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Reddit AMA recap: Medicaid expansion in Mississippi with Senior Political Reporter Geoff Pender

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Reddit AMA recap: Medicaid expansion in Mississippi with Senior Political Reporter Geoff Pender

Mississippi's growing health crisis threatens to close at least a dozen hospitals across the state and puts Mississippi in the lead nationally for rates of uninsured people.

READ MORE: ‘What’s your plan, watch Rome burn?’: Politicians continue to reject solution to growing hospital crisis

Studies have shown and advocates have long touted the benefits of Medicaid expansion, but state leaders remain steadfast in their opposition. As such, Mississippi remains one of only 11 states in the country not to expand the federal-state program.

Mississippi Today launched an ongoing series looking at the impact of the health care crisis on the people and institutions of the state.

As part of that project, Senior Political Reporter Geoff Pender answered readers' questions on Reddit about Medicaid expansion (or the lack thereof) in the state. Here's a recap:

Click to jump to a specific question

Q: Thank you for doing this and continuing to push on this topic.

As I sit here seeing the Greenwood hospital closing while the governor touts tax breaks for companies and the state government refuses this aid… I just do not get it.

Unless I think of all of the non-rational reasons for it.

A: Unfortunately, we are hearing from many corners that Greenwood may be the canary in the coal mine right now. We have heard some dire predictions of late from state hospital and other officials. State Health Officer Dr. Edney recently warned that we're looking at at least half a dozen hospitals on the brink, and others are saying our entire system is troubled. I don't know that Medicaid expansion would be the panacea for all that, but most experts are saying the influx of billions of federal dollars for health care would stave off many of these problems.

Q: As the Q&A article describes, there are political and economic arguments against expansion, but what in your opinion are the underlying motives for the stance? Are the politicians perhaps more driven by financial incentive from opposition groups in addition to maintaining their political platforms for the sake of the party? And as for general people, do you think it’s related to a mentality of being against handouts and of “pulling yourself up by your bootstraps”? What do you think are the underlying feelings and motivations to these stances?

And lastly, how do you think these underlying reasons can be negotiated with to make progress towards achieving expansion?

A: As far as the current drivers of opposition to expansion, I would say they are now more political than economic, and have been so for quite a while. For one thing, we have empirical evidence from other states, including now Louisiana and Arkansas, that show expansion isn’t the budget-buster our leaders once feared.

We also have reams of studies and evidence from other states showing we would see net positive benefits – thousands of jobs created, savings of double-digit percentages in uncompensated care for hospitals, more workforce participation (ours is typically lowest in the country), net GDP growth and even projected growth in population. Also, we’ve seen firsthand over the last two years that Mississippi, with our economy so heavily dependent on federal spending, sees booming state budget growth when there is an influx of billions of federal dollars. We’re sitting on more than $2 billion in basically surplus state money right now, largely the result of the influx of federal pandemic spending.

And again, this expansion is aimed primarily at the “working poor,” people in the gap between being poor enough for other help or being able to afford private insurance or pay medical bills out of pocket. As many have pointed out, a lot of the folks we’re talking about with this are working more than one job. As for pulling one’s self up by bootstraps, too many folks are one ER visit away from not having any bootstraps, and once someone gets a chronic illness because of lack of preventive care, it costs taxpayers anyway (and more).

No, the opposition now would appear to be more purely political (partisan) and philosophical – not wanting expansion of “Obamacare,” and opposition to expansion of a government program, even if in the long run it’s projected to benefit the workforce and private sector.

That opposition to government programs, however, appears to be selective among state leaders. One recent anecdote struck me in particular. Gov. Reeves recently held a press conference to trumpet the state’s work on expanding broadband internet across rural Mississippi. This is being funded with federal tax dollars. Instead of lamenting such government largesse, Reeves vowed to see that “we not only get our fare share, but that we get more than our fair share.” It would appear it’s OK to take hundreds of millions of federal dollars for internet service to areas where the private sector won’t do it, but not OK to take federal money to help keep people alive and well and working.

