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Medicaid expansion bill inches forward in Senate with few details

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Senate Republican leaders continue to keep any particulars of their Medicaid expansion plans close to the vest, with a committee passing only a shell of a bill Tuesday to meet a deadline and keep it alive.

Meanwhile, a Medicaid expansion bill the House passed last week sits untouched in the Senate, and the two Republican-led chambers do not appear to be in sync on the issue.

Senate leaders have said they are dead set on any expansion of Medicaid coverage including a work requirement for recipients. This would require federal approval, which many say is unlikely. The House version includes a work requirement, but says the program would still be expanded even if the feds don’t approve a work requirement.

“If no work requirements, no expansion,” Senate Medicaid Chairman Kevin Blackwell, R-Southaven, said about the bill he calls “expansion light.”

Senate Bill 2735, authored by Blackwell, remains only a skeleton bill bringing forth the code sections necessary to expand Medicaid, with details to be hashed out later.

On Tuesday, Blackwell spent 25 seconds explaining the bill to committee members and 15 seconds counting a committee vote. Rita Potts Parks, R-Corinth, was the only No vote.

No questions were asked in committee.

Blackwell said the Senate measure, like the House plan, likely would raise the income eligibility for Medicaid coverage to 138% of the federal poverty level, up to about $20,000 annually for an individual. He said the plan would likely require Medicaid expansion recipients to pay premiums on a sliding scale based on income. 

READ MORE: ‘Moral imperative’: House overwhelmingly passes Mississippi Medicaid expansion

Mississippi is one of 10 states that has not expanded Medicaid to cover the working poor with the federal government picking up at least 90% of the cost. For the last decade, most Republican leaders, including now Gov. Tate Reeves, have decried expansion as “Obamacare” and “welfare” and the issue has not even garnered serious discussion or hearings in recent years.

But polls have shown growing support for expansion — even among Republicans — as Mississippi’s hospitals founder from providing free care to the uninsured and the state continues to have health statistics and outcomes that rival Third World areas.

New Republican House Speaker Jason White supports expansion, and second-term Lt. Gov. Delbert Hosemann has said he’s open to it and wants to help create a healthier workforce in Mississippi.

A prerequisite that Mississippi’s plan have a work requirement could kill its expansion. During the Biden administration, federal Centers for Medicaid Services has rescinded work requirements previously approved for other states during the Trump administration and has not approved new ones. Georgia remains in litigation with federal government over the work requirement issue.

Blackwell and other Senate Republicans realize the realpolitik of getting a work requirement approved, and say implementing expansion could perhaps be pushed back until after this year’s presidential election, so a new administration might approve a work requirement.

While both House and Senate leaders say they support a work requirement, the one in House Bill 1725 – which overwhelmingly passed the House – is only a “best-case scenario.” The bill has a provision that if federal authorities do not approve the waiver necessary to allow a Mississippi work requirement is not granted by Sept. 30, 2024, Medicaid would still be fully expanded to people up to 138% of the federal poverty level, starting in January 2025.

Blackwell said he doesn’t believe an expansion bill could garner the votes it needs from the Senate without the work requirement.

“Their [House] bill has a component, the first section, for the working people,” Blackwell said. “But if CMS comes back and says they’re not going to accept that, it’s traditional expansion. And we’re not going to get that passed over on this side.”

Senator Chad McMahan, R-Guntown, a member of the Medicaid committee, said he is in favor of expansion — both because he knows his constituents support it, and also because of his personal experiences growing up in a low-income, working-class family.

“I came from a family that didn’t have health insurance for a number of years,” McMahan said, “and I saw the fear in my mom and dad’s face when I got hurt and they had to decide about paying a car note, paying a house note or paying medical bills. And that’s why I’m sympathetic to the legislation. Working people in this state need a safety net, they need a way to access some basic medical care.”

But he said he would have a hard time supporting an expansion bill that had no work requirement.

“There’s a difference between just giving handouts and giving people a hand up to help them,” McMahan said. “I want to provide the working people of this state an opportunity to have some type of health care if their employer doesn’t provide that.”

Blackwell said the Senate bill could perhaps contain language and dates to allow a new presidential administration to take office — and approve a work waiver — before expansion would start.

“I’d love for there to be a change and I think the rest of the country would love for there to be a change,” he said. “We’ll just have to see whatever timeframes we put in are going to try to accommodate that potential change.”

