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How Medicaid expansion could have saved Tim’s leg — and changed his life

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How Medicaid expansion could have saved Tim’s leg — and changed his life

Note: This article is part of Mississippi Today’s ongoing Mississippi Health Care Crisis project. Read more about the project by clicking here.

Tim Floyd has never been one to sit still. 

After being forced to leave community college to move home to Guntown to help his mom pay the bills, he landed a job driving a truck in his early 20s. But three or four years later, he was diagnosed with sleep apnea, a dangerous condition for professional drivers because it can lead to fatigue and slow reactions when driving. Just like that, his truck driving career was over.

The health insurance that job had provided him abruptly disappeared — and his life has never been the same since.

“It made me no longer insurable to drive the truck, and that’s what led me down the path of not being able to find a job with health insurance and not being able to afford (private) insurance with the jobs I had,” said Floyd, now 46 years old.

Since then, Floyd has been trapped in what is called the "health insurance gap": he doesn't qualify for Mississippi's strict and limited Medicaid program, and he doesn't have private health insurance from an employer. He can't afford a private plan himself. 

Meanwhile, over the past five years, Floyd's serious health problems have mounted. He’s been diagnosed with diabetes. He's lost part of his leg. He's battled cancer. He told Mississippi Today he’s sure he has medical debt, but he tries not to think about it: the past few years have just been about surviving each day.

Floyd’s conundrum is not unique in Mississippi. The state leads the nation in both rates of poverty and of uninsured people. Mississippi remains one of 12 states – and will likely soon be one of only 10 – not to accept federal dollars and provide health insurance to hundreds of thousands of Mississippians, many of them working poor.

Studies, including one from the state economist, have shown expanding Medicaid would cover up to about 230,000 Mississippians making up to 138% of the federal poverty level, or about $30,000 in annual income for a family of three. Floyd would have been covered under expanded Medicaid during the years he worked as a cashier and other low wage jobs, but because Mississippi never expanded, he wasn't.

The study also showed the state would save anywhere from $186 million to $207 million from 2022 through 2027 and create thousands of jobs. 

Medicaid expansion has also been associated with reductions in mortality in addition to declines in medical debt, which is highest in the South and in lower-income communities. 

But both Speaker of the House Philip Gunn and Gov. Tate Reeves remain unwaveringly opposed to expansion. 

“Extending Medicaid to people who can’t afford health insurance would offer them and their families basic financial security to live a healthy life, that includes preventative care. Mississippians shouldn’t face financial ruin if they need health care or worry that a lack of preventative health care could cost them their lives,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program. 

After he lost the trucking job, Floyd then worked many other jobs – including multiple at one time – but never landed another that offered health insurance. 

The combination of jobs wasn’t enough to afford private insurance or pay out-of-pocket medical costs. So he remained uninsured and stopped going to the doctor. 

Six in 10 uninsured adults say they have postponed getting health care they needed due to cost, according to KFF. Uninsured adults are also more likely to report skipping recommended tests or treatment due to cost than adults with insurance. 

In 2012, that practice caught up to Floyd. He was working a construction job when a rock got stuck under his foot inside his boot and created a sore. He put some antibiotic ointment and a Bandaid on it and continued working. But six months later, the sore became infected and his foot swelled up. He used savings to go see a doctor, who referred him to a wound specialist. 

For the next five years, he battled that sore: he would treat it and stay off his feet for a month (which would sometimes cause him to lose whatever job he had at the time), the sore would heal, and he would go back to work. Then the whole cycle repeated again. 

In 2017, a doctor suggested he have his blood sugar tested. So Floyd, again, dipped into his savings for a basic appointment and test. The results showed he was diabetic, and the sores were diabetic foot ulcers. The infection was now in his bones.   

There was only one option at that point: amputate his leg from the knee down. So again, just like that, his life changed. The charity program at North Mississippi Medical Center where he received his care covered the costs of the surgery, he said. Six months later, he was fitted for a prosthetic and began the process of rebuilding his strength and relearning how to do the things dear to him: basic things like walk, take care of the family’s dog, play the drums. 

“It was hard. It was hard not only on me but on the people that cared about me,” he said. “Also, my emotional health wasn’t all that great … It took me about another year (after getting the prosthetic) to be able to walk unassisted – no cane or walker or nothing. Then, just building –  going from being pretty active to being very sedentary to trying to get active again took me another year from that before I got my stamina back up to where I could work.”