As for how this opposition might be overcome – I don’t know that anyone has a simple answer to that. One thing I hear all the time, though, even from some who have opposed expansion, is time. I have heard over and again in recent years that it’s probably just a matter of time before Mississippi expands Medicaid. Polling in recent years would indicate the populace may already be a bit ahead of our politicians on this policy … and, of course, look at other states relenting, such as Arkansas, Louisiana.

We attempted to delve into some of this opposition, past and present, here.

READ MORE: Who’s opposed to Mississippi Medicaid expansion and why?

Q: Can Medicaid expansion prevent local hospitals from closing?

A: It's unclear if it definitely would — rural hospitals in particular are facing major headwinds with personnel shortages and costs, supplies, inflation, uncompensated care. But most projections by experts have shown net benefits, and we've seen in other states that expansion helped. Particularly, in Louisiana, rural hospitals saw reductions in uncompensated care costs in the 55% range. This alone could give struggling rural hospitals some breathing room.

This study indicates hospitals in expansion states are less likely to close.

Q: With Medicaid expansion costing far more than initially predicted in other states, it delivering consistently poor health outcomes for those on the program, and it failing to ultimately help save rural providers as seen in Colorado and Indiana…why advocate so intensely for expanding a program that’s heading toward insolvency besides the fact that it will pad the pockets of and expand profits for big hospitals?

A: As for costing more than predicted, as I understand, this has not truly been the case at least on the state level. Some states have seen more people than initially predicted, but that has also been offset by people shifting from their traditional Medicaid to that with the higher match rate from the feds, and other non-direct economic benefits.

As for Colorado, I just recently read a report that rural hospitals there are "about 6 times less likely to close than hospitals in non-expansion states, according to a study by researchers at the University of Colorado Anschutz Medical Campus." I'm not sure what you are looking at, but would like to see it if you can forward a link.

As for poor health outcomes, I'm not sure Mississippi would have anywhere to go but up. Mississippi Medicaid has had poor health outcomes, but that has been primarily because only the sickest of the sick, so to speak, are on its adult population. Proponents say that the working-poor expansion population would receive more preventive care and improve outcomes — but you are right, that has been one major argument against expansion in Mississippi.

I don't know that expansion would pad the pockets and profits of big hospitals. It would help ameliorate the $600 million or so in uncompensated care that is hammering, in particular, smaller rural hospitals.

READ MORE:
The Mississippi Health Care Crisis
Mississippi moms and babies suffer disproportionately. Medicaid expansion could help.
How Medicaid expansion could have saved Tim’s leg — and changed his life
Q&A: What is Medicaid expansion, really?

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

Mississippi Today

On this day in 1965

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mississippitoday.org – Jerry Mitchell – 2025-01-25 07:00:00

Jan. 25, 1965

Oprah Winfrey portrays Annie Lee Cooper in “Selma.” Credit: Atsushi Nishijima, courtesy of Paramount Pictures, Pathé and Harpo Films

Annie Lee Cooper — portrayed by Oprah Winfrey in the film “Selma” — had been standing in line for hours outside the Dallas County courthouse in Selma, Alabama, once again attempting to register to vote. 

Sheriff Jim Clark and his deputies appeared. The 6-foot Clark had a reputation for racism and violence, carrying a billy club and cattle prod and telling others that the only problem with his job was “all this n—– fuss here of late. … You just have to know how to handle them.” He ordered the activists to leave, despite the fact they were legally entitled to register. 

Cooper recalled, “I was just standing there when his deputies told a man with us to move, and when he didn’t, they tried to kick him. That’s when (Clark), and I got into it. I try to be nonviolent, but I just can’t say I wouldn’t do the same thing all over again if they treat me brutish like they did this time.” 

Clark began poking her over and over in the neck with his billy club. She finally struck back, knocking him down. Deputies attacked her, beating her with a billy club. They threw her into jail, where she began to sing spirituals. 

Cooper had returned to Selma to care for her sick mother three years earlier. She had registered to vote where she lived in Kentucky and Ohio, but when she tried to register, the clerk told her she failed the test. She kept trying and joined SNCC’s first Freedom Day, where she waited with 400 others to register to vote in fall 1963. She was fired from her job and struck with a cattle prod. And after she was jailed in 1965, she never gave up. 

