Espy, wrote: “It was a well-known fact that in 1875 nearly every Democratic club in the State was converted into an armed military company.”
A federal grand jury concluded: “Fraud, intimidation, and violence perpetrated at the last election is without a parallel in the annals of history.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Mississippi Today’s NewsMatch Campaign is Here: Support Journalism that Strengthens Mississippi
High-quality journalism like ours depends on reader support; without it, we simply couldn’t exist. That’s why we’re proud to join the NewsMatch movement, a national initiative aimed at raising $50 million for nonprofit newsrooms that serve communities like ours here in Mississippi, where access to reliable information has often been limited.
In a time when trusted journalists and media sources are disappearing, we believe the stakes couldn’t be higher. Without on-the-ground, trustworthy reporting, civic engagement suffers, accountability falters and corruption often goes unaddressed. But it doesn’t have to be this way.
Here at Mississippi Today we act as watchdogs, holding those in power accountable, and as storytellers, giving a platform to voices that have been ignored for too long. And we’re committed to keeping our stories free for everyone because information should be accessible when it’s needed most.
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Every dollar raised strengthens our ability to serve you with fact-based journalism on issues that impact your everyday life—whether it’s covering local election issues or reporting on decisions affecting schools, safety and economic growth in Mississippi. Your support makes it possible for us to stay rooted in the community, offering nuanced perspectives that help Mississippians understand and engage with what’s happening around them.
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We’ll examine what’s at stake if local newsrooms lose press freedoms and will discuss how you, as members of the public, can help protect it. This event is open to Mississippi Today and Verite News members as a special thank-you for supporting local journalism and standing with us in this mission. Donate today to RSVP!
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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Hinds County loses fight over control of jail
The Hinds County sheriff and Board of Supervisors have lost an appeal to prevent control of its jail by a court-appointed receiver and an injunction that orders the county to address unconstitutional conditions in the facility.
Two members from a three-judge panel of the 5th U.S. Circuit Court of Appeals agreed with decisions by U.S. District Judge Carlton Reeves to appoint a receiver to oversee day-to-day jail operations and keep parts of a previous consent decree in place to fix constitutional violations, including a failure to protect detainees from harm.
However, the appeals court called the new injunction “overly broad” in one area and is asking Reeves to reevaluate the scope of the receivership.
The injunction retained provisions relating to sexual assault, but the appeals court found the provisions were tied to general risk of violence at the jail, rather than specific concerns about the Prison Rape Elimination Act. The court reversed those points of the injunction and remanded them to the district court so the provisions can be removed.
The court also found that the receiver should not have authority over budgeting and staff salaries for the Raymond Detention Center, which could be seen as “federal intrusion into RDC’s budget” – especially if the receivership has no end date.
Hinds County Board of Supervisors President Robert Graham was not immediately available for comment Friday. Sheriff Tyree Jones declined to comment because he has not yet read the entire court opinion.
In 2016, the Department of Justice sued Hinds County alleging a pattern or practice of unconstitutional conditions in four of its detention facilities. The county and DOJ entered a consent decree with stipulated changes to make for the jail system, which holds people facing trial.
“But the decree did not resolve the dispute; to the contrary, a yearslong battle ensued in the district court as to whether and to what extent the County was complying with the consent decree,” the appeals court wrote.
This prompted Reeves to hold the county in contempt of court twice in 2022.
The county argued it was doing its best to comply with the consent decree and spending millions to fix the jail. One of the solutions they offered was building a new jail, which is now under construction in Jackson.
The county had a chance to further prove itself during three weeks of hearings held in February 2022. Focuses included the death of seven detainees in 2021 from assaults and suicide and issues with staffing, contraband, old infrastructure and use of force.
Seeing partial compliance by the county, in April 2022 Reeves dismissed the consent decree and issued a new, shorter injunction focused on the jail and removed some provisions from the decree.
But Reeves didn’t see improvement from there. In July 2022, he ordered receivership and wrote that it was needed because of an ongoing risk of unconstitutional harm to jail detainees and staff.
The county pushed back against federal oversight and filed an appeal, arguing that there isn’t sufficient evidence to show that there are current and ongoing constitutional violations at the jail and that the county has acted with deliberate indifference.
Days before the appointed receiver was set to take control of the jail at the beginning of 2023, the 5th Circuit Court ordered a stay to halt that receiver’s work. The new injunction ordered by Reeves was also stayed, and a three-person jail monitoring team that had been in place for years also was ordered to stop work.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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