Tim Floyd, left, listens as his father, Macky Floyd, plays the guitar at their home in Guntown, Miss., Friday, Nov. 4, 2022.

The Tupelo hospital – a hub for health care and employment in north Mississippi – offers a financial assistance program for uninsured and underinsured patients like Floyd who need emergency or medically necessary care. The hospital and its subsidiaries spent over $190 million in fiscal year 2021 in charity care and uninsured discounts.

The hospital is situated in the district of Sen. Chad McMahan, a Republican who also lives in Floyd’s same small hometown of Guntown. McMahan drew criticism from Republican counterparts in 2021 when he indicated he was willing to discuss Medicaid expansion “and look at what (it) might look like.”

Today, he still maintains he sympathizes with people who work but are uninsured. He says he’s not for Medicaid expansion, per se, but does believe it should be discussed and that the health care system in Mississippi needs to be reformed.

“I think everything has to be on the table – whether or not we’re going to have Medicaid enhancements or Medicaid expansion or if we’re going to have a modernization of the way prices, menu prices, are put out from hospitals,” or how insurance companies operate, he said. 

McMahan said he regularly speaks with administrators at the hospital that employs nearly 9,000 people. 

“For the hospital system I represent, they have annual salaries of half a billion a year and then an annual income revenue stream of 1 billion-plus. Last year, they gave away 19% in charity,” he said. “… It’s unsustainable. In what other business can you give away 19% (and survive)?” 

Beyond the economics of Medicaid expansion and health care reform, McMahan, who grew up without health insurance as the son of a carpenter and a clerk, says he feels for Floyd and identifies with him.

“In the 9th grade I got hurt, and my parents didn’t have insurance … I remember seeing the fear in my family’s eyes and hearing discussions at the dinner table when my parents would be discussing what we were going to eliminate from the family budget that month to pay for the $20,000 hospital bill I had,” he said. 

“I’m sympathetic to him (Floyd) because I was like that myself … If we’re going to do any type of Medicaid overhaul, there has to be a work requirement. I’m not for anyone getting a public service unless they’re in a position to contribute.”

Tim Floyd plays the djembe drum at a festival in Amory, Miss. in 2021.

Finally recovered from losing his leg, Floyd started submitting job applications again in 2020 – right as the U.S. began reporting its first COVID-19 cases and the country subsequently shut down. 

Floyd, still uninsured and ineligible for disability, discovered a knot on his neck. He went to the doctor and was diagnosed with an ear infection and prescribed antibiotics. Floyd said the doctor didn’t mention any further testing. 

“You know, actually, most doctors that I’ve dealt with understand my situation. Because I am uninsured, they don’t even bring that stuff (additional testing) up,” he said about. 

Over the next year, the lump got bigger. He returned to the same doctor, who at that time recommended a biopsy. The biopsy, which the hospital’s charity care program again covered, revealed he had stage II Hodgkin’s lymphoma.

The oncologist told him if it had been diagnosed earlier, it would’ve been caught at stage I and required less rigorous treatment, he said.

He went through six weeks each of chemotherapy and radiation, which burned his vocal chords. Until now, his health conditions hadn’t kept him from his musical talents: singing and playing the drums in a band called Proximity Rule. But for a while, he couldn’t sing, and it was difficult to even speak.

Floyd, who has been in remission since May of 2021, is now on disability, which pays him about $800 a month. The cancer and amputated leg didn’t qualify him for the government assistance – but the later addition of a severe carpal tunnel diagnosis did. 

Looking back, he says, the logic of state leaders who have refused to expand Medicaid is baffling. 

“It would make a lot more sense to find people like me … and (give) them Medicaid for a short period of time to get back healthy so they can continue working and continue providing for their family ….,” he said. “Because if they don’t have health insurance, they don’t go to the doctor and get seen, eventually they’re gonna be just like me, and we’re on the hook for them for the rest of their life.”

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

Mississippi Today

Mississippi Legislature approves DEI ban after heated debate

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mississippitoday.org – @MSTODAYnews – 2025-04-02 16:34:00

Mississippi lawmakers have reached an agreement to ban diversity, equity and inclusion programs and a list of “divisive concepts” from public schools across the state education system, following the lead of numerous other Republican-controlled states and President Donald Trump’s administration.  

