Connect with us

Mississippi Today

Louisiana Gov. John Bel Edwards: Medicaid expansion ‘easiest big decision I ever made’

Published

on

Two-term Louisiana Gov. John Bel Edwards calls expanding Medicaid as he took office in 2016 “the easiest big decision I have ever made” — and one that has had clear and convincing positive results for Louisianans.

“To me it was an obvious no-brainer, and maybe it’s easier for me to say that than others because I believe in making government work,” Edwards said in a recent interview with Mississippi Today. “I don’t believe in just saying, ‘Well, we just don’t want to expand government.’ Quite frankly, I don’t expect St. Peter to ask that question one day: Did you expand government? But I do expect him to ask what I did for the least fortunate among us.”

Louisiana, like other states nationwide, was at the time facing a health care crisis. It led the nation in rates of uninsured people — 22%-23%, mostly the “working poor.”

“We had many hospitals, especially rural hospitals, that were in danger of closing when I became governor,” Edwards said. “But because we have expanded Medicaid, we have not lost a single one.

“I’m not going to try to tell you that it fixed all of our problems and that all of a sudden we have the best health outcomes in the country,” Edwards continued. “What I can tell you is it addressed our most pressing problems, and it has created an environment where we can more easily produce better health outcomes because you just have more people with the ability to go to a doctor.”

Edwards said that when he became governor of Louisiana in 2016, the politics of Medicaid expansion "were probably about the same" as they are now in neighboring Mississippi, and so was the dire health care situation. He would unequivocally recommend Mississippi leaders take advantage of the federal program designed to help poor states with health care.

READ MORE: ‘A no-brainer’: Why former Arkansas Gov. Mike Beebe successfully pushed Medicaid expansion

Edwards notes the politics on expansion have changed in Louisiana.

"In Louisiana we have a gubernatorial campaign underway, and I don't believe there is a single major candidate of either party who says anything other than they will leave the Medicaid expansion in place."

Mississippi Today interviewed the term-limited Gov. Edwards on Medicaid expansion as the end of his term nears, on a policy he says "ranks at the very top" of his accomplishments. The interview is below, edited for brevity.

Mississippi Today: Could you give a brief/broad overview of the situation when you took office, and of the impact Medicaid expansion has had in Louisiana since 2016.

Gov. John Bel Edwards: First, I'll talk about the impact it's had on our overall state budget. Secondly, individuals and families — many for the first time — have health insurance. And thirdly, we saw positive impact on the financial bottom line of hospitals across our state.

When I became governor, we had the largest general fund budget deficit in our state's history. It exceeded $2 billion for the first full fiscal year that started July 1, 2016, and that was a little more than 20% of all our state general fund. And that deficit occurred after several years of leading the nation in cuts to higher education, and cuts to basic health care delivery systems in our state.

And the cuts were just horrible with respect to Medicaid ... You have optional programs, but the optional programs were like hospice, end-stage renal disease care — things that most people would never consider optional, like things that would impact a person's ability to stay in a nursing home.

The people who were caught uninsured were working poor people. The poorest of the poor qualified for Medicaid. Those who worked and made enough money had private insurance or employer sponsored insurance. Working poor people were left out of that equation, and our uninsured rate among working aged adults was the highest in the country, around 22%-23%.

If someone is uninsured and they have access to any health care, it's likely to be an emergency room, which is the most costly way to receive health care. It's also the least effective way to manage disease ... That care either went totally uncompensated by the health care provider, meaning they had to pay for its themselves, or it might have been compensated in part by the (federal-state Disproportionate Share Hospitals) program.

But the DiSH program costs the state about 40 cents on the dollar. Medicaid expansion has never cost more than 10 cents on the dollar, and in Louisiana, the 10 cents is actually borne by the health care providers themselves because the hospitals realized their bottom lines would benefit so much that they assessed themselves.

This has produced an awful lot of compensation for these hospitals. Their bottom line is so much better — and this is all hospitals, our community hospitals, our very large hospitals like Ochsner, like Franciscan Missionaries of Our Lady, like Children's Hospitals of New Orleans. But also, and I suspect most importantly, rural hospitals, because they were the ones struggling the most just to keep their doors open and routinely cutting programs and reducing staff to stay afloat.

We were able to address all of that through the Medicaid expansion, and it helped our state budget tremendously. My predecessor said he refused to expand Medicaid because we couldn't afford it. The truth is we couldn't afford not to do it. It actually helped our bottom line and allowed us to shore up the financing of our hospitals.

