Mississippi Today
Q&A: Rev. Charlton Johnson on seeing Medicaid expansion not as a financial issue, but a moral necessity
Rev. Charlton Johnson only joined Together for Hope as leader of its Delta region in September, but he began thinking about Medicaid expansion long before that.
Together for Hope, an organization that works with people in the poorest counties in the country, has ramped up its efforts advocating for Medicaid expansion in Mississippi. The nonprofit hosts summits all over the states to bring together faith leaders, medical experts and health care advocates to raise awareness about Medicaid expansion. The policy, which would provide health insurance for an additional 200,000 to 300,000 Mississippians, would greatly improve health care access for the communities they work with, according to the organization.
But Gov. Tate Reeves remains steadfast in his opposition, despite support from a majority of Mississippians, and has derisively referred to Medicaid expansion as adding more people to “welfare rolls.”
Mississippi is one of only 10 states that has not expanded Medicaid. Over its first few years of implementation, research shows expansion would bring in billions of dollars to Mississippi and help the state’s struggling hospitals.
Johnson, who was born in Greenville and who has worked as a chaplain for hospitals in Memphis and Jackson, acknowledges its financial benefits. But expansion is about more than that, according to Johnson — it’s really about helping your neighbor.
Johnson spoke with Mississippi Today about the need for Medicaid expansion, and what the Governor’s refusal to consider the policy says about morality in Mississippi.
This interview has been edited for clarity and length.
Mississippi Today: Talk to me a little bit about what Together for Hope is and what it does for people who have not heard of it.
Rev. Charlton Johnson: It is a coalition with its focus on fighting rural, persistent poverty. Persistent poverty is defined as an area that has been under the federal threshold for poverty for consistently 30 years, and in Mississippi alone, we have 53 counties that meet that definition of persistent poverty. We are a national group, so I’m serving what we call the Delta region, which comprises the poorest counties in Mississippi, in Arkansas and Missouri; some parishes in Louisiana; Illinois — basically along the Mississippi River.
MT: Can you explain a little more in detail what the organization does, specifically?
Johnson: We serve as a bridge for grassroots organizations and what we call grass-top organizations that are trying to find ways to make an impact on the ground. For instance, there is this group that we partner with out of the Delta called Hands for Hope. They have tried to intervene with the food scarcity in that area because they don’t have a lot of grocery stores and fresh foods. Most people do their grocery shopping at Family Dollar or Dollar General. Now, they have a space where they receive fresh foods, like a distribution. Our job is making that connection between the community and that organization. A lot of grassroots organizations have a mission or idea of how they want to help the community, but they don’t always have the resources to turn something around.
MT: What kind of work does Together for Hope do around Medicaid expansion?
Johnson: It’s largely advocacy, with hosting the summit. Expansion has not been framed the right way. That was even mentioned in our last staff meeting, that we almost need to just pull it back from saying Medicaid expansion versus just starting to meet those who are in the gap. There are so many people who are in that void of not being able to receive health care.
As a chaplain in hospitals, I’ve seen people use the emergency room as their primary care physicians, or they can’t go to the doctor and get sick enough they end up in the ER. That’s because people don’t have insurance. Seeing that was an awakening moment for me — it was when I began to recognize that people are not just running in here because they’re sick. It’s because the hospital has become their only option.
MT: I’m sure you were hearing about expansion long before starting this job. How do you think we have been talking about expansion, and how do you think we should be talking about it?
Johnson: Before coming into this role, I heard conversations about the need to expand Medicaid, which came while President Obama was in office. But there was so much resistance from red states to support that kind of initiative. People were trying to do their best to tear it apart. And Mississippi, of course, being the red state that it has long been, did not accept monies to help make this program more robust in Mississippi. So to hear Governor Reeves saying that he still isn’t interested in expanding Medicaid, to me it is just continuing the talking point that I heard from people who share his political ideology. When I heard that this organization Together for Hope was out there trying to help people better understand how it helps, not just people but the community as a whole and to also fight poverty, I wanted to be on the front lines.