House and Senate lawmakers approved a compromise bill in votes on Tuesday and Wednesday. It will likely head to Republican Gov. Tate Reeves for his signature after it clears a procedural motion.

The agreement between the Republican-dominated chambers followed hours of heated debate in which Democrats, almost all of whom are Black, excoriated the legislation as a setback in the long struggle to make Mississippi a fairer place for minorities. They also said the bill could bog universities down with costly legal fights and erode academic freedom.

Democratic Rep. Bryant Clark, who seldom addresses the entire House chamber from the podium during debates, rose to speak out against the bill on Tuesday. He is the son of the late Robert Clark, the first Black Mississippian elected to the state Legislature since the 1800s and the first Black Mississippian to serve as speaker pro tempore and preside over the House chamber since Reconstruction.

“We are better than this, and all of you know that we don’t need this with Mississippi history,” Clark said. “We should be the ones that say, ‘listen, we may be from Mississippi, we may have a dark past, but you know what, we’re going to be the first to stand up this time and say there is nothing wrong with DEI.'”

Legislative Republicans argued that the measure — which will apply to all public schools from the K-12 level through universities — will elevate merit in education and remove a list of so-called “divisive concepts” from academic settings. More broadly, conservative critics of DEI say the programs divide people into categories of victims and oppressors and infuse left-wing ideology into campus life.

“We are a diverse state. Nowhere in here are we trying to wipe that out,” said Republican Sen. Tyler McCaughn, one of the bill’s authors. “We’re just trying to change the focus back to that of excellence.”

The House and Senate initially passed proposals that differed in who they would impact, what activities they would regulate and how they aim to reshape the inner workings of the state’s education system. Some House leaders wanted the bill to be “semi-vague” in its language and wanted to create a process for withholding state funds based on complaints that almost anyone could lodge. The Senate wanted to pair a DEI ban with a task force to study inefficiencies in the higher education system, a provision the upper chamber later agreed to scrap.

The concepts that will be rooted out from curricula include the idea that gender identity can be a “subjective sense of self, disconnected from biological reality.” The move reflects another effort to align with the Trump administration, which has declared via executive order that there are only two sexes.

The House and Senate disagreed on how to enforce the measure but ultimately settled on an agreement that would empower students, parents of minor students, faculty members and contractors to sue schools for violating the law.

People could only sue after they go through an internal campus review process and a 25-day period when schools could fix the alleged violation. Republican Rep. Joey Hood, one of the House negotiators, said that was a compromise between the chambers. The House wanted to make it possible for almost anyone to file lawsuits over the DEI ban, while Senate negotiators initially bristled at the idea of fast-tracking internal campus disputes to the legal system.   

The House ultimately held firm in its position to create a private cause of action, or the right to sue, but it agreed to give schools the ability to conduct an investigative process and potentially resolve the alleged violation before letting people sue in chancery courts.

“You have to go through the administrative process,” said Republican Sen. Nicole Boyd, one of the bill’s lead authors. “Because the whole idea is that, if there is a violation, the school needs to cure the violation. That’s what the purpose is. It’s not to create litigation, it’s to cure violations.” 

If people disagree with the findings from that process, they could also ask the attorney general’s office to sue on their behalf.

Under the new law, Mississippi could withhold state funds from schools that don’t comply. Schools would be required to compile reports on all complaints filed in response to the new law.

Trump promised in his 2024 campaign to eliminate DEI in the federal government. One of the first executive orders he signed did that. Some Mississippi lawmakers introduced bills in the 2024 session to restrict DEI, but the proposals never made it out of committee. With the national headwinds at their backs and several other laws in Republican-led states to use as models, Mississippi lawmakers made plans to introduce anti-DEI legislation.

The policy debate also unfolded amid the early stages of a potential Republican primary matchup in the 2027 governor’s race between State Auditor Shad White and Lt. Gov. Delbert Hosemann. White, who has been one of the state’s loudest advocates for banning DEI, had branded Hosemann in the months before the 2025 session “DEI Delbert,” claiming the Senate leader has stood in the way of DEI restrictions passing the Legislature. 