But it also helped these working poor people because many of them for the first time in their lives had an insurance card in their pockets ... As the medical community here has told me many times, it saved a lot of lives here in Louisiana ... I believe that Medicaid expansion is a pro-life position.

MT: Did Louisiana see an increase in gross domestic product from Medicaid expansion?

Edwards: We had GDP gains. I can't say it's because of Medicaid expansion or that it's responsible for X percentage of that, but I can tell you we have had the highest personal income ever. We have had the lowest unemployment rates ever and we have had the most people working ever. We have had tremendous growth in our GDP, and I just intuitively know it helped.

... By getting away from all that uncompensated care and the matching payments we had to put up, and because hospitals assessed themselves to cover the 10% costs, we were then able to use the budget savings and the money we had to address other pressing concerns that we inherited after a long period of disinvestment in our state. It allowed us to invest in other critical priorities.

MT: How has expansion affected Louisiana’s workforce?

Edwards: So, you have a relationship with a primary care physician. You have routine appointments and diagnostic evaluations, breast cancer screenings, prostate cancer screenings ... Your disease gets diagnosed earlier. Your treatment starts sooner, and it comes with a prescription benefit, so you have a way to be healthier. You're a more productive worker. You're less likely to be laid off. You're more likely to be able to support your family. That business has a healthier employee who shows up to work more often and is more productive — and the business didn't have to pay for it.

I’ve had employers tell me they had good employees, but they weren’t necessarily healthy. They had a disease. They didn’t have health insurance, so they had to miss work to go and wait around an emergency room. They would have to call in sick more often. These employers benefit from having a healthier, more productive workforce that doesn’t come at their expense.

When you expand Medicaid for the working poor, you also work with the health care providers so that they don’t just have appointments 9-5 Monday through Friday, but you work with them so they have appointments after hours during the week, have places they can go on the weekends so that they don’t have to miss work in order to access basic care.

Now we have the advent of telehealth, which can be covered through the Medicaid program and allow them to see doctors and even specialists without having to travel. That is particularly onerous for poor people in rural areas that lack the resources and also are furthest away from the nearest physicians that they need to see.

MT: Has expansion had an impact on mental health and-or substance abuse?

Edwards: It comes with behavioral health benefits for mental health, and it also comes with benefits for those people who have addiction disorders, and those benefits both in patient and outpatient. That's clearly something we still don’t have enough of, but we have a lot more services available now than we ever did before.

MT: What is your take on Mississippi's battle over expanding Medicaid and its ongoing hospital/health care crisis? What advice would you give to Mississippi – particularly its politicians and leaders – on Medicaid expansion?

Edwards: I don’t think the whole time I have been governor I have addressed comments critical to another state or the leadership of another state. I will say the situation there, the one that I read about and the one that I know a little bit about firsthand — my wife is from Wayne County, Mississippi, and all of her family is still up there — it looks an awful lot like the situation we had here. The politics were probably about the same here.

... Here in Louisiana, we decided that decision was made by the federal government when they passed the Affordable Care Act — otherwise known as Obamacare — a feature of which was Medicaid expansion. So that decision was made by the Obama administration and the Congress at that time. It hasn’t been repealed, so it remains available to states, although not mandatory as it was originally intended. I believe that we should try to make government work for those who need it the most. The working poor people certainly need health care.

I believe that you should make available to your state federal programs that not only do that, but provide a benefit to your budget so that you can then have the flexibility to address other pressing concerns as well. We were able to do that here. Obviously the situation as it exists in Mississippi to the extent that I am familiar with it — I'm rather familiar — looks an awful lot like what we had here in Louisiana.

I would certainly recommend Medicaid expansion to the Legislature there, to the governor there, to the people who are running for governor there. I would recommend it to Gov. Reeves, to Brandon Presley and to everyone else.

MT: How is expansion viewed across the aisle now in Louisiana? What level of opposition remains there? Any chance Louisiana voters would go along with undoing expansion?

Edwards: Obviously people might expect me to give a full throated defense of Medicaid expansion. I was a champion of it while Gov. Jindal was in office and refused to do it. I ran for office saying I was going to do it, and I have since done it. I would just invite anybody to come over here and talk to the hospital association, talk to hospital medical directors and CEOs.