McMahan said, “I think the work requirement is a big piece of it for Republicans. It’s got to be a helping hand. We have the lowest work participation rate in the United States. And if we can figure out a way to help people go to work and provide some health care, I’m for that.”

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

Mississippi Today

Gloster residents protest Drax’s new permit request

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mississippitoday.org – Alex Rozier – 2024-11-15 13:33:00

GLOSTER — Drax, the United Kingdom-based wood pellet producer that’s violated air pollution limits in Mississippi multiple times, is asking the state to raise the amount of emissions it’s allowed to release from its facility in Gloster.

In September, the state fined Drax $225,000 for releasing 50% over the permitted limit of HAPs, or Hazardous Air Pollutants, from its facility Amite BioEnergy. In a pending permit application that it submitted to the Mississippi Department of Environmental Quality in 2022, the company is seeking to transition from a “minor source” of HAPs to a “major source.”

A “major source” permit would remove the limit over the facility’s total HAP emissions, but it would apply a new limit over the rate at which Drax could release the pollutants.

This year’s fine was its second penalty for violating Mississippi law around air pollution limits. In 2020, the state fined the company $2.5 million for releasing over three times the legal threshold of Volatile Organic Compounds, or VOCs, one of the largest such fines in state history. Drax underestimated its VOC releases since the facility opened in 2016, but didn’t realize it until 2018. The facility didn’t come into compliance until 2021.

The Environmental Protection Agency lists a variety of potential health impacts from exposure to HAPs, including damage to the immune system and respiratory issues. VOCs can also cause breathing problems, as well as eye, nose and throat irritation, according to the American Lung Association.

About sixty people packed into a Gloster public library for MDEQ’s public hearing over Drax’s permit application on Nov. 14, 2024.

For years since Drax’s violations became public, nearby residents have attributed health issues to living near the facility. During a public hearing on Drax’s permit request Thursday in Gloster, attendees reiterated those concerns.

“We all experience headaches every day,” resident Christie Harvey said about her and her grandchildren. Harvey said she has asthma too, and her doctor was “baffled” by her symptoms. “Each week I have to take (my grandchildren) to the clinic for upper respiratory issues … It’s not fair that we have to go through this. Drax needs to lower the pollution as much as possible.”

Part of the public outcry is the proximity of people’s homes to the plant, which is within a mile of Gloster’s downtown.

A screenshot of Google Maps showing the location of Drax’s Amite BioEnergy facility relative to the rest of Gloster. The facility is within a mile of the downtown area.

“The wood pellet plant in Lucedale is situated in an industrial park outside of town,” Andrew Whitehurst of Healthy Gulf, an environmental group dedicated to protecting the Gulf of Mexico’s natural resources, said at the meeting. “The wood pellet plant that (Enviva is) trying to put in Bond will be situated north and west of the downtown area. Not like this when it’s right smack in the middle (of the city). It’s totally inappropriate. People can’t take it, they don’t deserve it.”

In a statement to Mississippi Today, Drax said it prioritizes the public health and environment in Gloster, adding that the permit modification is a part of standard business practice.

“When we first began operations, some of our original permits were not fit for purpose,” spokesperson Michelli Martin said via e-mail. “We are now working to acquire the appropriate permits for our operating output and to improve our compliance. Within these permits the requirements may change based on engineering data and industry standards. This permit modification is part of our ongoing plan to provide MDEQ with the most accurate data. Drax fully supports the resolution of our permitting request and looks forward to working with MDEQ to finalize the details.”

While researchers, including from Brown University, are studying the health symptoms of residents near the wood pellet plant, there is no proven connection between the facility’s emissions and those symptoms.

Erica Walker, a Jackson native who teaches epidemiology at Brown and who’s leading the study, spoke to Mississippi Today earlier this year. Regardless of the cause and effect, she said, the decision to put the plant near disadvantaged communities with poor health outcomes is concerning.

“We want to make sure we aren’t additionally burdening already burdened communities,” Walker said.

Operations resume at Drax in Gloster, Miss., on Friday, Feb. 16, 2024. Some Gloster residents are concerned with the industrial pollution caused by the company that produces wood pellets in the town. Credit: Eric J. Shelton/Mississippi Today

About 1,300 people live in the city, according to Census data, and 39% live below the poverty line.

Moreover, Gloster residents often have to travel hours, to cities such as McComb and Baton Rouge, to find the nearest medical specialist. Amite County, where Gloster is, has a higher rate of uninsured residents than the rest of the state, according to County Health Rankings, and the ratio of residents to primary care physicians is over three times greater in the county than Mississippi as a whole.