MT: I’m wondering how you, as a pastor, square red states that are really religious with this resistance to helping some of the most vulnerable people in the state?
Johnson: I have a hard time. As a person of faith, it’s so hypocritical to me, because when you look at the 10 commandments, Jesus teaches that all of those commandments can be boiled down to two. The first is loving God, but the second one is loving your neighbor as yourself. And if I love my neighbor, then I recognize that we have a mutual interest in each other doing well.
That’s not something that I readily see in a hospitality state like Mississippi. So that’s hard for me to square for myself personally, but I also recognize that we’re all at different places in our walk of faith. I think if you’re Christian, you walk the walk of Christ long enough at some point, it changes your heart, and it begins to alter the way you see those around you, so I have hope that one day they’ll see that change.
But until that day, it just means that those of us who do see the need for change, need to not only be vocal, but need to be out front with doing those acts of compassion, of grace and mercy.
MT: If you were to explain what Medicaid expansion is to someone who wasn’t familiar with it, or someone who opposes it, what would you say about the policy and its significance?
Johnson: I’ve been holding on to a passage in Psalms 23 which says that “though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me.” It’s not that we don’t have something to fear, but Christ is with us. Christ is with the hurting. And to say that we are Christ’s followers means that we need to follow Christ to where those who are hurting to help, to offer grace, to offer support.
And I see access to health care as a means of offering grace to people, or expanding Medicaid, bridging the gap — whatever phrase people want to put to it.
MT: Together for Hope advocates for expansion because of their work in communities of poverty, as I understand it, so can you talk a little bit about the connection between poverty and poor health outcomes?
Johnson: If people are not getting the medical care they need, the health disparities are going off the charts. People are dying unnecessarily because they don’t even have the option of going to the doctor when they need it. When they get sick, they have to just muster through it and hope that they’ll be okay. And I don’t think that’s what it means to live in a community.
MT: If Mississippi continues to forgo expansion, what are the consequences for the communities you work with?
Johnson: Those health outcomes will continue to get worse and worse is the short answer. But I don’t think that robs compassionate people of ingenuity. We’re going to find a way to help people.
Expansion seems the most logical way that it can be done, but if we have to find an I’ll-climb-the-mountain-side way of helping people with health care access, we will.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1997
Dec. 22, 1997
The Mississippi Supreme Court upheld the conviction of white supremacist Byron De La Beckwith for the 1963 murder of Medgar Evers.
In the court’s 4–2 decision, Justice Mike Mills praised efforts “to squeeze justice out of the harm caused by a furtive explosion which erupted from dark bushes on a June night in Jackson, Mississippi.”
He wrote that Beckwith’s constitutional right to a speedy trial had not been denied. His “complicity with the Sovereignty Commission’s involvement in the prior trials contributed to the delay.”
The decision did more than ensure that Beckwith would stay behind bars. The conviction helped clear the way for other prosecutions of unpunished killings from the Civil Rights Era.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Medicaid expansion tracker approaches $1 billion loss for Mississippi
About the time people ring in the new year next week, the digital tracker on Mississippi Today’s homepage tabulating the amount of money the state is losing by not expanding Medicaid will hit $1 billion.
The state has lost $1 billion not since the start of the quickly departing 2024 but since the beginning of the state’s fiscal year on July 1.
Some who oppose Medicaid expansion say the digital tracker is flawed.
During an October news conference, when state Auditor Shad White unveiled details of his $2 million study seeking ways to cut state government spending, he said he did not look at Medicaid expansion as a method to save money or grow state revenue.
“I think that (Mississippi Today) calculator is wrong,” White said. “… I don’t think that takes into account how many people are going to be moved off the federal health care exchange where their health care is paid for fully by the federal government and moved onto Medicaid.”
White is not the only Mississippi politician who has expressed concern that if Medicaid expansion were enacted, thousands of people would lose their insurance on the exchange and be forced to enroll in Medicaid for health care coverage.
