Mississippi Today
Q&A: Harvard public health dean talks Medicaid expansion and heartbreaking mortality rates of Delta mothers
Q&A: Harvard public health dean talks Medicaid expansion and heartbreaking mortality rates of Delta mothers
Michelle Williams, a renowned epidemiologist and dean of the Harvard T.H. Chan School of Public Health, caught up with health editor Kate Royals following the state Legislature’s decision to expand postpartum Medicaid coverage.
Harvard University’s School of Public Health has an active program focused on the maternal mortality rate in the Mississippi Delta. Williams has also paid close attention to Mississippi’s debate over Medicaid expansion.
While Williams says she is heartened by Gov. Tate Reeves’ decision to extend postpartum coverage, the esteemed public health expert says the new law doesn’t go far enough.
Kate Royals: Tell me about the school’s work in the Mississippi Delta.
Michelle Williams: We have a long history of collaborating on research and education in the Delta, in partnership with state officials, community health centers and local colleges, including Mississippi State and the University of Mississippi.
When you talk about health in Mississippi, the focus is often on the dire statistics, such as sky-high infant and maternal mortality. But it’s important to know that the state has a history of truly important innovation. For instance, the first community health centers sprang up in Mississippi — an outgrowth of the civil rights movement. Our collaborations aim to build on and nurture those innovations.
We gather regularly with our partners to discuss and develop health care programs. We work together on research grants, too. As one example, we would love to secure funding to enable state health officials to make regular home visits to new moms in the Mississippi Delta; we would then evaluate the impact of the program and widely disseminate lessons learned.
Finally, we organize academic exchanges so students in Mississippi spend time at Harvard and vice versa, with opportunities to get involved in research and community projects. I recently talked to one of our (master’s of Public Health) students who is in Clarksdale for her fieldwork practicum, working with a program called “Baby University” that teaches new parents about early childhood development and gives them tips for supporting their babies’ growth.
Royals: You have cited some pretty startling statistics about outcomes for mothers – particularly Black mothers – in Mississippi compared to other countries. What were those?
Williams: I’m glad you asked, because I think these are statistics that every policy maker – and every citizen – should know.
For Black women in Mississippi, the mortality rate is 65.1 deaths per 100,000 live births, according to the state Department of Health.
That’s a horrifying number. To put it in context, Black women in Mississippi are nearly 20 times more likely to die from complications of pregnancy or childbirth than women in Greece, Poland, or Slovenia. They’re nearly 8 times more likely to die than women in Turkey.
The mortality rate for white women in Mississippi is lower, at 16.2 deaths per 100,0000 live births, but that is still far above the U.S. average. They are at least three times more likely to die from complications of pregnancy or childbirth than women in the UK or Canada.
Each of those deaths is a tragedy with long-lasting effects: Too many young, promising lives cut short; too many children who grow up without the love and support of their mothers; too many families who struggle with grief for the rest of their lives.
It is heartbreaking but it is also, quite frankly, infuriating. We know why maternal mortality rates are so high among Black women. They are high because of the devastating impacts of structural racism and individual bias, including lack of access to appropriate care. That we allow this to continue to happen, in the wealthiest country in the world, is unforgivable.
Royals: What do you believe, from your research and experience, will be the benefits of extending the health care coverage of mothers on Medicaid for women and babies in Mississippi?
Williams: We know from state data that 42.5% of pregnancy-related maternal deaths in Mississippi occur between 60 days and a year after childbirth. That’s the precise period that would be covered by the Medicaid expansion bill now on the governor’s desk.
I am certain that having access to care in this period will save lives. Remaining on Medicaid will give new mothers … access to mental health care, which is critically important for not only a mother’s health but also the health of her children. It will also allow women to get care for chronic conditions such as high blood pressure, diabetes and obesity. That’s important because cardiovascular conditions are the most common cause of pregnancy-related maternal deaths in the state.
There are many other benefits as well. Extending Medicaid coverage should help more young mothers get … screened for cancer. This is crucial because Mississippi has among the highest mortality rates in the nation for breast, cervical and colorectal cancer, all of which can often be treated successfully if detected early.
The bill should also help new mothers get access to contraception to help them control the spacing of future pregnancies. Given that abortion is now banned in Mississippi, with very limited exceptions, access to effective birth control is critical.
Finally, I want to emphasize what I mentioned earlier: Extending Medicaid will improve the odds not only for the mom, but for the newborn – and for any other children in the family. This generational effect is particularly important in Mississippi, which has long had the highest infant mortality rate in the U.S.
As every parent knows, the first year of a child’s life is wondrous, but it can also be tiring, isolating, and stressful. Parents are better equipped to navigate those stresses and support their children through this crucial phase of development if they have access to the care they need to keep themselves healthy.
