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Inside Mississippi’s coverage gap, workers say health care is a ‘pipe dream’ or ‘whimsical idea’

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When Brandon Allred woke up in the hospital after suffering heat stroke and a series of seizures at work, all he could think about was how much it was going to cost.

It was a legitimate concern: Seven years later, he’s still paying off the medical debt.

“It’s not just anxiety,” the 35-year-old father said, “but also the conscious, embarrassing fact that I’m living in one of the richest countries in the world and I am a natural born citizen and I have to sit here day by day and think ‘I dream of healthcare.’ I dream of a day where I can get all my teeth fixed and not have to worry about that. Or maybe I can figure out what was going on with me with those seizures.”

Allred, a prep cook and the primary provider for his six young daughters, works full-time but falls into Mississippi’s coverage gap, where he says health care is but a “pipe dream” and a “whimsical idea.”

Brandon Allred, 35-year-old father of six, works full-time but falls into Mississippi’s coverage gap. He is still paying off medical debt from a hospital visit seven years ago. Photo: Courtesy of Brandon Allred

The coverage gap is made up of low-income workers who make more than 28% of the federal poverty level — the maximum income allowed to currently qualify for Medicaid in the state — but less than the 100% of the federal poverty level needed to get subsidies that would make private insurance plans affordable. And it’s surprisingly big, comprising roughly 74,000 Mississippians, according to a recent KFF study.

If Medicaid were expanded in Mississippi – one of only 10 states that has not done so – Allred and tens of thousands of other working Mississippians like him would be covered. Income-eligible adults without children would also be covered.

It’s estimated that 123,000 uninsured Mississippians would gain coverage under expansion – that includes the 74,000 people under the poverty level and an additional 49,000 uninsured adults whose income is between 100% and 138% of the FPL. That means that under expansion, a family of four could make up to $43,056 and qualify for Medicaid.

Critics of expansion argue that anyone, even if they’re not offered health insurance through their employer, can purchase it through the marketplace. Those plans exist, but are so expensive that for those in the coverage gap, they practically do not exist.

Other critics of expansion argue that because there is a chance that some privately-insured Mississippians would switch to Medicaid under expansion, that’s reason to keep the 123,000 uninsured Mississippians uninsured — and turn down at least $1 billion a year in federal money to cover most of the cost.

Private insurance plans, especially ones with low premiums, have high deductibles that can easily run $5,000 a year. A plan with a deductible on the higher end of that spectrum would equate to about $400 a month – on top of premiums and copays – that an individual would need to pay in order for insurance companies to start picking up the slack.

A majority of uninsured adults make slightly too much to qualify for Medicaid under the present eligibility criteria, and so have no path toward health care.

As it stands, Medicaid eligibility for adults in Mississippi is very limited.

Firstly, Medicaid in Mississippi doesn’t currently cover childless adults – period. And even adults who have children would need to be making less than 28% of the federal poverty level to be eligible for Medicaid. For a family of two, such as a single mother and her child, 28% of the federal poverty level would be about $5,700 a year, or $475 a month.

That means that a working mother making incrementally more, such as 29% of the federal poverty level, would not qualify for Medicaid but would have to use nearly her entire salary if she were to pay out of pocket for a private insurance plan through the marketplace. This is an obvious impossibility for someone paying for rent and food and other basic necessities.

Nobody knows that better than Lakeisha Preston, a single working mother who couldn’t afford the deductibles on her insurance plan, and therefore was stuck paying out of pocket for a bout of pneumonia that put her in the hospital in 2019.

Over four years later she’s still paying off that medical bill – which forced her to move back in with her parents and take out personal loans.

“I had health insurance, it’s just that the deductibles were so high,” Preston explained. “I don’t go to the doctor all the time, and of course you have to meet the deductible first before the insurance covers you. So I was in that predicament.”

Ironically, Preston works at a federal Medicaid call center. She helps thousands of people, with incomes similar to hers, enroll in Medicaid in states with Medicaid expansion. As a Mississippian, she cannot get that coverage.

Preston said: “As a call center worker, I expect more from the state of Mississippi.”

Mississippi lawmakers have debated the need for expansion — mostly over partisan political reasons — for over a decade, despite the state’s abysmal public health metrics and pleas from doctors, hospital leaders and other health providers.

On Thursday, the deadline day for bills to pass their original chambers, Care4Mississippi, a coalition of 36 organizations whose goal is health care for all Mississippians, held a press conference at the Capitol. Doctors and health officials shared experiences from the frontline and urged lawmakers to pass expansion bills.

“As a pediatrician, I have seen firsthand the impact of parents’ health on their children,” Dr. Anita Henderson said during the press conference. “Children need their parents, and their parents need to act healthy, mentally, physically, and able to engage with their children. I have seen patients whose parents worked, sometimes two jobs, and lacked health insurance … The men and women in Mississippi are living almost a decade less than the people of Hawaii.”

Dr. Anita Henderson speaks to the media about Medicaid expansion during a press conference at the Capitol in Jackson, Miss., Thursday, March 14, 2024. Credit: Eric J. Shelton/Mississippi Today

This is the first year since Medicaid expansion was offered to states under the Affordable Care Act in 2014 that Mississippi Republican legislative leadership is considering it seriously. A House Republican bill overwhelmingly passed the full House and now sits in the Senate – which just killed its own expansion bill, according to Medicaid Chair Kevin Blackwell, R-Southaven.

But Allred said that after a decade, lawmakers aren’t moving fast enough or treating the situation for the health care crisis that it is.

“If there was a state that needed to have a red flag pinned on it to say ‘you have a medical emergency to take care of,’ it would be Mississippi,” he said. “And we need a rethinking of what health care is for our citizens in the state.”

Allred saw his father lose all his money as he battled cancer in the last six months of his life – despite the fact he’d worked hard at one company for 30 years. Growing up, his mother warned him not to let a medical debt go to collections, and said it always felt like “the medical industry was there to be feared.”

The father of six said he hopes that by the time his daughters are grown, they won’t have to choose between paying rent or paying a medical bill. Right now, his children are covered by Medicaid. But he worries if legislation isn’t passed, they’ll be in the same predicament he’s in once they turn 18.

“I don’t want them to follow in the same footsteps as me when they shouldn’t have to,” Allred reflected. “When they’re being told their whole life they’re being raised in the greatest country in the world but they’re also being told the greatest country in the world can not take care of you.”

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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