During the first Senate floor debate over the chamber’s DEI legislation during this year’s legislative session, Hosemann seemed to be conscious of these political attacks. He walked over to staff members and asked how many people were watching the debate live on YouTube. 

As the DEI debate cleared one of its final hurdles Wednesday afternoon, the House and Senate remained at loggerheads over the state budget amid Republican infighting. It appeared likely the Legislature would end its session Wednesday or Thursday without passing a $7 billion budget to fund state agencies, potentially threatening a government shutdown.

“It is my understanding that we don’t have a budget and will likely leave here without a budget. But this piece of legislation …which I don’t think remedies any of Mississippi’s issues, this has become one of the top priorities that we had to get done,” said Democratic Sen. Rod Hickman. “I just want to say, if we put that much work into everything else we did, Mississippi might be a much better place.”

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

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House gives Senate 5 p.m. deadline to come to table, or legislative session ends with no state budget

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mississippitoday.org – @MSTODAYnews – 2025-04-02 16:13:00

The House on Wednesday attempted one final time to revive negotiations between it and the Senate over passing a state budget.

Otherwise, the two Republican-led chambers will likely end their session without funding government services for the next fiscal year and potentially jeopardize state agencies.

The House on Wednesday unanimously passed a measure to extend the legislative session and revive budget bills that had died on legislative deadlines last weekend. 

House Speaker Jason White said he did not have any prior commitment that the Senate would agree to the proposal, but he wanted to extend one last offer to pass the budget. White, a Republican from West, said if he did not hear from the Senate by 5 p.m. on Wednesday, his chamber would end its regular session. 

“The ball is in their court,” White said of the Senate. “Every indication has been that they would not agree to extend the deadlines for purposes of doing the budget. I don’t know why that is. We did it last year, and we’ve done it most years.” 

But it did not appear likely Wednesday afternoon that the Senate would comply.

The Mississippi Legislature has not left Jackson without setting at least most of the state budget since 2009, when then Gov. Haley Barbour had to force them back to set one to avoid a government shutdown.

The House measure to extend the session is now before the Senate for consideration. To pass, it would require a two-thirds majority vote of senators. But that might prove impossible. Numerous senators on both sides of the aisle vowed to vote against extending the current session, and Lt. Gov. Delbert Hosemann who oversees the chamber said such an extension likely couldn’t pass. 

Senate leadership seemed surprised at the news that the House passed the resolution to negotiate a budget, and several senators earlier on Wednesday made passing references to ending the session without passing a budget. 

“We’ll look at it after it passes the full House,” Senate President Pro Tempore Dean Kirby said. 

The House and Senate, each having a Republican supermajority, have fought over many issues since the legislative session began early January.

But the battle over a tax overhaul plan, including elimination of the state individual income tax, appeared to cause a major rift. Lawmakers did pass a tax overhaul, which the governor has signed into law, but Senate leaders cried foul over how it passed, with the House seizing on typos in the Senate’s proposal that accidentally resembled the House’s more aggressive elimination plan.

The Senate had urged caution in eliminating the income tax, and had economic growth triggers that would have likely phased in the elimination over many years. But the typos essentially negated the triggers, and the House and governor ran with it.

The two chambers have also recently fought over the budget. White said he communicated directly with Senate leaders that the House would stand firm on not passing a budget late in the session. 

But Senate leaders said they had trouble getting the House to meet with them to haggle out the final budget. 

On the normally scheduled “conference weekend” with a deadline to agree to a budget last Saturday, the House did not show, taking the weekend off. This angered Hosemann and the Senate. All the budget bills died, requiring a vote to extend the session, or the governor forcing them into a special session.

If the Legislature ends its regular session without adopting a budget, the only option to fund state agencies before their budgets expire on June 30 is for Gov. Tate Reeves to call lawmakers back into a special session later. 

“There really isn’t any other option (than the governor calling a special session),” Lt. Gov. Delbert Hosemann previously said. 

If Reeves calls a special session, he gets to set the Legislature’s agenda. A special session call gives an otherwise constitutionally weak Mississippi governor more power over the Legislature. 

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

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Amount of federal cuts to health agencies doubles

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mississippitoday.org – @MSTODAYnews – 2025-04-02 14:48:00

Cuts to public health and mental health funding in Mississippi have doubled – reaching approximately $238 million – since initial estimates last week, when cancellations to federal grants allocated for COVID-19 pandemic relief were first announced.