As part of its application, Drax is seeking a Title V permit under the Clean Air Act, which the EPA requires for major sources of air pollutants. This gives the EPA the opportunity to review Drax’s application and public comments submitted with it. The public can submit comments on the application until Nov. 26, and can do so through MDEQ’s website.

The Mississippi Environmental Quality Permit Board, which is made up of officials from several state agencies, will then decide whether or not to grant the new permits. A full overview of the process and Drax’s application is available online.

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

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Mississippi receives ‘F’ rating on preterm birth rate

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mississippitoday.org – Sophia Paffenroth – 2024-11-15 10:11:00

Mississippi received an F grade for its rate of preterm births in 2023 – those occurring before 37 weeks gestation – from the 2024 March of Dimes report card

Mississippi’s preterm birth rate was 15%, the worst in the country. Any state with a rate greater than 11.5% also received an F. The U.S. average was 10.4%. 

Preterm births in Mississippi have risen steadily over the last decade, increasingly nearly 2% since 2013. In Jackson, the state capital, nearly one in five babies are born preterm, according to the report. 

“As a clinician, I know the profound impact that comprehensive prenatal care has on pregnancy outcomes for both mom and baby,” Dr. Amanda P. Williams, interim chief medical officer at March of Dimes, said in a press release. “Yet, too many families, especially those from our most vulnerable communities, are not receiving the support they need to ensure healthy pregnancies and births. The health of mom and baby are intricately intertwined. If we can address chronic health conditions and help ensure all moms have access to quality prenatal care, we can help every family get the best possible start.” 

In addition to inadequate prenatal care, factors such as smoking, hypertension, diabetes and unhealthy weight can cause people to be more likely to have a preterm birth.

The report highlighted several other metrics, including infant mortality – in which Mississippi continues to lead the nation. 

In 2022, 316 babies in the state died before their first birthday. Among babies born to Black mothers, the infant mortality rate is 1.3 times higher. 

The state’s maternal mortality rate of 39.1 per 100,000 live births is nearly double the national average of 23.2.

Mississippi has yet to expand Medicaid – one of only 10 states not to do so – and tens of thousands of working Mississippians remain without health insurance. It also has not implemented paid family leave, doula reimbursement by Medicaid, or supportive midwifery policies – all of which March of Dimes says are critical to improving and sustaining infant and maternal health care.

The Legislature passed a law last session that would make timely prenatal care easier for expectant mothers, but more than four months after the law was supposed to go into effect, pregnant women still can’t access the temporary coverage.

“March of Dimes is committed to advocating for policies that make healthcare more accessible like Medicaid expansion, addressing the root causes of disparities, and increasing awareness of impactful solutions like our Low Dose, Big Benefits campaign, which supports families and communities to take proactive steps toward healthy pregnancies,” Cindy Rahman, March of Dimes interim president and CEO, said in a press release.

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

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Mississippi Today

On this day in 2017

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mississippitoday.org – Jerry Mitchell – 2024-11-15 07:00:00

Nov. 15, 2017

Credit: Simon & Schuster

Author Jesmyn Ward became the first Black American to win the National Book Award twice. 

Growing up in DeLisle, Mississippi, “I read everything,” she wrote. “Still, I still felt as if a part of me was wandering. That there was a figure in me, walking the desert, waiting for a word. A word that would sound out of the wilderness to declare that it was speaking to me, for me, within me. The sonic sear of that voice: a new knowing of not only the world I walked, but of me.” 

She became the first person in her family to go to college. She attended Stanford University, where she earned a bachelor’s in English and a master’s in media studies. 

When a drunken driver killed her younger brother, she decided to become a writer in his memory. 

After earning a master’s in fine arts in creative writing from the University of Michigan, she and her family were caught by the floodwaters of Hurricane Katrina, but managed to take shelter with a family. 

She won her first National Book Award for “Salvage the Bones,” which was set during the days of Katrina. 

“When I hear people talking about the fact that they think we live in a post-racial America,” she said, “it blows my mind, because I don’t know that place. I’ve never lived there.” 

She won her second National Book Award for “Sing, Unburied, Sing,” becoming the first woman and first Black American to win two National Book Awards. She also won a MacArthur “genius” grant, one of a handful of Mississippians to receive the award. In 2022, she became the youngest person to ever receive the Library of Congress Prize for American Fiction.

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

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