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Louisianans on Medicaid expansion can get care across river at Natchez hospital

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Louisianans on Medicaid expansion can get care across river at Natchez hospital

by Bobby Harrison, Mississippi Today
November 30, 2022

Just across the Mississippi River bridge from Natchez are the Louisiana towns of Vidalia, Ferriday and other communities where there are people who have health care coverage through the expansion of Medicaid.

Those Louisianans, if they are in the correct Medicaid health care network, can obtain medical services across the bridge in Mississippi at Merit Natchez hospital. People in Mississippi, of course, also can receive health care at Merit, one of the largest health care providers in southwest Mississippi.

But those Mississippians cannot take advantage of Medicaid expansion to help pay their medical bills because Mississippi, unlike Louisiana, does not have Medicaid expansion.

“Expanding Medicaid was Gov. (John Bell) Edwards’ first official act when he took office in 2016,” Laura Leist, a spokeswoman for the Democratic governor, told Mississippi Today via email. “He often says it’s the easiest big decision he’s made as governor.”

Kay Ketchings, a spokesperson for the Natchez hospital, said Merit will work with Louisianans who are not in network to provide them medical care as it will with Mississippians who have no access to Medicaid expansion. But Merit Natchez, like other Mississippi hospitals, have a difficult time collecting payment from many poor people who are not covered by Medicaid expansion. They often do not have the money to pay, leaving hospitals to eat those costs or pass the costs on to other patients.

“Medicaid covers the most vulnerable residents in Mississippi …,” Ketchings said. “It is an important step toward advancing the overall health of Mississippians because it provides sustainable coverage for continued access to preventive care and physician assistance with chronic conditions. Like others in healthcare, we are supportive of efforts to expand coverage for vulnerable Mississippians.”

Louisiana is one of the few Southern states to expand Medicaid. Medicaid provides health care coverage for primarily the working poor who earn up to 138% of the federal poverty level or about $18,750 for an individual. The federal government pays 90% of the cost plus substantial incentives for the states that have not expanded Medicaid to do so.

South Dakota voters earlier this month voted to expand Medicaid. Now 11 states, mostly in the Southeast, have not taken advantage of the expansion as is offered as part of the Patient Protection and Affordable Care Act, also known as Obamacare.

A map of the states that have not expanded Medicaid looks much the same as a footprint of the NCAA’s Southeastern Conference with four notable exceptions – Arkansas, Louisiana, Kentucky and Missouri. Those four states, including two contiguous to Mississippi, have expanded Medicaid.

Of the 11 states that have not expanded Medicaid, seven have schools in the Southeastern Conference, and all seven have higher percentages of their population uninsured or lacking health care coverage than does the nation at a whole.

The four SEC states that have expanded Medicaid have higher percentages of their population with health insurance coverage than those that have not expanded Medicaid.

“Today, more than 747,000 of Louisiana’s working poor have access to health care, including mammograms and other preventive heath screenings, mental health resources and substance abuse services,” said Leist. “Louisiana’s uninsured rate has dropped from 22.7% in 2015 prior to expansion to just 9.4%, and rural hospitals that were on the verge of closing before expansion have been able to stay open and continue serving their communities.”

In Mississippi, the Hospital Association, with many of its member medical centers in financial straits, is one of the most vocal supporters of Medicaid expansion. Mississippi's State Health Officer Daniel Edney has said that 38, or 54%, of the state’ rural hospitals are in danger of closing. Hospital Association officials say Medicaid expansion would provide a boost to those struggling hospitals by decreasing the amount of uncompensated care they deliver.

But Mississippi political leaders have blocked efforts to expand Medicaid. They have provided a litany of reasons for opposing the expansion, ranging from the state cannot afford it to not wanting to expand welfare programs in the state.

Susan Dunlap, a spokesperson for Kentucky Gov. Andy Beshear, a Democrat, said Medicaid expansion has been a positive in the Bluegrass state.

“Costs to the state have matched what was anticipated,” she said. “Expansion of this program resulted in economic growth through increased state and local tax revenue, the creation of new jobs and additional (health care) provider revenue.”

She said the expansion has resulted in people being able to get medical care, including important but non-life threatening procedures, such as knee replacements, shoulder surgeries and tonsillectomies.

In three Southern states, Louisiana, Arkansas and Kentucky, Medicaid was expanded under Democratic governors. But in those states, the expansion has been largely supported by Republican-controlled legislatures that have not tried to repeal the program. And in Arkansas, it has been continued under a Republican governor. And Arkansas-Gov. elect Sarah Huckabee Sanders, former spokesperson for President Donald Trump, has not advocated for the repeal of that state’s version of Medicaid expansion. In Arkansas, the state uses the federal Medicaid expansion matching funds to purchase private insurance for those who otherwise would be eligible for the Medicaid expansion program.

