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

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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.

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Mississippi Today

Mississippi River flooding Vicksburg, expected to crest on Monday

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mississippitoday.org – @alxrzr – 2025-04-25 16:04:00

Warren County Emergency Management Director John Elfer said Friday floodwaters from the Mississippi River, which have reached homes in and around Vicksburg, will likely persist until early May. Elfer estimated there areabout 15 to 20 roads underwater in the area.

A truck sits in high water after the owner parked, then boated to his residence on Chickasaw Road in Vicksburg as a rising Mississippi River causes backwater flooding, Friday, April 25, 2025.

“We’re about half a foot (on the river gauge) from a major flood,” he said. “But we don’t think it’s going to be like in 2011, so we can kind of manage this.”

The National Weather projects the river to crest at 49.5 feet on Monday, making it the highest peak at the Vicksburg gauge since 2020. Elfer said some residents in north Vicksburg — including at the Ford Subdivision as well as near Chickasaw Road and Hutson Street — are having to take boats to get home, adding that those who live on the unprotected side of the levee are generally prepared for flooding.

A rising Mississippi River causing backwater flooding near Chickasaw Road in Vicksburg, Friday, April 25, 2025.
Old tires aligned a backyard as a deterrent to rising water north of Vicksburg along U.S. 61, Friday, April 25, 2025.
As the Mississippi River rises, backwater flooding creeps towards a home located on Falk Steel Road in Vicksburg, Friday, April 25, 2025.

“There are a few (inundated homes), but we’ve mitigated a lot of them,” he said. “Some of the structures have been torn down or raised. There are a few people that still live on the wet side of the levee, but they kind of know what to expect. So we’re not too concerned with that.”

The river first reached flood stage in the city — 43 feet — on April 14. State officials closed Highway 465, which connects the Eagle Lake community just north of Vicksburg to Highway 61, last Friday.

Flood waters along Kings Point Road in Vicksburg, Friday, April 25, 2025.

Elfer said the areas impacted are mostly residential and he didn’t believe any businesses have been affected, emphasizing that downtown Vicksburg is still safe for visitors. He said Warren County has worked with the U.S. Army Corps of Engineers and the Mississippi Emergency Management Agency to secure pumps and barriers.

“Everybody thus far has been very cooperative,” he said. “We continue to tell people stay out of the flood areas, don’t drive around barricades and don’t drive around road close signs. Not only is it illegal, it’s dangerous.”

NWS projects the river to stay at flood stage in Vicksburg until May 6. The river reached its record crest of 57.1 feet in 2011.

The boat launch area is closed and shored up on Levee Street in Vicksburg as the Mississippi River rises, Friday, April 25, 2025.
The boat launch area (right) is closed and under water on Levee Street in Vicksburg as the Mississippi River rises, Friday, April 25, 2025.
City of Vicksburg workers shore up the bank along Levee Street as the Mississippi River rises, Friday, April 25, 2025.
The old pedestrian bridge spanning the Mississippi River in Vicksburg, Friday, April 25, 2025.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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With domestic violence law, victims ‘will be a number with a purpose,’ mother says

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mississippitoday.org – @MSTODAYnews – 2025-04-25 15:07:00

Joslin Napier. Carlos Collins. Bailey Mae Reed. 

They are among Mississippi domestic violence homicide victims whose family members carried their photos as the governor signed a bill that will establish a board to study such deaths and how to prevent them. 

Tara Gandy, who lost her daughter Napier in Waynesboro in 2022, said it’s a moment she plans to tell her 5-year-old grandson about when he is old enough. Napier’s presence, in spirit, at the bill signing can be another way for her grandson to feel proud of his mother. 

“(The board) will allow for my daughter and those who have already lost their lives to domestic violence … to no longer be just a number,” Gandy said. “They will be a number with a purpose.” 

Family members at the April 15 private bill signing included Ashla Hudson, whose son Collins, died last year in Jackson. Grandparents Mary and Charles Reed and brother Colby Kernell attended the event in honor of Bailey Mae Reed, who died in Oxford in 2023. 

Joining them were staff and board members from the Mississippi Coalition Against Domestic Violence, the statewide group that supports shelters and advocated for the passage of Senate Bill 2886 to form a Domestic Violence Facility Review Board. 

The law will go into effect July 1, and the coalition hopes to partner with elected officials who will make recommendations for members to serve on the board. The coalition wants to see appointees who have frontline experience with domestic violence survivors, said Luis Montgomery, public policy specialist for the coalition. 

A spokesperson from Gov. Tate Reeves’ office did not respond to a request for comment Friday.

Establishment of the board would make Mississippi the 45th state to review domestic violence fatalities. 

Montgomery has worked on passing a review board bill since December 2023. After an unsuccessful effort in 2024, the coalition worked to build support and educate people about the need for such a board. 

In the recent legislative session, there were House and Senate versions of the bill that unanimously passed their respective chambers. Authors of the bills are from both political parties. 

