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

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
Mississippi Legislature approves DEI ban after heated debate
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.
Mississippi Today
House gives Senate 5 p.m. deadline to come to table, or legislative session ends with no state budget
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.
Mississippi Today
Amount of federal cuts to health agencies doubles
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.
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.

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.
-
Mississippi Today24 hours ago
Pharmacy benefit manager reform likely dead
-
News from the South - Alabama News Feed6 days ago
Severe storms will impact Alabama this weekend. Damaging winds, hail, and a tornado threat are al…
-
News from the South - Alabama News Feed5 days ago
University of Alabama student detained by ICE moved to Louisiana
-
News from the South - Oklahoma News Feed4 days ago
Tornado watch, severe thunderstorm warnings issued for Oklahoma
-
News from the South - Virginia News Feed5 days ago
Youngkin removes Ellis, appoints Cuccinelli to UVa board | Virginia
-
News from the South - Florida News Feed7 days ago
Peanut farmer wants Florida water agency to swap forest land
-
News from the South - Kentucky News Feed6 days ago
A little early morning putting at the PGA Tour Superstore
-
News from the South - Georgia News Feed4 days ago
Georgia road project forcing homeowners out | FOX 5 News