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Q&A: Why Arkansas could be a model for Mississippi Medicaid expansion

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10 months ago

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As leaders from the House and Senate will soon begin meeting to find common ground on their dueling Medicaid expansion proposals, some people have pointed to Arkansas as a model that could prove successful in Mississippi.

Arkansas, a red state that shares many demographic similarities with Mississippi, implemented its expansion plan, now called Arkansas Health and Opportunity for Me (ARHOME), in 2014. The program provides health coverage to about 250,000 Arkansans. It has cut the state’s uninsured rate in half, and it has helped struggling hospitals stay open.

The expansion program in Arkansas has been so successful that it’s been renewed each year since 2014 by a supermajority of the state’s Republican-controlled legislature.

READ MORE: ‘A no-brainer’: Why former Arkansas Gov. Mike Beebe successfully pushed Medicaid expansion

Mississippi Today invited Dr. Joe Thompson, who was Arkansas’ surgeon general under Republican Gov. Mike Huckabee and Democratic Gov. Mike Beebe, to explain how Arkansas’ expansion program has worked. Thompson now serves as president and CEO of the Arkansas Center for Health Improvement.

Mississippi Today: Arkansas implemented a pretty unique Medicaid expansion model. How does your state’s program work?

Dr. Joe Thompson: Instead of enrolling uninsured people in the state-run Medicaid program, Arkansas obtained permission from the federal government to use federal Medicaid funds for “premium assistance” — an historically available but rarely used strategy by states. Arkansas purchases private health insurance plans offered on the health insurance marketplace to provide adult Arkansans earning up to 138% of the federal poverty level insurance coverage — with 90% of the costs coming from the federal government.

Newly covered individuals effectively get private coverage and the healthcare access they need; providers get paid commercial insurance rates far higher than Medicaid rates; and insurers benefit because the state is a large, guaranteed purchaser in an otherwise risky individual insurance market.

Governors and legislators have made changes to the program over the years, including a work requirement that was implemented in 2018 and blocked by a federal judge the following year, but the basic structure has remained the same.

MT: How has the program impacted Arkansas?

Thompson: For starters, it cut our adult uninsured rate, which had been among the highest in the nation, by half. Newly insured Arkansans gained access to treatment for chronic conditions that had gone untreated for years, as well as preventive care that allowed them to avoid other health problems and associated costs.

The newly insured also became able to pay for hospital visits, reducing uncompensated care costs at Arkansas hospitals by more than half. Since 2012, no rural Arkansas hospital has closed without being reopened or replaced, while 59 rural hospitals have closed in the six states surrounding Arkansas, including five hospitals in Mississippi.

MT: Some Mississippians are concerned about being able to afford the state match to draw down federal dollars. How has that gone in Arkansas?

Thompson: The federal government pays 90% of expansion costs, but even so, opponents of Medicaid expansion warned that Arkansas’ obligation to pay the remaining 10% would break the budget. In 2016, however, a consultant hired by the Republican legislative leadership analyzed the economic impact of Medicaid expansion and found it would have a net positive impact of $757 million on the state budget between 2017 and 2021 through reduced state expenditures and increased tax revenues.

It’s important to note that the residents of Mississippi and the other holdout states have not been spared from paying for Medicaid expansion. They have been helping to fund it for over a decade through their federal tax dollars, but the money has been flowing into states like Arkansas and Louisiana instead of benefiting the working poor, hospitals, and economies of their home states.

MT: There’s been some concern expressed about how expansion would affect insurers in Mississippi. How has the Arkansas model addressed similar concerns there?

Thompson: Some benefits Arkansas has received from Medicaid expansion are tied to unique aspects of the state’s program. Medicaid expansion is a huge decision for states — they can focus on the expansion decision alone or, as Arkansas did, use expansion to shape both the private and public health insurance systems.

Prior to our expansion, insurance carriers could cherry-pick the counties in which they would offer coverage. Arkansas now requires insurers participating in the exchange to offer coverage statewide, creating competition and consumer choice in all areas of the state. Arkansas also enrolled people deemed “medically frail” in traditional Medicaid, creating an expansion population that was relatively young, healthy and low-risk for insurers to cover. In 2014, average marketplace premiums in Arkansas were among the highest in the region, but since 2017 they have been lower than in any of the surrounding states, including Mississippi.

Arkansas’ decision to provide private health coverage has also been advantageous for enrollees. Private coverage does not carry the stigma of Medicaid, and because payment rates are higher for commercially insured patients than for Medicaid patients, Medicaid expansion enrollees in Arkansas have been less likely to encounter barriers to care than traditional Medicaid enrollees.

MT: How many people are actually enrolled in Arkansas, and should Mississippians worry about costs if more people enroll as time goes on?