“Out of the 38 (states that have expanded Medicaid), none have stopped,” Tim Moore, chief executive with the Mississippi Hospital Association, recently told the Senate Public Health Committee during a hearing on the financial difficulties facing Mississippi hospitals.

“They continue to use it. They continue to take down federal dollars. It has been a good thing for everybody, including the state, the patients and the providers.”

The states with the highest uninsured rates in the nation are primarily Southern states that have not expanded Medicaid. Texas is the highest at 18.4%, while Georgia and Florida are at 13.2% followed by Mississippi at 13%, according to a recent report by the Health Foundation.

The national uninsured rate is 9.2%, according to the same study. The Southern states that have expanded Medicaid all have uninsured rates near or below the national average. Kentucky's uninsured rate is 6.4%.

Uninsured rates across the national have declined significantly since the 2010 passage of the Affordable Care Act that also includes the health care exchange that allows people to buy insurance coverage in most cases with the help of a government subsidy.

But there are people who do not qualify for health insurance policies through the health care exchange because their income is below a certain level. The architects of the Affordable Care Act envisioned they would be covered through Medicaid expansion, not contemplating there would be states like Mississippi that opted not to participate in the program.

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

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On this day in 1977, Alex Haley awarded Pulitzer for ‘Roots’

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April 19, 2025

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On this day in 1977, Alex Haley awarded Pulitzer for 'Roots'

mississippitoday.org – @MSTODAYnews – 2025-04-19 07:00:00

by Jerry Mitchell, Mississippi Today
April 19, 2025

April 19, 1977

Alex Haley was awarded a special Pulitzer Prize for “Roots,” which was also adapted for television. 

Network executives worried that the depiction of the brutality of the slave experience might scare away viewers. Instead, 130 million Americans watched the epic miniseries, which meant that 85% of U.S. households watched the program. 

The miniseries received 36 Emmy nominations and won nine. In 2016, the History Channel, Lifetime and A&E remade the miniseries, which won critical acclaim and received eight Emmy nominations.

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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Speaker White wants Christmas tree projects bill included in special legislative session

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April 18, 2025

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Speaker White wants Christmas tree projects bill included in special legislative session

mississippitoday.org – @MSTODAYnews – 2025-04-18 10:38:00

by Taylor Vance, Mississippi Today
April 18, 2025

House Speaker Jason White sent a terse letter to Lt. Gov. Delbert Hosemann on Thursday, saying House leaders are frustrated with Senate leaders refusing to discuss a “Christmas tree” bill spending millions on special projects across the state. 

The letter signals the two Republican leaders remain far apart on setting an overall $7 billion state budget. Bickering between the GOP leaders led to a stalemate and lawmakers ending their regular 2025 session without setting a budget. Gov. Tate Reeves plans to call them back into special session before the new budget year starts July 1 to avoid a shutdown, but wants them to have a budget mostly worked out before he does so.

White’s letter to Hosemann, which contains words in all capital letters that are underlined and italicized, said that the House wants to spend cash reserves on projects for state agencies, local communities, universities, colleges, and the Mississippi Department of Transportation.

“We believe the Senate position to NOT fund any local infrastructure projects is unreasonable,” White wrote. 

The speaker in his letter noted that he and Hosemann had a meeting with the governor on Tuesday. Reeves, according to the letter, advised the two legislative leaders that if they couldn’t reach an agreement on how to disburse the surplus money, referred to as capital expense money, they should not spend any of it on infrastructure. 

A spokesperson for Hosemann said the lieutenant governor has not yet reviewed the letter, and he was out of the office on Thursday working with a state agency. 

“He is attending Good Friday services today, and will address any correspondence after the celebration of Easter,” the spokesperson said. 

READ MORE: Mississippi lawmakers end 2025 session unable to agree (or even meet about) state budget: Legislative recap

Hosemann has recently said the Legislature should set an austere budget in light of federal spending cuts coming from the Trump administration, and because state lawmakers this year passed a measure to eliminate the state income tax, the source of nearly a third of the state’s operating revenue.

Lawmakers spend capital expense money for multiple purposes, but the bulk of it — typically $200 million to $400 million a year — goes toward local projects, known as the Christmas Tree bill. Lawmakers jockey for a share of the spending for their home districts, in a process that has been called a political spoils system — areas with the most powerful lawmakers often get the largest share, not areas with the most needs. Legislative leaders often use the projects bill as either a carrot or stick to garner votes from rank and file legislators on other issues. 

A Mississippi Today investigation last year revealed House Ways and Means Chairman Trey Lamar, a Republican from Sentobia, has steered tens of millions of dollars in Christmas tree spending to his district, including money to rebuild a road that runs by his north Mississippi home, renovate a nearby private country club golf course and to rebuild a tiny cul-de-sac that runs by a home he has in Jackson.