Go to the most rural isolated, poorest parts of our state ask them about Medicaid expansion, and then go talk to employers in those areas and see what a difference its made for them.

The opposition has just melted away here. It's virtually nonexistent. I think that’s borne out by the campaign that’s underway where not a single candidate says they would undo the Medicaid expansion, and it would be a perilous position for them to take in the campaign if they said that.

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

Did you miss our previous article...
https://www.biloxinewsevents.com/?p=279342

Mississippi Today

Will new state-appointed Jackson court have city-based jurists? Yes, chief justice decides

Published

on

mississippitoday.org – Mina Corpuz – 2025-01-24 14:04:00

In 2023 as lawmakers were passing the bill that would establish a state-appointed court within Jackson, there was talk about appointing “the best and the brightest” judges from around the state to serve – a comment some Black legislators said implied they couldn’t be found within a majority Black Hinds County. 

Over a year later, the Capitol Complex Improvement District Court is set to open next week, and three judges with roots in Jackson and live in the capital have been appointed to serve. 

The judges who were sworn in during a Friday ceremony said they were interested in the positions because they wanted to serve the community where many of them grew up and live. 

“This is a very serious undertaking to citizens who live in this city,” said Judge Christopher Collins, who will serve on a part-time basis. He moved to Jackson for the role. 

Judge Stanley Alexander and James Holland will be the full-time judges.

Supreme Court Chief Justice Mike Randolph swears in Stanley Alexander during the opening of the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

Alexander is a former assistant district attorney in multiple judicial districts and he worked in the attorney general’s office, including as director of the Division of Public Integrity. Holland has practiced law for over 40 years and has trial experience, including defense in state and federal courts. He ran an unsuccessful race for Hinds County district attorney in 2015.

Collins has been a prosecutor and public defender. His judicial experience includes work as a circuit and municipal judge, intervention court judge and a judge for the Mississippi Band of Choctaw Indians. 

Dr. Bryana Smith McDougal, is sworn in as Clerk of the Capitol Complex Improvement District Court by Supreme Court Chief Justice Mike Randolph, during the opening of the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

Bryana Smith McDougal was appointed as the court’s clerk. She previously was judicial assistant to former Supreme Court Justice Jim Kitchens and an assistant deputy clerk for the Supreme Court. She grew up in Jackson and lives in Madison.

Supreme Court Chief Justice Mike Randolph, who appointed the judges and clerk, said he considered many from across the state and took recommendations. It was through letters of recommendation and conversations with the three judges that showed that they were the best for the position. 

“These judges have proven themselves,” Randolph said. 

House Bill 1020, passed in 2023, created the court. The CCID court was supposed to be operating last year, but it waited on a building to operate. Now business will begin operation Monday at 8 a.m. at its renovated facility at 201 S. Jefferson St., a former bus terminal in downtown. 

A graph showing the workings of the criminal justice system displayed at the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

The CCID court will hear misdemeanor cases and initial appearances for felonies investigated by Capitol Police. Those cases have been handled in the existing Hinds County court system during the interim.

“We want to stay current (with cases.) Our goal is to support and supplement the current court system,” Holland said. 

At the Friday ceremony, Gov. Tate Reeves said the court and the ongoing work of Capitol Police will help make Jackson safer. 

“Make no mistake. Jackson’s best days are ahead of us,” he said. 

Reeves stood alongside various government officials, law enforcement and lawmakers, including House Ways and Means Chairman Trey Lamar, who authored HB 1020, and Public Safety Commissioner Sean Tindell, whose agency includes Capitol Police. 

Lamar said the court will be for the regular people of Jackson who want to have their kids play safely in their yards, people who want an efficient and blind justice system and families who will be supported by future jobs that come to the city. 

HB 1020 also expanded the jurisdiction of the Capitol Police from within the district to Jackson. The district covers downtown, the area around Jackson State University, Belhaven, the hospitals, Fondren and up to Northside Drive. A bill has been proposed this session to expand the district even further. 

In recent years, Capitol Police has been built up from a former security force for government buildings into a law enforcement agency. 

The court and police expansion were touted as solutions to crime and a backlogged Hinds County court system. Pushback came from Jackson lawmakers, advocacy groups and community members and two lawsuits were filed, but they have since been resolved. 

Prosecutors from the attorney general office’s Public Integrity Unit were also appointed to work in the CCID court, but they were not announced Friday. A spokesperson said their identities will be known once the court opens. 

