Mississippi Today

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

Published

9 months ago

March 14, 2024

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.

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Mississippi Today

On this day in 1911

Published

22 hours ago

December 21, 2024

Staff Editor

mississippitoday.org – Jerry Mitchell – 2024-12-21 07:00:00

Dec. 21, 1911

A colorized photograph of Josh Gibson, who was playing with the Homestead Grays Credit: Wikipedia

Josh Gibson, the Negro League’s “Home Run King,” was born in Buena Vista, Georgia.

When the family’s farm suffered, they moved to Pittsburgh, and Gibson tried baseball at age 16. He eventually played for a semi-pro team in Pittsburgh and became known for his towering home runs.

He was watching the Homestead Grays play on July 25, 1930, when the catcher injured his hand. Team members called for Gibson, sitting in the stands, to join them. He was such a talented catcher that base runners were more reluctant to steal. He hit the baseball so hard and so far (580 feet once at Yankee Stadium) that he became the second-highest paid player in the Negro Leagues behind Satchel Paige, with both of them entering the National Baseball Hame of Fame.

The Hall estimated that Gibson hit nearly 800 homers in his 17-year career and had a lifetime batting average of .359. Gibson was portrayed in the 1996 TV movie, “Soul of the Game,” by Mykelti Williamson. Blair Underwood played Jackie Robinson, Delroy Lindo portrayed Satchel Paige, and Harvey Williams played “Cat” Mays, the father of the legendary Willie Mays.

Gibson has now been honored with a statue outside the Washington Nationals’ ballpark.

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

Mississippi Today

On this day in 1958

Published

2 days ago

December 20, 2024

Staff Editor

mississippitoday.org – Jerry Mitchell – 2024-12-20 07:00:00

Dec. 20, 1958

Bruce Boynton played a key role in the U.S. Supreme Court case that led to the Freedom Riders protests of 1961. Credit: Jay Reeves/Associated Press

Bruce Boynton was heading home on a Trailways bus when he arrived in Richmond, Virginia, at about 8 p.m. The 21-year-old student at Howard University School of Law — whose parents, Amelia Boynton Robinson and Sam Boynton, were at the forefront of the push for equal voting rights in Selma — headed for the restaurant inside the bus terminal.

The “Black” section looked “very unsanitary,” with water on the floor. The “white” section looked “clinically clean,” so he sat down and asked a waitress for a cheeseburger and a tea. She asked him to move to the “Black” section. An assistant manager followed, poking his finger in his face and hurling a racial epithet. Then an officer handcuffed him, arresting him for trespassing.

Boynton spent the night in jail and was fined $10, but the law student wouldn’t let it go. Knowing the law, he appealed, saying the “white” section in the bus terminal’s restaurant violated the Interstate Commerce Act. Two years later, the U.S. Supreme Court agreed. “Interstate passengers have to eat, and they have a right to expect that this essential transportation food service,” Justice Hugo Black wrote, “would be rendered without discrimination prohibited by the Interstate Commerce Act.”

A year later, dozens of Freedom Riders rode on buses through the South, testing the law. In 1965, Boynton’s mother was beaten unconscious on the day known as “Bloody Sunday,” where law enforcement officials beat those marching across the Selma bridge in Alabama. The photograph of Bruce Boynton holding his mother after her beating went around the world, inspiring changes in voting rights laws.

He worked the rest of his life as a civil rights attorney and died in 2020.

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‘Something to be proud of’: Dual-credit students in Mississippi go to college at nation’s highest rate

Published

2 days ago

December 20, 2024

Staff Editor

mississippitoday.org – Molly Minta – 2024-12-20 06:00:00

Mississippi high school students who take dual-credit courses go to college at the nation’s highest rate, according to a recent report.

It’s generally true that students who take college classes while in high school attend college at higher rates than their peers. Earlier this year, a study from the Community College Research Center at Teacher’s College, Columbia University found that nationally, 81% of dual-credit students go to college.

In Mississippi, that number shoots up to 93%, meaning the vast majority of the state’s high school students who take college classes enroll in a two- or four-year university.

“When we did this ranking, boom, right to the top it went,” said John Fink, a senior research associate and program lead at the research center who co-authored the study.

State officials say there’s likely no silver bullet for the high rate at which Mississippi’s dual-credit students enroll in college. Here, “dual credit” means a course that students can take for both high school and college credit. It’s different from “dual enrollment,” which refers to a high school student who is also enrolled at a community college.