There is little oversight on how these funds are spent, and there is no requirement that lawmakers disburse the money in an equal manner or based on communities’ needs. 

In the past, lawmakers borrowed money for Christmas tree bills. But state coffers have been full in recent years largely from federal pandemic aid spending, so the state has been spending its excess cash. White in his letter said the state has “ample funds” for a special projects bill.

“We, in the House, would like to sit down and have an agreement with our Senate counterparts on state agency Capital Expenditure spending AND local projects spending,” White wrote. “It is extremely important to our agencies and local governments. The ball is in your court, and the House awaits your response.”

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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Advocate: Election is the chance for Jackson to finally launch in the spirit of Blue Origin

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April 18, 2025

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Advocate: Election is the chance for Jackson to finally launch in the spirit of Blue Origin

mississippitoday.org – @BobbyHarrison9 – 2025-04-18 10:05:00

by Pauline Rogers, Mississippi Today
April 18, 2025

Editor’s note: This essay is part of Mississippi Today Ideas, a platform for thoughtful Mississippians to share fact-based ideas about our state’s past, present and future. You can read more about the section here.

As the world recently watched the successful return of Blue Origin’s historic all-women crew from space, Jackson stands grounded. The city is still grappling with problems that no rocket can solve.

But the spirit of that mission — unity, courage and collective effort — can be applied right here in our capital city. Instead of launching away, it is time to launch together toward a more just, functioning and thriving Jackson.

The upcoming mayoral runoff election on April 22 provides such an opportunity, not just for a new administration, but for a new mindset. This isn’t about endorsements. It’s about engagement.

It’s a moment for the people of Jackson and Hinds County to take a long, honest look at ourselves and ask if we have shown up for our city and worked with elected officials, instead of remaining at odds with them.

Pauline Rogers

It is time to vote again — this time with deeper understanding and shared responsibility. Jackson is in crisis — and crisis won’t wait.

According to the U.S. Census projections, Jackson is the fastest-shrinking city in the United States, losing nearly 4,000 residents in a single year. That kind of loss isn’t just about numbers. It’s about hope, resources, and people’s decision to give up rather than dig in.

Add to that the long-standing issues: a crippled water system, public safety concerns, economic decline and a sense of division that often pits neighbor against neighbor, party against party and race against race.

Mayor Chokwe Antar Lumumba has led through these storms, facing criticism for his handling of the water crisis, staffing issues and infrastructure delays. But did officials from the city, the county and the state truly collaborate with him or did they stand at a distance, waiting to assign blame?

On the flip side, his runoff opponent, state Sen. John Horhn, who has served for more than three decades, is now seeking to lead the very city he has represented from the Capitol. Voters should examine his legislative record and ask whether he used his influence to help stabilize the administration or only to position himself for this moment.

Blaming politicians is easy. Building cities is hard. And yet that is exactly what’s needed. Jackson’s future will not be secured by a mayor alone. It will take so many of Jackson’s residents — voters, business owners, faith leaders, students, retirees, parents and young people — to move this city forward. That’s the liftoff we need.

It is time to imagine Jackson as a capital city where clean, safe drinking water flows to every home — not just after lawsuits or emergencies, but through proactive maintenance and funding from city, state and federal partnerships. The involvement of the U.S. Environmental Protection Agency in the effort to improve the water system gives the city leverage.

Public safety must be a guarantee and includes prevention, not just response, with funding for community-based violence interruption programs, trauma services, youth job programs and reentry support. Other cities have done this and it’s working.

Education and workforce development are real priorities, preparing young people not just for diplomas but for meaningful careers. That means investing in public schools and in partnerships with HBCUs, trade programs and businesses rooted right here.

Additionally, city services — from trash collection to pothole repair — must be reliable, transparent and equitable, regardless of zip code or income. Seamless governance is possible when everyone is at the table.

Yes, democracy works because people show up. Not just to vote once, but to attend city council meetings, serve on boards, hold leaders accountable and help shape decisions about where resources go.

This election isn’t just about who gets the title of mayor. It’s about whether Jackson gets another chance at becoming the capital city Mississippi deserves — a place that leads by example and doesn’t lag behind.

The successful Blue Origin mission didn’t happen by chance. It took coordinated effort, diverse expertise and belief in what was possible. The same is true for this city.

We are not launching into space. But we can launch a new era marked by cooperation over conflict, and by sustained civic action over short-term outrage.

On April 22, go vote. Vote not just for a person, but for a path forward because Jackson deserves liftoff. It starts with us.

Pauline Rogers is a longtime advocate for criminal justice reform and the founder of the RECH Foundation, an organization dedicated to supporting formerly incarcerated individuals as they reintegrate into society. She is a Transformative Justice Fellow through The OpEd Project Public Voices Fellowship.

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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