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

Continue Reading

Mississippi Today

UMMC refuses to answer questions about shuttered diversity office

Published

on

mississippitoday.org – Molly Minta – 2025-01-24 10:51:00

Until a few years ago, the University of Mississippi Medical Center’s press releases and social media posts regularly touted the accomplishments of faculty and staff who worked to promote diversity, equity and inclusion at the public hospital. 

In one example from 2021, the vice chancellor for health affairs, LouAnn Woodward, affirmed the hospitals’ commitment to a range of administrative efforts, centered around the Office of Diversity and Inclusion, to comply with civil rights law and increase minority enrollment.

“Diversity among our workforce and student populations and an inclusive environment are, and must always be, core considerations at the Medical Center,” Woodward said. 

Then sometime before the start of this fiscal year, UMMC closed its diversity office. 

The public hospital is now refusing to answer questions about when or why that decision was made, if any employees were let go as a result, or what happened to the more than $1 million in funding that once supported the office. 

It is unclear if UMMC announced the decision internally; the hospital did not say if it had. Partially redacted faculty senate meeting minutes from 2024, obtained through a public records request, contain no mention of the move, even though the faculty have a committee dedicated to diversity and inclusion. 

A March 2024 announcement lists the now-defunct office’s chief diversity officer among new hires at the School of Population Health, indicating UMMC may have shuttered the office around that time. 

That’s also when UMMC appears to have scrubbed the office from its website, according to the Internet Archive. The URL for the office now redirects to a web page titled “Diversity and Inclusion at UMMC” which states “throughout UMMC’s three mission areas – education, research and health care – a climate of diversity and inclusion is present.” 

Missing from the webpage are the many initiatives the diversity office oversaw, including a professional development certificate. 

While UMMC is not the only institution of higher learning in Mississippi to shutter or reimagine its efforts to foster DEI on campus, the public hospital appears unique in its reticence about the decision. 

Other institutions in Mississippi have made their plans to revamp DEI offices more accessible. Last fall, the University of Mississippi announced its decision to reinvent its diversity division in a campus-wide email from the chancellor. Earlier in the year, Mississippi State University’s vice president for access, opportunity and success appeared before faculty to discuss the reasons behind the diversity division’s new focus.

In response to questions from Mississippi Today, UMMC’s director of communications provided a written statement with the preface that the hospital would have no further comments. 

“While we no longer have that office, our commitment to access and opportunity for all students, faculty and staff remains,” Patrice Guilfoyle wrote in an email. “If we are to effectively address Mississippi’s persistent and daunting health challenges, it will take everyone working together to fulfill our tripartite mission of education, research and patient care.”

Though funding fluctuated, the office was allocated $1,029,143 during the 2023-2024 fiscal year, according to budget documents obtained through a public records request. About a third of the office’s funding came from state appropriations. 

Until its closure, it appears the office was led by a member of Woodward’s executive cabinet, a role Woodward created shortly after she was appointed in 2015, according to a press release announcing the hire. The chief diversity officer was charged with creating a strategic diversity and inclusion plan for the hospital. 

“Not only did I want this work to be represented and visible at the highest level of leadership, this new institutional role would cover all three of our missions as well as coordinate diversity and inclusion efforts between them,” Woodward said

The chief diversity officer also oversaw three employees as of fiscal year 2023, according to information UMMC reported to the state auditor that year, including a cultural competency and education manager who ran workshops on topics like health disparities and a program coordinator who worked on the office’s annual award ceremony. 

Beyond that, the office also hosted a professional development program and held monthly conversations to foster “dialogue among members of the UMMC community on stimulating topics in pursuit of sharing and understanding experiences, emotions, and different perspectives,” according to a newsletter

This legislative session, lawmakers have filed multiple bills to ban DEI at state-supported institutions of higher learning, as well as one directed at public and charter schools. Mississippi has not passed such a ban, but lawmakers may be primed to do so on the heels of President Donald Trump’s executive orders targeting DEI in the federal government. 

UMMC has in the past curtailed programs after receiving pushback from lawmakers. 

In 2023, the hospital shuttered an LGBTQ+ focused clinic months after cutting gender-affirming care for trans minors because lawmakers complained.

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

Continue Reading

Mississippi Today

What would Dr. Naismith think if he watched Ole Miss and Mississippi State?

