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The long history of white, Southern politicians rejecting health care expansion

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The long history of white, Southern politicians rejecting health care expansion

Southern politicians have a long history of opposing efforts to provide government-sponsored health care for their constituents.

In 1947, President Harry Truman proposed legislation that essentially would provide universal health care paid through fees and taxes. Remember, health care options for working people in those days were even more dire than now with fewer people having employer-based health insurance.

Truman’s proposal was killed in part by Southern Democrats in the U.S. House and Senate. Nobel Prize-winning economist Paul Krugman wrote in his book, “The Conscience of a Liberal,” that Southern politicians opposed the plan of the Democratic president because they feared that it would lead to a government mandate to integrate hospitals.

“Keeping Black people out of white hospitals was more important to Southern politicians than providing poor whites with the means to get medical treatment,” Krugman wrote.

Southern politicians, as it turns out, are still not crazy about government-sponsored health insurance.

A quick glance at a map of the states that have and have not expanded Medicaid is startling. Of the 11 states that have not expanded Medicaid, eight (if Texas is included) are Southern states.

The map of the non-expansion states, a matter of fact, looks a lot like the footprint of the collegiate Southeastern Conference sports league with the exception of Louisiana, Arkansas, Kentucky and Missouri. Those four states have expanded Medicaid. Granted, most would say that Missouri is not a Southern state, but it is in the SEC.

At any rate, it is the SEC states, led by Southern politicians, now Republican Southern politicians, who are again resisting efforts to expand government-sponsored health care to help their poor constituents.

No longer, of course, are hospitals segregated. They were integrated in the 1960s, according to Krugman, when another government-sponsored program was enacted: Medicare, which provides health care to the elderly.

While it has been established by various studies that the largest percentage of people who would benefit from Medicaid expansion are people of color, it is important to point out that there are many white citizens who also would benefit.

Medicaid expansion, as is allowed as part of the Patient Protection and Affordable Care Act, provides health insurance for primarily the working poor — for people earning up to 138% of the federal poverty level, or $18,754 per year for an individual. In Mississippi, the traditional Medicaid program covers, generally speaking, poor pregnant women, poor children, certain groups of poor retirees and the disabled, but not the working poor.

The federal government pays the bulk of the health care costs for those on Medicaid expansion. When Southern politicians express their opposition to Medicaid expansion, they often simply proclaim they “are against Obamacare” as if that is enough reason to oppose it.

“I am opposed to Obamacare expansion in Mississippi. I am opposed to Obamacare expansion in Mississippi. I am opposed to Obamacare expansion in Mississippi. I don’t know how many ways I can explain this to y’all,” Republican Gov. Tate Reeves said in response to reporters’ questions.

When the nation’s only Black president — Barack Obama — passed through Congress in 2010 the Affordable Care Act, almost all Republicans were opposed to “Obamacare.” But now solid Republican states like Montana, North Dakota, Utah and Idaho have embraced Medicaid expansion. In Republican-controlled South Dakota, voters just approved a ballot initiative to adopt Medicaid expansion. For the most part, it is just Southern politicians eschewing Medicaid expansion.

John Bell Williams also was against expanding health care when he served in the U.S. House representing Mississippi. As a congressman, he voted against Democratic President Lyndon Johnson’s plan to enact a Medicaid program for a small population of the underprivileged.

But as governor, Williams later called a special session in 1969 and urged the Legislature to opt into the Medicaid program.

In a speech to the Legislature, Williams said, “Let us not delude ourselves into the false notion that we can — or will — evade the burden of caring for these unfortunate people. Our society, through the instrument of government, has always shouldered this responsibility, and I am sure it always will.”

Williams went on to say the state could not afford to turn down a federal health care program that would require the state to provide only 20% of the matching funds. He spoke of the economic impact it would have on the state.

“The simple fact is that someone pays for health services, and we must decide, who will do it and how,” he explained.

The special session lasted from July 22 to Oct. 11. In the end, the Mississippi Legislature opted into the program, proving that Southern politicians did not always oppose improving health care for their poor constituents.

Whether that will happen with Medicaid expansion remains to be seen.

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

Mississippi Today

Mississippi lawmakers keep mobile sports betting alive, but it faces roadblock in the Senate

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mississippitoday.org – Michael Goldberg – 2025-03-04 18:06:00

A panel of House lawmakers kept alive the effort to legalize mobile sports betting in Mississippi, but the bill does not appear to have enough support in the Senate to pass.

Hours before a Tuesday evening legislative deadline, the House Gaming Committee inserted into two Senate bills the language from a measure the full House passed last month to permit online betting. The legislation would put Mississippi on track to join a growing number of states that allow online sports wagering.

But the House Gaming Committee had to resort to the procedural move after its Senate counterpart declined to take up its bill. Senate Gaming Chairman David Blount, a Democrat from Jackson, said he does not support the measure, prompting frustration from House Gaming Chairman Casey Eure, a Republican from Saucier. Eure said he implemented suggested changes from the Senate after lawmakers couldn’t agree on a final proposal in 2024.

“This shows how serious we are about mobile sports betting,” Eure said. “I’ve done everything he’s asked for … I’ve done everything they’ve asked for plus some.”

In a February 88-10 vote, the House approved a new version of the Mississippi Mobile Sports Wagering Act, which Eure said was reworked to address concerns raised by the Senate last year. The new version would allow a casino to partner with two sports betting platforms rather than one. Allowing casinos to partner with an extra platform is designed to assuage the concerns of casino leaders and lawmakers who represent areas where gambling is big business.