Slashed funding to the state’s health department will impact community health workers, planned improvements to the public health laboratory, the agency’s ability to provide COVID-19 vaccinations and preparedness efforts for emerging pathogens, like H5 bird flu. 

The grant cancellations, which total $230 million, will not be catastrophic for the agency, State Health Officer Dr. Daniel Edney told members of the Mississippi House Democratic Caucus at the Capitol April 1. 

But they will set back the agency, which is still working to recover after the COVID-19 pandemic decimated its workforce and exposed “serious deficiencies” in the agency’s data collection and management systems.

The cuts will have a more significant impact on the state’s economy and agency subgrantees, who carry out public health work on the ground with health department grants, he said. 

“The agency is okay. But I’m very worried about all of our partners all over the state,” Edney told lawmakers. 

The health department was forced to lay off 17 contract workers as a result of the grant cancellations, though Edney said he aims to rehire them under new contracts. 

Other positions funded by health department grants are in jeopardy. Two community health workers at Back Bay Mission, a nonprofit that supports people living in poverty in Biloxi, were laid off as a result of the cuts, according to WLOX. It’s unclear how many more community health workers, who educate and help people access health care, have been impacted statewide.

The department was in the process of purchasing a comprehensive data management system before the cuts and has lost the ability to invest in the Mississippi Public Health Laboratory, he said. The laboratory performs environmental and clinical testing services that aid in the prevention and control of disease. 

Mississippi State Health Officer Dr. Dan Edney addresses lawmakers during the Democratic caucus meeting at the State Capitol in Jackson, Miss., on Tuesday, April 1, 2025. The discussion centered on potential federal healthcare funding cuts.

The agency has worked to reduce its dependence on federal funds, Edney said, which will help it weather the storm. Sixty-six percent of the department’s budget is federally funded. 

The Centers for Disease Control and Prevention pulled back $11.4 billion in funding to state health departments nationwide last week. The funding was originally allocated by Congress for testing and vaccination against the coronavirus as part of COVID-19 relief legislation, and to address health disparities in high-risk and underserved populations. An additional $1 billion from the Substance Abuse and Mental Health Services Administration was also terminated. 

“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” the Department of Health and Human Services Director of Communications Andrew Nixon said in a statement.

HHS did not respond to questions from Mississippi Today about the cuts in Mississippi.

Democratic attorneys general and governors in 23 states filed a lawsuit against the U.S. Department of Health and Human Services Tuesday, arguing that the sudden cancellation of the funding was unlawful and seeking injunctive relief to halt the cuts. Mississippi did not join the suit. 

Mental health cuts

The Department of Mental Health received about $7.5 million in cuts to federal grants from the Substance Abuse and Mental Health Services Administration. 

Phaedre Cole, president of the Mississippi Association of Community Mental Health Centers, speaks to lawmakers about federal healthcare funding cuts during the Democratic caucus meeting at the State Capitol in Jackson, Miss., on Tuesday, April 1, 2025.

Over half of the cuts were to community mental health centers, and supported alcohol and drug treatment services for people who can not afford treatment, housing services for parenting and pregnant women and their children, and prevention services. 

The cuts could result in reduced beds at community mental health centers, Phaedre Cole, the director of Life Help and President of Mississippi Association of Community Mental Health Centers, told lawmakers April 1. 

Community mental health centers in Mississippi are already struggling to keep their doors open. Four centers in the state have closed since 2012, and a third have an imminent to high risk of closure, Cole told legislators at a hearing last December. 

“We are facing a financial crisis that threatens our ability to maintain our mission,” she said Dec. 5. 

Cuts to the department will also impact diversion coordinators, who are charged with reducing recidivism of people with serious mental illness to the state’s mental health hospital, a program for first-episode psychosis, youth mental health court funding, school-aged mental health programs and suicide response programs. 

The Department of Mental Health hopes to reallocate existing funding from alcohol tax revenue and federal block grant funding to discontinued programs.

The agency posted a list of all the services that have received funding cuts. The State Department of Health plans to post such a list, said spokesperson Greg Flynn.

Health leaders have expressed fear that there could be more funding cuts coming. 

“My concern is that this is the beginning and not the end,” said Edney.  

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

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