Thompson: Some opponents of Medicaid expansion have accused Arkansas’ program of out-of-control growth, pointing out that enrollment was projected at the program’s inception to be about 250,000 but grew to more than 340,000 in 2022. In fact, enrollment only reached that level because of a now-defunct rule that required states to keep people continuously enrolled in Medicaid programs during the COVID-19 public health emergency. Arkansas resumed eligibility checks for Medicaid programs last April, and by the end of 2023, total enrollment in ARHOME was just under 252,000 — very close to original projections.

Medicaid expansion’s slow journey toward nationwide adoption is reminiscent of the original federal-state Medicaid partnership, which was enacted by Congress in 1965 but not adopted by every state until 1982, when the last holdout, Arizona, came on board. Change can be hard, but polls show that voters, including Mississippi voters, favor Medicaid expansion. It’s no wonder that the number of holdout states keeps dwindling.

READ MORE: Negotiations begin: Where do House, Senate, governor stand on Medicaid expansion? Is there room for compromise?

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

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‘This is a stupid bill’: Mississippi House advances DEI ban

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3 hours ago

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February 5, 2025

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mississippitoday.org – Michael Goldberg – 2025-02-05 17:41:00

Mississippi House Republican lawmakers advanced a bill that would shutter DEI programs in all of the state’s public schools, ban certain concepts from being taught in classrooms and dictate how schools define gender. 

The sweeping legislation would impact all public schools from the K-12 to community colleges and universities. It threatens to withhold state funds based on “complaints” that anyone could lodge. It would empower people to sue schools accused of violating the law.

And it drew impassioned opposition from House Democrats, almost all of whom are Black, in the state with the nation’s highest percentage of Black residents.

“House Bill 1193 is not just another piece of legislation,” said Rep. Jeffery Harness, D-Fayette. “It is a direct attack on the hard-fought battles that African Americans, other minorities, women and marginalized communities have waged for centuries. It is a cowardly attempt to sanitize history, to pretend that racism no longer exists, and to maintain the status quo of privilege of those who have always held power in this country.

The state house approved House Bill 1193, sponsored by Rep. Joey Hood, R-Ackerman, in a 74-41 vote. The bill would eliminate diversity training programs that “increase awareness or understanding of issues related to “race, sex, color, ethnicity, gender identity, sexual orientation, religion or national origin.” It also bans school officials from asking job applicants to submit diversity statements on such issues in the hiring process.

Hood said his proposal is necessary for ensuring employment decisions and student activities are based solely on individual merit without consideration of one’s views on DEI. He also said the bill targets programs and academic concepts that many people find objectionable and that no one group would be singled out.

“I haven’t heard anybody stand up and tell me that one of these divisive concepts are wrong,” Hood said. “I don’t think it’s unfair. I think these statements apply equally to all individuals.”

The legislation goes further than regulating hiring and training procedures in educational settings. It also meddles with classroom instruction, barring universities from offering courses that promote “divisive concepts,” including “transgender ideology, gender-neutral pronouns, heteronormativity, gender theory, sexual privilege or any related formulation of these concepts.” 

Schools would not be able to “promote” the ideas above, but the law does direct them to promote a definition of gender.

The bill was updated in committee to add a provision that forces all public schools to teach and promote there are two genders, male and female. The move mirrors an executive order signed by President Donald Trump calls for the federal government to define sex as only male or female. Another order Trump signed also eliminated DEI in the federal government.

If the legislation were to become law, any public school or state-accredited nonpublic school that receives more than two complaints alleging a violation could lose state money.

DEI programs have come under fire mostly from conservatives, who say the programs divide people into categories of victims and oppressors, exacerbate antisemitism and infuse left-wing ideology into campus life. DEI also has progressive critics, who say the programs can be used to feign support for reducing inequality without actually doing so.

But proponents say the programs have been critical to ensuring women and minorities aren’t discriminated against in schools and workplace settings. They say the programs are necessary to ensure that institutions meet the needs of increasingly diverse student populations.

Hood said there are already federal laws in place that protect minorities from discrimination.

Democrats said the bill could dissuade student-athletes from attending universities in Mississippi and chill freedom of speech. They also said the bill wouldn’t eliminate favoritism in college admissions and hiring.

Democratic Rep. Omeria Scott introduced an amendment banning “legacy admissions” — the practice of favoring applicants with family ties or connections to alumni. That amendment was defeated.

Rep. Willie Bailey, D-Greenville, argued against the bill, saying, “The Bible could not be taught under this bill — it talks about diversity, it talks about equity, it talks about inclusion.”

“This is a stupid bill,” Bailey said.

