Mississippi Today
Governor’s allies on advisory board thwart effort to give poor moms timely health care
The state Medicaid director and a hospital CEO — neither of them doctors — bucked recommendations from health care professionals and delayed a vote that could have made it easier for expecting Mississippians to receive timely prenatal care.
The move comes just days after the release of a maternal mortality report that shows Mississippi is still one of the most dangerous places in the country to give birth.
The Mississippi Medical Care Advisory Committee heard presentations from Dr. Anita Henderson, former president of the state pediatric association, and Dr. Jaleen Sims, a Jackson-based OB-GYN. The two said at the committee’s Friday meeting that establishing pregnancy presumptive eligibility for Medicaid could make it easier to receive timely prenatal care in Mississippi.
The committee —made up of 11 members appointed by the governor, lieutenant governor and speaker of the House — is tasked by state law to advise the Division of Medicaid, which covers most births in Mississippi. The committee’s recommendation to the state Legislature this past year to extend postpartum Medicaid coverage was influential in the legislation’s subsequent passage.
Medicaid Director Drew Snyder, appointed by former Gov. Phil Bryant and reappointed by Gov. Tate Reeves, has opposed Medicaid expansion and was reluctant to endorse expanding postpartum care to mothers despite the urging of doctors this past year, in line with Reeves. On Friday, Snyder urged the committee to hold off on recommending presumptive Medicaid eligibility for expectant mothers. Kent Nicaud, a hospital CEO who is a strong political supporter of Reeves, aided Snyder in the effort by amending a motion that would have recommended the policy’s adoption.
Pregnancy presumptive eligibility allows people to receive health care when they’re pregnant, even if they’re not on Medicaid because it’s presumed that they qualify.
It’s an important step to reducing barriers to timely care. It can be complicated to get pregnancy Medicaid coverage, and those complications can mean the difference between a preventable pregnancy-related death and a safe delivery.
Though Medicaid policy states a person can qualify by simply attesting they are pregnant, most doctors and expecting people are under the impression a pregnancy test from a health care provider is required to be covered. Sims previously told Mississippi Today that despite the division’s policy, her patients applying for Medicaid have been asked for further confirmation to verify they’re pregnant.
That means Mississippians generally must pay out-of-pocket for a doctor’s pregnancy test test because they’re not presumed eligible for Medicaid. Then they must wait for their Medicaid application to be approved to receive care, unless they’re willing to continue paying out-of-pocket. Some doctors won’t even see them before they’re insured.
The division does retroactively reimburse prenatal care after applications are approved, but Matt Westerfield, spokesperson for the Division of Medicaid, told Mississippi Today last year that it takes the agency about 24 days to approve pregnancy applications.
Following the doctors’ presentations at the committee meeting, State Health Officer Dr. Daniel Edney made a motion for the committee to recommend the adoption of pregnancy presumptive eligibility to the Legislature or the division.
“Give these women a chance to have their babies,” Edney said. “Why wouldn’t we do it if we’re in such a crisis?”
After the motion was seconded, however, Snyder spoke up in opposition.
“Twenty minutes of discussion from two presenters is not enough on this complex issue,” Snyder said. “Rather than saying, ‘Let’s do everything we can,’ let’s do what’s smart and what works and what’s actually connected to improving outcomes.”
Snyder, an attorney, asked the committee if the division could consider and research the policy and return to the committee with their findings.
Dr. Billy Long, a gastroenterologist based in Madison, then expressed confusion about who had the power to establish the policy.
“I thought I heard you say, ‘Medicaid could not make this decision,’” he said to Snyder.
Snyder replied, “That’s correct, we need to send this to the Legislature,” and then immediately declined to get into the “nuances.”
It’s not clear what agency has the power to establish presumptive eligibility. Snyder, appointed Medicaid director by former Gov. Phil Bryant and reappointed by Reeves, has said previously that the Division of Medicaid wouldn’t utilize pregnancy presumptive eligibility unless directed to by the Legislature. Westerfield previously told Mississippi Today that position is to avoid paying “providers for services for women who subsequently would not qualify for Medicaid.”