Royals: I understand you applaud Mississippi for passing extended postpartum coverage but maintain there’s much more to be done. Can you say more about that, and how Medicaid expansion factors in?
Williams: Absolutely. That’s a great question.
The extension is critical for all the reasons I mentioned above. But the state could – and should – enact the full Medicaid expansion allowed under the Affordable Care Act. So far, I believe 39 states plus D.C. have taken advantage of this provision to extend Medicaid to nearly all adults with income up to a certain level, typically about $20,000 a year for a single person. That would cover not just new mothers, but all adults who meet the income guidelines.
One particular group that would benefit is young women who are not yet pregnant but might conceive in the near future. It would give them access to the care they needed to get chronic diseases like hypertension and diabetes under control. That could be a game changer in reducing maternal mortality.
And of course, Medicaid is not the only way to protect public health.
I firmly believe that Mississippi must restore physicians’ freedom to deliver the full range of health care for every resident, including gender-affirming care and abortion. State policy makers must also address the environmental factors that threaten health and well-being. That includes the unconscionable water crisis in Jackson, air pollution in Pascagoula, and the lack of access to fresh fruits and vegetables in “food deserts” across the state.
Williams cited the following articles in her responses:
Health Status : Maternal and infant mortality
Mississippi State Plan for Comprehensive Cancer Control 2018-2022
A Mississippi community is ‘grateful’ for more air testing, but skeptical of what comes next | WWNO
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Stories Videos
Mississippi Stories: Michael May of Lazy Acres
In this episode of Mississippi Stories, Mississippi Today Editor-at-Large Marshall Ramsey takes a trip to Lazy Acres. In 1980, Lazy Acres Christmas tree farm was founded in Chunky, Mississippi by Raburn and Shirley May. Twenty-one years later, Michael and Cathy May purchased Lazy Acres. Today, the farm has grown into a multi seasonal business offering a Bunny Patch at Easter, Pumpkin Patch in the fall, Christmas trees and an spectacular Christmas light show. It’s also a masterclass in family business entrepreneurship and agricultural tourism.
For more videos, subscribe to Mississippi Today’s YouTube channel.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1921
Jan. 21, 1921
George Washington Carver became one of the first Black experts to testify before Congress.
His unlikely road to Washington began after his birth in Missouri, just before the Civil War ended. When he was a week old, he and his mother and his sister were kidnapped by night raiders. The slaveholder hired a man to track them down, but the only one the man could locate was George, and the slaveholder exchanged a race horse for George’s safe return. George and his brother were raised by the slaveholder and his wife.
The couple taught them to read and write. George wound up attending a school for Black children 10 miles away and later tried to attend Highland University in Kansas, only to get turned away because of the color of his skin. Then he attended Simpson College in Indianola, Iowa, before becoming the first Black student at what is now Iowa State University, where he received a Master’s of Science degree and became the first Black faculty member.
Booker T. Washington then invited Carver to head the Tuskegee Institute’s Agriculture Department, where he found new uses for peanuts, sweet potatoes, soybeans and other crops.
In the past, segregation would have barred Carver’s testimony before Congress, but white peanut farmers, desperate to convince lawmakers about the need for a tariff on peanuts because of cheap Chinese imports, believed Carver could captivate them — and captivate he did, detailing how the nut could be transformed into candy, milk, livestock feed, even ink.
“I have just begun with the peanut,” he told lawmakers.
Impressed, they passed the Fordney-McCumber Tariff of 1922.
In addition to this work, Carver promoted racial harmony. From 1923 to 1933, he traveled to white Southern colleges for the Commission on Interracial Cooperation. Time magazine referred to him as a “Black Leonardo,” and he died in 1943.
That same year, the George Washington Carver Monument complex, the first national park honoring a Black American, was founded in Joplin, Missouri.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Legislative recap: 2025 tax cut battle has been joined
After relatively brief debate and questioning given its magnitude, the state House passed the first meaningful legislation of the new session: House Bill 1, a measure that would eliminate the state income tax, trim taxes on non-prepared food and raise sales and gasoline taxes.
It would mark a sea change in state tax structure, a shift from income to consumption taxation.
“We are at a place where we can finally tell the hard-working people of Mississippi we can eliminate the tax on work,” House Ways and Means Chairman Trey Lamar, HB1’s author, told his colleagues.
The measure passed the House 88-24. It gained some Democratic support in the supermajority Republican House, with nine Democrats voting in favor, 24 against and 12 voting present.
The proposal garnered some bipartisan support because it includes at least a couple of items Democratic lawmakers have championed in the past: A gasoline tax to help fix crumbling roadways, and a reduction in the “grocery” tax, or the sales tax levied on unprepared food, of which Mississippi has the highest overall rate in the nation.
It still met with some Democratic opposition in part because it is a sea change toward more “regressive” taxation. Proponents say this is just, people should pay more for state services they use, such as roadways, and for things they buy as opposed to taxing income. Opponents say this places a proportionately higher tax burden on people of modest means.