The Voting Rights Act passed Congress, and she was able to vote. She lived to be 100, and the city of Selma named a street after her. Winfrey said she decided to portray Cooper because of “what her courage meant to an entire movement. Having people look at you and not see you as a human being — she just got tired of it.”

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

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Will new state-appointed Jackson court have city-based jurists? Yes, chief justice decides

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mississippitoday.org – Mina Corpuz – 2025-01-24 14:04:00

In 2023 as lawmakers were passing the bill that would establish a state-appointed court within Jackson, there was talk about appointing “the best and the brightest” judges from around the state to serve – a comment some Black legislators said implied they couldn’t be found within a majority Black Hinds County. 

Over a year later, the Capitol Complex Improvement District Court is set to open next week, and three judges with roots in Jackson and live in the capital have been appointed to serve. 

The judges who were sworn in during a Friday ceremony said they were interested in the positions because they wanted to serve the community where many of them grew up and live. 

“This is a very serious undertaking to citizens who live in this city,” said Judge Christopher Collins, who will serve on a part-time basis. He moved to Jackson for the role. 

Judge Stanley Alexander and James Holland will be the full-time judges.

Supreme Court Chief Justice Mike Randolph swears in Stanley Alexander during the opening of the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

Alexander is a former assistant district attorney in multiple judicial districts and he worked in the attorney general’s office, including as director of the Division of Public Integrity. Holland has practiced law for over 40 years and has trial experience, including defense in state and federal courts. He ran an unsuccessful race for Hinds County district attorney in 2015.

Collins has been a prosecutor and public defender. His judicial experience includes work as a circuit and municipal judge, intervention court judge and a judge for the Mississippi Band of Choctaw Indians. 

Dr. Bryana Smith McDougal, is sworn in as Clerk of the Capitol Complex Improvement District Court by Supreme Court Chief Justice Mike Randolph, during the opening of the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

Bryana Smith McDougal was appointed as the court’s clerk. She previously was judicial assistant to former Supreme Court Justice Jim Kitchens and an assistant deputy clerk for the Supreme Court. She grew up in Jackson and lives in Madison.

Supreme Court Chief Justice Mike Randolph, who appointed the judges and clerk, said he considered many from across the state and took recommendations. It was through letters of recommendation and conversations with the three judges that showed that they were the best for the position. 

“These judges have proven themselves,” Randolph said. 

House Bill 1020, passed in 2023, created the court. The CCID court was supposed to be operating last year, but it waited on a building to operate. Now business will begin operation Monday at 8 a.m. at its renovated facility at 201 S. Jefferson St., a former bus terminal in downtown. 

A graph showing the workings of the criminal justice system displayed at the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

The CCID court will hear misdemeanor cases and initial appearances for felonies investigated by Capitol Police. Those cases have been handled in the existing Hinds County court system during the interim.

“We want to stay current (with cases.) Our goal is to support and supplement the current court system,” Holland said. 

At the Friday ceremony, Gov. Tate Reeves said the court and the ongoing work of Capitol Police will help make Jackson safer. 

“Make no mistake. Jackson’s best days are ahead of us,” he said. 

Reeves stood alongside various government officials, law enforcement and lawmakers, including House Ways and Means Chairman Trey Lamar, who authored HB 1020, and Public Safety Commissioner Sean Tindell, whose agency includes Capitol Police. 

Lamar said the court will be for the regular people of Jackson who want to have their kids play safely in their yards, people who want an efficient and blind justice system and families who will be supported by future jobs that come to the city. 

HB 1020 also expanded the jurisdiction of the Capitol Police from within the district to Jackson. The district covers downtown, the area around Jackson State University, Belhaven, the hospitals, Fondren and up to Northside Drive. A bill has been proposed this session to expand the district even further. 

In recent years, Capitol Police has been built up from a former security force for government buildings into a law enforcement agency. 

The court and police expansion were touted as solutions to crime and a backlogged Hinds County court system. Pushback came from Jackson lawmakers, advocacy groups and community members and two lawsuits were filed, but they have since been resolved. 

Prosecutors from the attorney general office’s Public Integrity Unit were also appointed to work in the CCID court, but they were not announced Friday. A spokesperson said their identities will be known once the court opens. 