Nicaud then suggested that Medicaid bring more information to the committee at a special meeting in January and repeatedly stressed that “educating” patients might be more helpful to improving outcomes for mothers and babies in Mississippi than presumptive eligibility.
Nicaud, who also doesn’t have a medical degree, is the president and CEO of Gulfport’s Memorial Health System and has donated almost $125,000 to Reeves since 2017.
Nicaud encouraged Edney to modify his motion, which Edney declined to do.
“We endorse the concept of presumptive eligibility unless there’s a reason we cannot,” Edney said. “If there’s an extra meeting, I’d be happy to attend.”
Nicaud then amended Edney’s motion to call a special meeting to discuss presumptive eligibility further and then make the committee’s recommendation to the division or Legislature.
Following the meeting, Snyder quickly left the Capitol chamber where the meeting was held and refused to take questions.
Henderson later expressed disappointment about the committee’s decision.
“Personally, I think it’s a no brainer,” she said. “I think this is an issue everyone should be on board with. If the rest of the country is, why aren’t we?”
Mississippi is one of 21 states as of January 2020 that doesn’t offer presumptive eligibility for pregnant people, according to KFF, and Mississippi is one of just three states that has not expanded Medicaid nor established presumptive eligibility.
According to a study commissioned with the University of Mississippi Center for Population Studies by the Center for Mississippi Health Policy, preterm births are less likely for low-income people when they live in a state with presumptive eligibility and expanded Medicaid.
Sen. Kevin Blackwell, R-Southaven, and Sen. Nicole Boyd, R-Oxford, say they will co-author a bill this upcoming Legislative session about presumptive eligibility for pregnant women. A previous attempt to establish presumptive eligibility by Rep. Missy McGee, R-Hattiesburg, did not make it out of committee this past session.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1908
Dec. 26, 1908
Pro boxing pioneer Jack Johnson defeated Tommy Burns, becoming the first Black heavyweight boxing champion.
Johnson grew up in Galveston, Texas, where “white boys were my friends and pals. … No one ever taught me that white men were superior to me.”
After quitting school, he worked at the local docks and then at a race track in Dallas, where he first discovered boxing. He began saving money until he had enough to buy boxing gloves.
He made his professional debut in 1898, knocking out Charley Brooks. Because prizefighting was illegal in Texas, he was occasionally arrested there. He developed his own style, dodging opponents’ blows and then counterpunching. After Johnson defeated Burns, he took on a series of challengers, including Tony Ross, Al Kaufman and Stanley Ketchel.
In 1910, he successfully defended his title in what was called the “Battle of the Century,” dominating the “Great White Hope” James J. Jeffries and winning $65,000 — the equivalent of $1.7 million today.
Black Americans rejoiced, but the racial animosity by whites toward Johnson erupted that night in race riots. That animosity came to a head when he was arrested on racially motivated charges for violating the Mann Act — transporting a woman across state lines for “immoral purposes.”
In fact, the law wasn’t even in effect when Johnson had the relationship with the white woman. Sentenced to a year in prison, Johnson fled the country and fought boxing matches abroad for seven years until 1920 when he served his federal sentence.
He died in 1946, and six decades later, PBS aired Ken Burns’ documentary on the boxer, “Unforgivable Blackness: The Rise and Fall of Jack Johnson,” which fueled a campaign for a posthumous pardon for Johnson. That finally happened in 2018, when then-President Donald Trump granted the pardon.
To honor its native son, Galveston has built Jack Johnson Park, which includes an imposing statue of Johnson, throwing a left hook.
“With enemies all around him — white and even Black — who were terrified his boldness would cause them to become a target, Jack Johnson’s stand certainly created a wall of positive change,” the sculptor told The New York Times. “Not many people could dare to follow that act.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Health department’s budget request prioritizes training doctors, increasing health insurance coverage
New programs to train early-career doctors and help Mississippians enroll in health insurance are at the top of the state Department of Health’s budget wish list this year.