“I would say the people hurt the most with this would be working people who have to put gas in their car to go to work or those who have to purchase materials to do a job,” House Democratic Leader Robert Johnson said.
Beyond that concern, opponents or skeptics worry that the foundation of the proposed tax overhaul would be built on shifting sands — a state economy that has been so rosy primarily from the federal government dumping billions of dollars in pandemic spending into Mississippi. With the federal spigot being cut off, some worry, the state economy could slump, and the massive tax cuts in this new plan could provide a state budget crisis, of which Mississippi has much experience, and underfunding of crucial services such as schools, roads, health care and law enforcement.
The largest hurdle Republican House leaders face in seeing their tax plan through to law is not in garnering bipartisan support. It’s internecine disagreement with the Senate Republican leadership, which still appears to harbor abovementioned concerns about overhauling tax structure in uncertain economic times and betting on growth to cover massive tax cuts.
Senate leaders have said they want to enact more tax cuts, but their plan has not yet been released. Lt. Gov. Delbert Hosemann has provided some details of what he wants to see, but it would appear he wants a more cautious approach on cuts. He has not publicly opined on the tax increases in the House plan.
Quote of the Week
“Have you ever worn a belt and suspenders, lady? It’s a belt and suspenders approach.” — Rep. Trey Lamar, R-Senatobia, to Rep. Omeria Scott, D-Laurel, during floor debate on Lamar’s bill to eliminate the state income tax and raise other taxes.
“No. I have not worn a belt and suspenders. I don’t know anyone who has worn a belt and suspenders,” Scott replied.
In Brief
House will renew push to legalize mobile sports betting
House Gaming Committee Chairman Casey Eure, R-Saucier, told Mississippi Today he plans on taking another crack at legalizing mobile sports betting in the state. In 2024, the House and Senate passed versions of legislation to permit online sports betting, but never agreed on a final proposal. Some lawmakers raised concerns that gambling platforms would have no incentive to partner with smaller casinos, and most of the money would instead flow to the Mississippi Gulf Coast’s already bustling casinos. Proponents say legalization would undercut the influence of illicit offshore sports betting platforms.
“I’ve been working on this bill for many years and I’m just trying to satisfy any concerns that the Senate may have so we can pass this and start collecting the tax dollars that the state deserves and not allowing everyone to place bets with these offshore accounts,” Eure said. “I feel like the state is losing between $40-$80 million a year in tax revenue.”
Sports wagering has been permitted in the state for years, but online betting has remained illegal amid fears the move could harm the bottom line of the state’s brick-and-mortar casinos. Mobile sports betting is legal in 30 states and Washington, D.C., according to the American Gaming Association. — Michael Goldberg
Hosemann makes Senate committee chair changes
Republican Lt. Gov. Delbert Hosemann last week named new chairmen of committees, after former state Sen. Jenifer Branning was sworn into office as a new justice on the Mississippi Supreme Court.
Sen. Chuck Younger, a Republican from Columbus, previously led the Senate Agriculture Committee and will replace Branning as chairman of the Transportation Committee. Sen. Neil Whaley, a Republican from Potts Camp, previously led the Senate Wildlife, Fisheries and Parks Committee, but will now lead the Senate Agriculture Committee.
Here are the other changes to Senate committees:
Sen. Ben Suber, a Republican from Bruce, will be the new chairman of the Senate Wildlife, Fisheries and Parks Committee
Sen. Bart Williams, a Republican from Starkville, is the new chairman of the Senate Public Property Committee
Sen. Scott DeLano, a Republican from Gulfport, will lead the Senate Technology Committee
Sen. Robin Robinson, a Republican from Laurel, will chair the Senate Labor Committee
Sen. Angela Turner Ford, a Democrat from West Point, will lead the Senate Drug Policy Committee. — Taylor Vance
What’s in a name? Democratic Rep. Scott hopes GOP majority will pass ‘Donald J. Trump Act’ bills
Perhaps tired of seeing many measures she authors ignored or shot down in flames by the Republican supermajority in the Mississippi Legislature, Democratic Rep. Omeria Scott of Laurel is trying a new strategy: naming bills after Republican President-elect Trump.
For this session, Scott has authored: House Bill 61, the “Donald J. Trump Voting Rights Restoration Act;” House Bill 62, the “Donald J. Trump Ban-The-Box Act … to prohibit public employers from using criminal history as a bar to employment;” and House Bill 249, the “Donald J. Trump Early Voting Act.” — Geoff Pender
More bills filed to criminalize abortion
Since the 2022 Dobbs Supreme Court decision overturned the constitutional right to an abortion, Mississippi lawmakers have proposed bills to criminalize workarounds to the state’s strict abortion ban – including criminalizing the abortion pill and out-of-state abortions. The 2025 legislative session is no exception.