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

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UMMC refuses to answer questions about shuttered diversity office

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mississippitoday.org – Molly Minta – 2025-01-24 10:51:00

Until a few years ago, the University of Mississippi Medical Center’s press releases and social media posts regularly touted the accomplishments of faculty and staff who worked to promote diversity, equity and inclusion at the public hospital. 

In one example from 2021, the vice chancellor for health affairs, LouAnn Woodward, affirmed the hospitals’ commitment to a range of administrative efforts, centered around the Office of Diversity and Inclusion, to comply with civil rights law and increase minority enrollment.

“Diversity among our workforce and student populations and an inclusive environment are, and must always be, core considerations at the Medical Center,” Woodward said. 

Then sometime before the start of this fiscal year, UMMC closed its diversity office. 

The public hospital is now refusing to answer questions about when or why that decision was made, if any employees were let go as a result, or what happened to the more than $1 million in funding that once supported the office. 

It is unclear if UMMC announced the decision internally; the hospital did not say if it had. Partially redacted faculty senate meeting minutes from 2024, obtained through a public records request, contain no mention of the move, even though the faculty have a committee dedicated to diversity and inclusion. 

A March 2024 announcement lists the now-defunct office’s chief diversity officer among new hires at the School of Population Health, indicating UMMC may have shuttered the office around that time. 

That’s also when UMMC appears to have scrubbed the office from its website, according to the Internet Archive. The URL for the office now redirects to a web page titled “Diversity and Inclusion at UMMC” which states “throughout UMMC’s three mission areas – education, research and health care – a climate of diversity and inclusion is present.” 

Missing from the webpage are the many initiatives the diversity office oversaw, including a professional development certificate. 

While UMMC is not the only institution of higher learning in Mississippi to shutter or reimagine its efforts to foster DEI on campus, the public hospital appears unique in its reticence about the decision. 

Other institutions in Mississippi have made their plans to revamp DEI offices more accessible. Last fall, the University of Mississippi announced its decision to reinvent its diversity division in a campus-wide email from the chancellor. Earlier in the year, Mississippi State University’s vice president for access, opportunity and success appeared before faculty to discuss the reasons behind the diversity division’s new focus.

In response to questions from Mississippi Today, UMMC’s director of communications provided a written statement with the preface that the hospital would have no further comments. 

“While we no longer have that office, our commitment to access and opportunity for all students, faculty and staff remains,” Patrice Guilfoyle wrote in an email. “If we are to effectively address Mississippi’s persistent and daunting health challenges, it will take everyone working together to fulfill our tripartite mission of education, research and patient care.”

Though funding fluctuated, the office was allocated $1,029,143 during the 2023-2024 fiscal year, according to budget documents obtained through a public records request. About a third of the office’s funding came from state appropriations. 

Until its closure, it appears the office was led by a member of Woodward’s executive cabinet, a role Woodward created shortly after she was appointed in 2015, according to a press release announcing the hire. The chief diversity officer was charged with creating a strategic diversity and inclusion plan for the hospital. 

“Not only did I want this work to be represented and visible at the highest level of leadership, this new institutional role would cover all three of our missions as well as coordinate diversity and inclusion efforts between them,” Woodward said

The chief diversity officer also oversaw three employees as of fiscal year 2023, according to information UMMC reported to the state auditor that year, including a cultural competency and education manager who ran workshops on topics like health disparities and a program coordinator who worked on the office’s annual award ceremony. 

Beyond that, the office also hosted a professional development program and held monthly conversations to foster “dialogue among members of the UMMC community on stimulating topics in pursuit of sharing and understanding experiences, emotions, and different perspectives,” according to a newsletter

This legislative session, lawmakers have filed multiple bills to ban DEI at state-supported institutions of higher learning, as well as one directed at public and charter schools. Mississippi has not passed such a ban, but lawmakers may be primed to do so on the heels of President Donald Trump’s executive orders targeting DEI in the federal government. 

UMMC has in the past curtailed programs after receiving pushback from lawmakers. 

In 2023, the hospital shuttered an LGBTQ+ focused clinic months after cutting gender-affirming care for trans minors because lawmakers complained.

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

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