Mississippi Today’s projections used for the tracker are based on studies conducted by the Institutions of Higher Learning University Research Center. Granted, there are a lot of variables in the study that are inexact. It is impossible to say, for example, how many people will get sick and need health care, thus increasing the cost of Medicaid expansion. But is reasonable that the projections of the University Research Center are in the ballpark of being accurate and close to other studies conducted by health care experts.
White and others are correct that Mississippi Today’s calculator does not take into account money flowing into the state for people covered on the health care exchange. But that money does not go to the state; it goes to insurance companies that, granted, use that money to reimburse Mississippians for providing health care. But at least a portion of the money goes to out-of-state insurance companies as profits.
Both Medicaid expansion and the health care exchange are part of the Affordable Care Act. Under Medicaid expansion people earning up to $20,120 annually can sign up for Medicaid and the federal government will pay the bulk of the cost. Mississippi is one of 10 states that have not opted into Medicaid expansion.
People making more than $14,580 annually can garner private insurance through the health insurance exchanges, and people below certain income levels can receive help from the federal government in paying for that coverage.
During the COVID-19 pandemic, legislation championed and signed into law by President Joe Biden significantly increased the federal subsidies provided to people receiving insurance on the exchange. Those increased subsidies led to many Mississippians — desperate for health care — turning to the exchange for help.
White, state Insurance Commissioner Mike Chaney, Gov. Tate Reeves and others have expressed concern that those people would lose their private health insurance and be forced to sign up for Medicaid if lawmakers vote to expand Medicaid.
They are correct.
But they do not mention that the enhanced benefits authored by the Biden administration are scheduled to expire in December 2025 unless they are reenacted by Congress. The incoming Donald Trump administration has given no indication it will continue the enhanced subsidies.
As a matter of fact, the Trump administration, led by billionaire Elon Musk, is looking for ways to cut federal spending.
Some have speculated that Medicaid expansion also could be on Musk’s chopping block.
That is possible. But remember congressional action is required to continue the enhanced subsidies. On the flip side, congressional action would most likely be required to end or cut Medicaid expansion.
Would the multiple U.S. senators and House members in the red states that have expanded Medicaid vote to end a program that is providing health care to thousands of their constituents?
If Congress does not continue Biden’s enhanced subsidies, the rates for Mississippians on the exchange will increase on average about $500 per year, according to a study by KFF, a national health advocacy nonprofit. If that occurs, it is likely that many of the 280,000 Mississippians on the exchange will drop their coverage.
The result will be that Mississippi’s rate of uninsured — already one of the highest in the nation – will rise further, putting additional pressure on hospitals and other providers who will be treating patients who have no ability to pay.
In the meantime, the Mississippi Today counter that tracks the amount of money Mississippi is losing by not expanding Medicaid keeps ticking up.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1911
Dec. 21, 1911
Josh Gibson, the Negro League’s “Home Run King,” was born in Buena Vista, Georgia.
When the family’s farm suffered, they moved to Pittsburgh, and Gibson tried baseball at age 16. He eventually played for a semi-pro team in Pittsburgh and became known for his towering home runs.
He was watching the Homestead Grays play on July 25, 1930, when the catcher injured his hand. Team members called for Gibson, sitting in the stands, to join them. He was such a talented catcher that base runners were more reluctant to steal. He hit the baseball so hard and so far (580 feet once at Yankee Stadium) that he became the second-highest paid player in the Negro Leagues behind Satchel Paige, with both of them entering the National Baseball Hame of Fame.
The Hall estimated that Gibson hit nearly 800 homers in his 17-year career and had a lifetime batting average of .359. Gibson was portrayed in the 1996 TV movie, “Soul of the Game,” by Mykelti Williamson. Blair Underwood played Jackie Robinson, Delroy Lindo portrayed Satchel Paige, and Harvey Williams played “Cat” Mays, the father of the legendary Willie Mays.
Gibson has now been honored with a statue outside the Washington Nationals’ ballpark.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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