In the last 10 years, participation in these programs has virtually exploded among Mississippi high school students. In 2014, about 5,900 students took dual-credit courses in Mississippi, according to the Mississippi Community College Board.

Now, it’s more than 18,000.

“It reduces time to completion on the post-secondary level,” said Kell Smith, Mississippi C0mmunity College Board’s executive director. “It potentially reduces debt because students are taking classes at the community college while they’re still in high school, and it also just exposes high school students to what post-secondary course work is like.”

“It’s something to be proud of,” he added.

There are numerous reasons why Mississippi’s dual-credit courses have been attracting more and more students and helping them enroll in college at the nation’s highest rate, officials say.

With a few college credits under their belt, students may be more inspired to go for a college degree since it’s closer in reach. Dual-credit courses can also build confidence in students who were on the fence about college without requiring them to take a high-stakes test in the spring. And the Mississippi Department of Education’s accountability model ensures that school districts are offering advanced courses like dual credit.

Plus, Mississippi’s 15 community colleges reach more corners of the state, meaning districts that may not be able to offer Advanced Placement courses can likely partner with a nearby community college.

“They’re sometimes like the only provider in many communities, and they’re oftentimes the most affordable providers,” Fink said.

Test score requirements can pose a barrier to students who want to take dual-credit courses, but that may be less of a factor in Mississippi. While the state requires students to score a 19 on ACT Math to take certain courses, which is above the state average, a 17 on the ACT Reading, below the state average of 17.9, is enough for other courses.

Transportation is another barrier that many high schools have eliminated by offering dual-credit courses on their campuses, making it so students don’t have to commute to the community colleges to take classes.

“They can leave one classroom, go next door, and they’re sitting in a college class,” said Wendy Clemons, the Mississippi Department of Education’s associate state superintendent for secondary education.

This also means high school counselors can work directly with dual-credit students to encourage them to pursue some form of college.

“It is much less difficult to graduate and not go to college when you already possess 12 hours of credit,” Clemons said.

Word-of-mouth is just as key.

“First of all, I think parents and community members know more about it,” Clemons said, “They have almost come to expect it, in a way.”

This all translates to benefits to students. Students who take dual-credit courses are more likely to finish college on time. They can save on student debt.

But not all Mississippi students are benefiting equally, Fink said. Thr research center’s report found that Black students in Mississippi and across the country were less likely to pursue dual-credit opportunities.

“The challenge like we see in essentially every state is that who’s in dual enrollment is not really reflective of who’s in high school,” Fink said.

Without more study, it’s hard to say specifically why this disparity exists in Mississippi, but Fink said research has generally shown it stems from elitist beliefs about who qualifies for dual-credit courses. Test score requirements can be another factor, along with underresourced school districts.

“The conventional thinking is (that) dual enrollment is just … another gifted-and-talented program?” Fink said. “It has all this baggage that is racialized … versus, are we thinking about these as opportunities for any high school student?”

Another factor may be the cost of dual-credit courses, which is not uniform throughout the state. Depending on where they live, some students may pay more for dual-credit courses depending on the agreements their school districts have struck with local community colleges and universities.

This isn’t just an equity issue for students — it affects the institutions, too.

“You know, we’ve seen that dual-credit at the community college level can be a double-edged sword,” Smith said. “We lose students who oftentimes … want to stay as long as they can, but there are only so many hours they can take at a community college.

Dual-credit courses, which are often offered at a free or reduced price, can also result in less revenue to the college.

“Dual credit does come at a financial price for some community colleges, because of the deeply discounted rates that they offer it,” Smith said. “The more students that you have taking dual-credit courses, the more the colleges can lose.”

State officials are also working to turn the double-edged sword into a win-win for students and institutions.

One promising direction is career-technical education. Right now, the vast majority of dual credit students enroll in academic courses, such as general education classes like Composition 1 or 2 that they will need for any kind of college degree.

“CTE is far more expensive to teach,” Clemons said.

Smith hopes that state officials can work to offer more dual-credit career-technical classes.

“If a student knows they want to enroll in career-tech in one of our community colleges, let’s load them up,” Smith said. “Those students are more likely to enter the workforce quicker. If you want to take the career-tech path, that’s your ultimate goal.”

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