Last year, 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 larger casinos.

Other changes include a provision that prevents people from placing bets with credit cards, a request from the Senate to guard against gambling addiction.

Blount said there were growing concerns in other states that have legalized online sports betting, including over what consumer protections can be put in place and the impact legalization could have on existing gambling markets.

READ MORE: House panel approves casino tax increase, a shot over bow on blockage of online sports betting

“This is a different industry than any other industry because it is subject to forces outside of the control of the folks who are on this business,” Blount said. “And so what I think we need to do as a state, and we have done this for decades, is we have provided a stable regulatory environment, regardless of who is in the legislature, regardless of who the governor is, without a lot of drama.”

The proposal would levy a 12% tax on sports wagers, with revenue reaching all 82 counties via the Emergency Road and Bridge Repair Fund. Eure said he believes the state is losing between $40 million and $80 million a year in tax revenue by keeping mobile sports betting illegal.

Proponents also say legalization would undercut the influence of illicit offshore sports betting platforms.

Since the start of the NFL season this year, Mississippi has recorded 8.69 million attempts to access legal mobile sportsbooks, according to materials presented to House members at an earlier committee meeting. That demand fuels a thriving illegal online gambling market in Mississippi, proponents have said. Opponents say legalization could devastate the bottom line of smaller casinos and lead to debt and addiction among gamblers.

Mobile sports betting is legal in 30 states and Washington, D.C., according to the American Gaming Association.

The House panel inserted the mobile sports betting language into SB 2381 and SB 2510. The bills now head to the full chamber for consideration.

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

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Mississippi Today

Key lawmaker reverses course, passes bill to give poor women earlier prenatal care

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mississippitoday.org – Sophia Paffenroth – 2025-03-04 15:54:00

A bill to help poor women access prenatal care passed a committee deadline at the eleventh hour after a committee chairman said he wouldn’t bring it up for a vote. 

The policy was signed into law last year, but never went into effect because of administrative hiccups. 

Last week, Senate Medicaid Chair Kevin Blackwell, R-Southaven, told Mississippi Today that he would not be taking up the House’s bill to fix the issues in the program, calling it “his prerogative as chairman.” 

However, on deadline day, Blackwell called the bill up in his committee. It passed unanimously and without discussion. It will now move on to the floor vote in the Senate, where it passed with overwhelming support last year. 

Blackwell declined to comment on why he changed course. 

Blackwell had previously added the policy to another Medicaid bill, but was criticized by House Medicaid Chair Missy McGee, R-Hattiesburg, for attaching her legislation to what she called a “$7 million laundry list of unrelated lobbyist requests.”

In addition, the policy in Blackwell’s tech bill included language that the Centers for Medicaid and Medicare Services – the agency charged with overseeing state Medicaid programs – denied last year. 

Presumptive eligibility for pregnant women allows low-income women who become newly eligible for Medicaid once pregnant to receive immediate coverage as soon as they find out they’re pregnant – even if their Medicaid application is still pending. The program is especially effective in states that have not expanded Medicaid.  

Mississippi is currently one of only three states with neither expansion or presumptive eligibility for pregnant women. 

An expectant mother would need to fall under the following income levels to qualify for presumptive eligibility in 2025:

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

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Mississippi Today

Health Department backtracks on plans for child care regulation revisions

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mississippitoday.org – Simeon Gates – 2025-03-04 14:53:00

After weeks of often contentious back-and-forth with child care providers, the Mississippi Department of Health is walking back its revised regulations for the industry.

External affairs and media relations director Greg Flynn confirmed the news, explaining that MSDH is still working on the proposed changes, and that they will not present them in the near future. “The topic will not be presented at the Board of Health meeting in April,” he stated.

Nicole Barnes, director of the Child Care Licensure Bureau, stated that, “Once the edits have been finalized, we will plan to share those accordingly with the child care advisory council.”

According to an MSDH spokesperson, MSDH leadership retracted the revisions on Feb. 28. It’s the same day the Division of Early Childhood Care & Development’s Child Care Payment Program Advisory Council was supposed to hold an ad hoc meeting going over the revisions. The meeting was cancelled after the announcement.

This update comes after months of upset among child care providers over revisions. Initially, MSDH filed to revise child care regulations last November. Child care providers criticized the revisions for being too restrictive and impractical. They also criticized the licensing agency for its rollout of the revisions. 

MSDH said these changes were necessary to follow the Child Care and Development Fund Block Grant Act’s health and safety requirements. They did not initially consult the Child Care Advisory Council or the Small Business Regulatory Committee. 

The agency maintained that it followed Mississippi Administrative Procedures Act. However, some child care providers said they violated state law by not notifying them of the proposed changes within three days of filing them, as well as being generally inconsiderate of providers’ needs.

“We are all committed to providing high-quality care for children in the state of Mississippi and want to partner with the Health Department to ensure their health and safety is our first priority,” said Lesia Daniel, owner of Funtime in Clinton and member of the advisory council.

Roberta Avila, a member of the Child Care Advisory Council, said there needs to be more transparency and consideration for providers during revision changes. “As a member of the Council I want to work in cooperation with the agency,” she said. “I hope we can start anew with the agency to ensure that all licensed  providers, who will be affected by any changes in the regs, are informed about the process and will have an opportunity to give timely input to the agency.”

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

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