Published

on

mississippitoday.org – Rick Cleveland – 2025-01-24 10:17:00

So, as I watched the last 90 seconds of Mississippi State’s overtime victory over Ole Miss last Saturday night at Starkville, I got to thinking: What would Dr. James Naismith, the inventor of basketball, think?

I had plenty of time to think. Because of video reviews, timeouts, fouls, free throws and more replay reviews, the last 90 seconds of playing time lasted 17 minutes of real time. The game itself took two hours, 41 minutes. That’s 161 minutes if you are keeping score, which is roughly four times the length of time the ball actually was in play.

I think I know what Naismith would think. I believe he would think: You know, this is not really what I had in mind.

Some historic perspective is necessary here. Dr. Naismith was not yet a doctor when he conjured up the game we call basketball. Later to become a doctor of both divinity and of medicine, Naismith was a recently hired YMCA training school instructor at Springfield (Mass.) College in December of 1891, 134 years and change ago. His boss, Dean Luther Gillick charged Naismith with the task of developing a new indoor sport to fill the void between football and baseball seasons. Seems the Springfield students were terribly bored with gymnastics.

Gillick told Naismith he wanted a sport that required skill and sportsmanship. He wanted a game that provided exercise for the whole body, yet a game played without extreme roughness causing damage to players and equipment. Had they watched the Rebels and Bulldogs last Saturday night, Gllick and Naismith might have covered their eyes. Extreme roughness and physicality ruled the night.

But all in all, Naismith did fairly well. Take last Saturday night, for example: Certainly none of players, nor the more than 9,000 fans at The Hump, were the least bit bored, except for during the numerous replay reviews. 

Given his advanced degree in divinity, Naismith probably would admit he was fortunate in some ways. For instance, after sketching out his idea for the sport, Naismith sent a janitor in search of two 15-inch by 15-inch boxes to hang at either end of the gymnasium. Basketball was almost boxball. Hoops was almost squares. The janitor couldn’t find the appropriate boxes and returned to Naismith carrying two peach baskets. And, yes, the baskets had bottoms. Initially a ladder was needed to retrieve the ball after made baskets.

Naismith’s class had 18 students. So it was the first game of basketball matched nine against nine. Tacking, pushing, holding and tripping were prohibited, but, then, so was dribbling. Clearly, as Bob Cousy, Pete Maravich, Juju Murray and Josh Hubbard have illustrated, the game would evolve. The first game, played with a soccer ball, ended with the score one to nothing. Accuracy has evolved, too.

Naismith’s game quickly grew in popularity, especially In the northeast. Naismith became something of a hero. In fact, some folks suggested the new sport be called Naismith-ball. To his everlasting credit, Naismith flatly rejected the idea.

You, as I, may wonder how some of the terms we use in basketball today came about. For instance, the player who patrols the area closest to the goal is often called the post-man even though there is no mail involved. Sometimes, he plays the low post. Sometimes, he moves farther away from the basketball and plays the high post. Why post? Glad you asked. Back in Naismith’s day, most gyms, including the one in Springfield, had posts in the middle of the courts to hold up the ceilings. The players had to maneuver around the posts. The player who played near the posts closest to the baskets was called the post-man.

Back then, many of the courts were elevated and doubled as stages (think Memorial Coliseum at Vanderbilt). There was an inherent danger of players falling off the stages and breaking legs, arms and noggins. Netting was often put up around the courts to protect the players from such danger, giving the playing floor the visual effect of a cage. And that’s why basketball players are often still referred to a cagers. Now you know.

Women took to the sport from almost the very beginning. The first women’s game was played in 1892 at Northampton, Mass. Men were not allowed to attend because the women played the game in bloomers. Uniforms, too, have evolved.

“Basketball,” Naismith wrote, “is a game to play. You don’t coach it.” Chris Jans and Chris Beard, two guys who make millions, surely would disagree. But maybe Naismith had the right idea. All that coaching – which happens mostly during TV timeouts – is part of what makes the last 90 seconds of a close game last more than 10 times that long.

In his book about basketball, Naismith wrote, “Let us all be able to lose gracefully and to win courteously; to accept criticism as well as praise; and, last of all, to appreciate the attitude of the other fellow at all times.”

Dr. Naismith, we can reasonably surmise, would not have appreciated the numerous refrains of “Go to hell Ole Miss” and “ref, you suck” last Saturday night.

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

Continue Reading

Trending