The agency tasked with overseeing public health in the state is asking for $4.8 million in additional state funding, a 4% increase over last year’s budget appropriation.
The department hopes to use funding increases to start three new medical residency programs across the state. The programs will be located in south central Mississippi, Meridian and the Delta and focus on internal and family medicine, obstetric care and rural training.
The Office of Mississippi Physician Workforce, which the Legislature moved from UMMC to the State Department of Health last year, will oversee the programs.
The office was created by the Legislature in 2012 and has assisted with the creation or supported 19 accredited graduate medical education programs in Mississippi, said health department spokesperson Greg Flynn.
A $1 million dollar appropriation requested by the department will fund a patient navigation program to help people access health services in their communities and apply for health insurance coverage.
People will access these services at community-based health departments, said Flynn.
Patient navigators will help patients apply for coverage through Medicaid or the Health Insurance Marketplace, said Health Department Senior Deputy Kris Adcock at the Joint Legislative Budget Committee meeting on Sept. 26.
“We want to increase the number of people who have access to health care coverage and therefore have access to health care,” she said.
The Health Insurance Marketplace is a federally-operated service that helps people enroll in health insurance programs. Enrollees can access premium tax credits, which lower the cost of health insurance, through the Marketplace.
The department received its largest appropriation from the state’s general fund in nearly a decade last year, illustrating a slow but steady rebound from drastic budget cuts in 2017 that forced the agency to shutter county health clinics and lay off staff.
State Health Officer Dr. Daniel Edney said he is “begging for some help with inflationary pressure” on the department’s operations budget at the State Board of Health meeting Oct. 9, but additional funding for operations was not included in the budget request.
“They’re (lawmakers) making it pretty clear to me that they’re not really interested in putting more money in (operations) to run the agency, and I understand that,” he said.
State agencies present budget requests to the Joint Legislative Budget Committee in September. The committee makes recommendations in December, and most appropriations bills are passed by lawmakers in the latter months of the legislative session, which ends in April.
The Department of Health’s budget request will likely change in the new year depending on the Legislature’s preferences, Edney said Oct. 9.
The state Health Department’s responsibilities are vast. It oversees health center planning and licensure, provides clinical services to underserved populations, regulates environmental health standards and operates infectious and chronic disease prevention programs.
Over half of the agency’s $600 million budget is funded with federal dollars. State funding accounts for just 15% of its total budget.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1956
Dec. 25, 1956
Fred Shuttlesworth somehow survived the KKK bombing that took out his home next to the Bethel Baptist Church in Birmingham, Alabama.
An arriving policeman advised him to leave town fast. In the “Eyes on the Prize” documentary, Shuttlesworth quoted himself as replying, “Officer, you’re not me. You go back and tell your Klan brethren if God could keep me through this, then I’m here for the duration.’”
Shuttlesworth and Bethel saw what happened as proof that they would be protected as they pursued their fight against racial injustice. The next day, he boarded a bus with other civil rights activists to challenge segregation laws that persisted, despite a U.S. Supreme Court decision that ordered the city of Montgomery, Alabama, to desegregate its bus service.
Months after this, an angry mob of Klansmen met Shuttlesworth after he tried to enroll his daughters into the all-white school in Birmingham. They beat him with fists, chains and brass knuckles. His wife, Ruby, was stabbed in the hip, trying to get her daughters back in the car. His daughter, Ruby Fredericka, had her ankle broken. When the examining physician was amazed the pastor failed to suffer worse injuries, Shuttlesworth said, “Well, doctor, the Lord knew I lived in a hard town, so he gave me a hard head.”
Despite continued violence against him and Bethel, he persisted. He helped Martin Luther King Jr. found the Southern Christian Leadership Conference and was instrumental in the 1963 Birmingham Campaign that led to the desegregation of downtown Birmingham.
A statue of Shuttlesworth can be seen outside the Birmingham Civil Rights Institute, and Birmingham’s airport bears his name. The Bethel church, which was bombed three times, is now a historic landmark.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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