The bill now heads to the Senate for consideration, which is expected to take up a proposal of its own restricting DEI.

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

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Measures allowing former felons to regain voting rights clear House committees 

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5 hours ago

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February 5, 2025

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mississippitoday.org – Taylor Vance – 2025-02-05 16:24:00

Two measures allowing some people convicted of disenfranchising felony offenses to regain their voting rights passed a House committee on Tuesday, allowing the House to consider reforming one of the most strict felony disenfranchisement systems in the nation. 

The House Constitution Committee passed a measure to amend the state Constitution to revise the list of crimes that would result in someone losing their right to vote for life. 

Rep. Price Wallace, a Republican from Mendenhall who leads the committee, told reporters that his focus is establishing a pathway for people previously convicted of nonviolent offenses, especially those who have not committed any other offense, to regain their voting rights. 

The constitutional amendment removes bribery, theft, obtaining money or goods under false pretenses, perjury, forgery and bigamy from the list of disenfranchising crimes. It adds human trafficking, sexual battery, child exploitation or commercial sexual activity. The list of crimes already includes murder, arson, rape and embezzlement. 

It can now go before the full House for consideration, where two-thirds of its members must approve it before it can go to the Senate for further debate. 

The House committee also passed a bill clarifying that if someone has a non-violent felony conviction that is also a disenfranchising crime, that offense could be expunged from their record, meaning it would be erased. 

If a disenfranchising felony can be expunged from a criminal record, the person would theoretically be allowed to register to vote again. 

Mississippi has one of the harshest disenfranchisement systems in the nation and a convoluted way for restoring voting rights to people. 

Other than receiving a pardon from the governor, the only way for someone to regain their voting rights is if two-thirds of legislators from both chambers at the Capitol, the highest threshold in the Legislature, agree to restore their suffrage. 

Lawmakers only consider about a dozen or so suffrage restoration measures during the session, and it’s typically one of the last items lawmakers take up before they adjourn for the year. 

Under the Mississippi Constitution, people convicted of a list of 10 felonies lose their voting rights for life. Opinions from the Mississippi Attorney General’s Office have since expanded the list of disenfranchising felonies to 24. 

The practice of stripping voting rights away from people for life is a holdover from the Jim Crow-era. The framers of the 1890 Constitution believed Black people were most likely to commit those crimes. 

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

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Jimmie ‘Jay’ Lee’s family one step closer to closure after discovery of remains

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7 hours ago

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February 5, 2025

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mississippitoday.org – Molly Minta – 2025-02-05 13:49:00

More than two years after Jimmie “Jay” Lee went missing, the remains of the University of Mississippi student and well-known member of Oxford’s LGBTQ+ community has been found.

On Wednesday, the Oxford Police Department released a statement to social media that the state Crime Lab confirmed the human skeletal remains found in Carroll County over the weekend belong to Lee.

“The Oxford Police Department made a commitment to finding Jay, no matter how long it took,” Chief Jeff McCutchen said in the release.

The confirmation comes after days of rumors flying around Grenada County, where Sheldon Timothy Herrington Jr., the University of Mississippi graduate charged with Lee’s murder, is from.

An object found with Lee’s remains fueled the speculation: A gold necklace with his name on it, Mississippi Today reported on Monday. The nameplate matched jewelry that Lee wore in videos on his Instagram that were posted two days before his disappearance on July 8, 2022.

The Carroll County Sheriff’s Department said in a press release that deer hunters stumbled on Lee’s remains in a wooded gully on Saturday, Feb. 1. The Oxford police statement did not include additional information about who found the remains or how.

“While this part of the investigation is complete, additional work remains,” police stated. “However, we are unable to provide further details at this time.”

It remains to be seen how this discovery will impact the case against Herrington, who was charged with capital murder and taken to trial by the Lafayette County district attorney in December. One juror refused to convict due to the lack of a body, resulting in a mistrial.

Lafayette County District Attorney Ben Creekmore has said he intends to retry Herrington. He could not be reached by press time.

In Oxford, Lee’s disappearance sparked a movement organized by Lee’s college friends called Justice for Jay Lee. On Wednesday, an Instagram account for the group posted a video of Lee dancing, his arm in the air, his long, blonde weave and sparkly silver skirt shimmering to club music.

The discovery brings members of Lee’s family one step closer to closure, said Tayla Carey, Lee’s sister.

“Speaking for myself, I can say it does bring me some type of happiness knowing he’s not out there alone anymore,” she said.

The next step is to celebrate Lee’s life by giving him the memorial he deserves, but Carey said she won’t feel closure until justice occurs with a new trial.

“It’s been a long two and a half years,” Carey said. “A very long, long, long two and a half years.”

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

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