The review board is tasked with reviewing a variety of documents to learn about the lead up and circumstances in which people died in domestic violence-related fatalities, near fatalities and suicides – records that can include police records, court documents, medical records and more. 

From each review, trends will emerge and that information can be used for the board to make recommendations to lawmakers about how to prevent domestic violence deaths. 

“This is coming at a really great time because we can really get proactive,” Montgomery said. 

Without a board and data collection, advocates say it is difficult to know how many people have died or been injured in domestic-violence related incidents.

A Mississippi Today analysis found at least 300 people, including victims, abusers and collateral victims, died from domestic violence between 2020 and 2024. That analysis came from reviewing local news stories, the Gun Violence Archive, the National Gun Violence Memorial, law enforcement reports and court documents. 

Some recent cases the board could review are the deaths of Collins, Napier and Reed. 

In court records, prosecutors wrote that Napier, 24, faced increased violence after ending a relationship with Chance Fabian Jones. She took action, including purchasing a firearm and filing for a protective order against Jones.

Jones’s trial is set for May 12 in Wayne County. His indictment for capital murder came on the first anniversary of her death, according to court records. 

Collins, 25, worked as a nurse and was from Yazoo City. His ex-boyfriend Marcus Johnson has been indicted for capital murder and shooting into Collins’ apartment. Family members say Collins had filed several restraining orders against Johnson. 

Johnson was denied bond and remains in jail. His trial is scheduled for July 28 in Hinds County.  

He was a Jackson police officer for eight months in 2013. Johnson was separated from the department pending disciplinary action leading up to immediate termination, but he resigned before he was fired, Jackson police confirmed to local media. 

Reed, 21, was born and raised in Michigan and moved to Water Valley to live with her grandparents and help care for her cousin, according to her obituary. 

Kylan Jacques Phillips was charged with first degree murder for beating Reed, according to court records. In February, the court ordered him to undergo a mental evaluation to determine if he is competent to stand trial, according to court documents. 

At the bill signing, Gandy said it was bittersweet and an honor to meet the families of other domestic violence homicide victims.

“We were there knowing we are not alone, we can travel this road together and hopefully find ways to prevent and bring more awareness about domestic violence,” she said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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Court to rule on DeSoto County Senate districts with special elections looming

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mississippitoday.org – @MSTODAYnews – 2025-04-25 15:06:00

A federal three-judge panel will rule in coming days on how political power in northwest Mississippi will be allocated in the state Senate and whether any incumbents in the DeSoto County area might have to campaign against each other in November special elections.  

The panel, comprised of all George W. Bush-appointed judges, ordered state officials last week to, again, craft a new Senate map for the area in the suburbs of Memphis. The panel has held that none of the state’s prior maps gave Black voters a realistic chance to elect candidates of their choice. 

The latest map proposed by the all-Republican State Board of Election Commissioners tweaked only four Senate districts in northwest Mississippi and does not pit any incumbent senators against each other. 

The state’s proposal would keep the Senate districts currently held by Sen. Michael McLendon, a Republican from Hernando and Sen. Kevin Blackwell, a Republican from Southaven, in majority-white districts. 

But it makes Sen. David Parker’s district a slightly majority-Black district. Parker, a white Republican from Olive Branch, would run in a district with a 50.1% black voting-age population, according to court documents. 

The proposal also maintains the district held by Sen. Reginald Jackson, a Democrat from Marks, as a majority-Black district, although it reduces the Black voting age population from 61% to 53%.  

Gov. Tate Reeves, Secretary of State Michael Watson, and Attorney General Lynn Fitch comprise the State Board of Election Commissioners. Reeves and Watson voted to approve the plan. But Watson, according to meeting documents, expressed a wish that the state had more time to consider different proposals. 

Fitch did not attend the meeting, but Deputy Attorney General Whitney Lipscomb attended in her place. Lipscomb voted against the map, although it is unclear why. Fitch’s office declined to comment on why she voted against the map because it involves pending litigation. 

The reason for redrawing the districts is that the state chapter of the NAACP and Black voters in the state sued Mississippi officials for drawing legislative districts in a way that dilutes Black voting power. 

The plaintiffs, represented by the ACLU, are likely to object to the state’s newest proposal, and they have until April 29 to file an objection with the court

The plaintiffs have put forward two alternative proposals for the area in the event the judges rule against the state’s plans. 

The first option would place McLendon and Blackwell in the same district, and the other would place McLendon and Jackson in the same district. 

It is unclear when the panel of judges will issue a ruling on the state’s plan, but they will not issue a ruling until the plaintiffs file their remaining court documents next week. 

While the November election is roughly six months away, changing legislative districts across counties and precincts is technical work, and local election officials need time to prepare for the races. 

The judges have not yet ruled on the full elections calendar, but U.S. Fifth Circuit Court of Appeals Judge Leslie Southwick said at a hearing earlier this month that the panel was committed have the elections in November. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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