Rep. William Tracy Arnold, R-Booneville, filed House Bill 616 that would make it a felony to manufacture or make accessible medication abortion. Anyone convicted of the crime would be subject to a fine between $1,000 and $5,000, as well as imprisonment between two and five years. Last year, about 250 Mississippians each month requested medication abortion from Aid Access, the only online telemedicine service supplying medication abortion via mail in the U.S.
Helping a minor receive an abortion would also be criminalized under House Bill 148 filed by Rep. Mark Tullos, R-Raleigh. That would include transporting a minor out of state to undergo an abortion, as well as helping a minor procure a medication abortion – both of which would be punishable by not less than 20 years in prison or a fine of not less than $50,000. — Sophia Paffenroth
By the Numbers
$1.1 billion
The estimated net annual cost of the House plan to eliminate the state income tax and raise sales taxes, once fully phased in. Proponents say economic growth would allow the state budget, currently about $7 billion a year, to absorb the cut. Eliminating the income tax would cost the state $2.2 billion in revenue, but the House plan would raise about $1.1 billion in other taxes in offset.
0
The amount of income tax Mississippians would pay after a 10-year phased in elimination of the state income tax. With previous cuts being phased in, state income taxes next year will already be reduced to 4%, among the lowest rates in the nation.
8.5 %
The new Mississippi sales tax, up from current 7%, under the House tax plan assuming most local governments would not opt out of adding a new 1.5% local sales tax.
13 cents more a gallon
The cost of the House’s proposed new 5% gasoline tax, based on last week’s average cost of gasoline in Mississippi of $2.62. The new 5% tax would be on top of the flat 18.4 cents a gallon current state excise on gasoline.
4%
The tax on unprepared food once a reduction of the current 7% would be phased in over a decade under the House plan. The state would over time reduce its sales tax on such groceries to 2.5%, but local governments would add a 1.5% sales tax to such items unless they opt out.
Full Legislative Coverage
Lawmakers must pass new legislation to improve access to prenatal care
Lawmakers will file another bill this session to help low-income pregnant women get into the doctor earlier – after the federal government rejected the program set up under last year’s law, because of discrepancies between what was written into state law and federal regulations for presumptive Medicaid eligibility. Read the story.
Proposal: eliminate income tax, add 5% tax on gas, allow cities, counties to levy local sales tax
House leaders last week unveiled a sweeping tax cut proposal that would eventually abolish the state income tax, slash taxes on groceries, increase local sales taxes and shore up funds for state and local road work. Read the story.
A new Mississippi law aims to limit jailing people awaiting mental health treatment. Is it working?
Officials say a new law to decrease the number of people being jailed solely because they need mental health treatment has led to fewer people with serious mental illness detained in jails – but the data is contradictory and incomplete. Lawmakers plan legislation to make more counties report the data. Read the story.
How soon we forget: Mississippi House push for record tax cuts revives fear of repeat budget crises
Eight years ago, from a combination of dozens of tax cuts the Legislature approved and a slumping economy, the state saw a budget crisis that resulted in severely underfunded schools, government layoffs, a near halt to building new roads and highways and problems maintaining the ones we have, too few state troopers on the highways and cuts to most major state services. Read the story.
NAACP legislative redistricting proposal pits two pairs of senators against each other
The Mississippi chapter of the ACLU has submitted a proposal to the courts to redraw the state’s legislative districts that creates two new majority-Black Senate districts and pits two pairs of incumbent senators against one another. Read the story.
Legislation to send more public money to private schools appears stalled as lawmakers consider other changes
Some top lawmakers in Mississippi’s Republican-controlled Legislature are prepared to make it easier for students to transfer between public schools but remain skeptical of sending more public money to private schools. Read the story.
House passes $1.1 billion income tax elimination-gas and sales tax increase plan in bipartisan vote
A bill that phases out the state income tax, cuts the state grocery tax and raises sales taxes and gasoline taxes passed the House of Representatives with a bipartisan vote on Thursday. Read the story.
Tate Reeves and other top Mississippi Republicans owe thanks to President Joe Biden
The tremendous cash surpluses that some state Republicans cite when defending their plan to eliminate the state’s income tax would not exist if not for the billions of dollars in federal funds that have been pumped into the state during Biden’s presidential tenure. Read the story.
Podcast: Mississippi transportation director discusses proposed new gasoline tax
Mississippi Department of Transportation Director Brad White tells Mississippi Today’s Geoff Pender and Taylor Vance he’s staying “in his lane” and out of the politics of a House tax overhaul that would eliminate the income tax and raise sales and gasoline taxes, but that he’s pleased lawmakers are trying to address the long running need for a steady new stream of money to help cover highway maintenance needs. Listen to the podcast.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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