Mississippi Today

‘Very problematic’: Medicaid drops another 22,000 Mississippians, mostly for paperwork issues

Published

1 year ago

August 17, 2023

The Mississippi Division of Medicaid removed another 22,000 Mississippians from its rolls in July in the second wave of disenrollments after the end of pandemic-era protections.

That brings the agency up to 51,967 disenrollments total during the unwinding process, with those numbers set to increase.

Beginning in March 2020, federal law prohibited state divisions of Medicaid from removing people from their rolls due to the COVID-19 public health emergency.

The emergency ended in May, and now agencies are reviewing the eligibility of their beneficiaries for the first time in more than three years.

According to one expert, Mississippi’s total number of disenrollments is not the most concerning statistic: It’s the fact that 80% of the people dropped so far have been disenrolled because of issues with their paperwork, which could mean many of them were still eligible.

“It’s very high,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families. “Yeah, that’s very problematic.”

Many of the people who have been procedurally disenrolled could be children. Kids in low-income families make up more than half of Mississippi’s overall Medicaid beneficiaries.

According to Mississippi Medicaid’s enrollment reports, 18,710 children have lost Medicaid coverage from June of this year to July. It’s unclear how many children have been dropped since — the agency has not yet updated its August numbers.

Mississippi is one of only three states that does not have Medicaid online accounts as of January 2023, according to the Kaiser Family Foundation, though people do have the option to complete their renewal online.

According to a July press release, Mississippi Medicaid enrollment increased by 187,894 people, or 26%, from March 2020 to June 2023, bringing Mississippi’s Medicaid rolls over 900,000 people for the first time in the agency’s history.

In June, Mississippi Medicaid was set to examine the records of 67,695 Mississippians whose coverage was up for review.

It found that a little under half of those, or 29,460, were no longer eligible. According to the agency, about 60% of the people who were removed had remained insured during the pandemic because of the extended eligibility rules.

The latest data release shows that of the 75,110 Mississippians who had their eligibility evaluated in July, 22,507, or 30%, were unenrolled.

The majority of those were terminated because of “procedural reasons,” meaning they lost coverage for not returning paperwork or related reasons.

That means many of the people dropped so far could be people who are still eligible.

Alker said Mississippi’s ex-parte rate was “relatively low” — ex-parte renewals are automatic renewals, and the best case scenario during unwinding. Mississippi Medicaid spokesman Matt Westerfield said that the agency is focused on increasing those ex-parte approval rates.

“If individuals qualify for Medicaid coverage, we’d rather make that determination without having to mail a form that they have to fill out and that a Medicaid specialist then has to process,” he said.

Combined with the high rate of procedural terminations — only 11 states have higher percentages, according to Alker’s organization — it’s cause for concern, she said, enough that she suggested Gov. Tate Reeves should step in.

“The governor should absolutely pause these procedural terminations and figure out what’s going on,” Alker said.

According to Westerfield, the Division requested permission from the Centers for Medicare and Medicaid Services on Aug. 7 for “four additional flexibilities that could help reduce procedural disenrollments while increasing ex-parte renewals.”

A letter provided to Mississippi Today by the Division shows that those “flexibilities” included permitting managed care plans to help beneficiaries submit renewal forms, renewing coverage for people whose information “is not returned or is not returned within a reasonable amount of time” and reinstating eligibility for people who were previously unenrolled more quickly. These allowances have not yet been approved, but Westerfield said the agency anticipates that soon.

People who were dropped because they didn’t submit the needed information can be reconsidered without a new application if they submit that information within 120 days of the disenrollment.

Though Mississippi Medicaid launched the “Stay Covered” outreach campaign that included postcard mailing, flyers and text and email blasts to make people aware of the unwinding process, the leader of a local health advocacy organization that has partnered with the agency previously told Mississippi Today that he doesn’t believe Mississippi Medicaid is doing enough to inform beneficiaries. Additionally, it’s not clear how many emails or letters have been disseminated — Westerfield previously did not respond to that question.

Westerfield did say the Division did not process renewals for a few months for beneficiaries in the Delta affected by tornadoes this spring, though it’s not clear if the agency is doing anything in particular to reach those people — who may be displaced — now.

The new data also reveals a growing backlog in Mississippi.

In June, about 5,000 renewals that were up for review were not completed. The new numbers show that an additional 15,000 reviews went uncompleted last month. Westerfield blamed it on the larger review group in the July reporting period compared to June.

Alker says the backlog isn’t uncommon, and it’s neither good nor bad news.

“We want states to take their time, and they still have a lot of time,” she said. States have until May 2024 to complete the unwinding process.

“But it speaks to the backlog and the system, and the fact that they don’t have enough staff to begin with in many states, including Mississippi,” Alker said. “The backlog will keep getting bigger, and that’s going to be a problem.”

And as unwinding continues and a mounting number of Mississippians are potentially without health care coverage, stress continues to mount on Mississippi’s health care infrastructure.

As Reeves and other Republican state leaders continue to oppose expanding Medicaid to the working poor, one report puts almost half of the state’s rural hospitals at risk of closure, and data from Alker’s organization shows that rural populations will be the ones most affected by unwinding.

“If there’s a big unwinding problem, it’s going to be really devastating for these rural communities,” she said.

CMS sent letters to all state Medicaid division directors last week, including Mississippi’s director Drew Snyder. Because Mississippi started disenrollments in June, CMS did not have comments about Mississippi’s procedural termination rate — they analyzed states’ May numbers in their letters.

However, the letter indicated they would continue to keep an eye on deficiencies in individual states’ unwinding processes.

“I think what was important about the letters is that CMS, this is the first time that they’ve done something publicly like this,” Alker said. “I took it as a sign that they’re stepping up their enforcement.”

As of August, almost 5 million people have been disenrolled from Medicaid nationwide, according to the Kaiser Family Foundation. The organization says up to 24 million people could end up losing coverage during the unwinding.

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

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Mississippi Today

Senate panel weighs how much — or whether — to cut state taxes

Published

3 hours ago

November 4, 2024

Staff Editor

mississippitoday.org – Taylor Vance – 2024-11-04 15:42:00

A group of state senators on Monday grappled with how much to slash state taxes or if they should cut them at all, portending a major policy debate at the Capitol for next year’s legislative session.

The Senate Fiscal Policy Study Group solicited testimony from the state government‘s leading experts on budget, economic and tax policies to prepare for an almost certain intense debate in January over how much they should trim state taxes while balancing the need to fund government services.

Senate Finance Chairman Josh Harkins, a Republican from Flowood whose committee has jurisdiction over tax policy, told Mississippi Today that he wanted senators to have basic facts in front of them before they help decide next year if Mississippi should cut taxes.

“We’re getting a tax cut the next two years whether we do anything or not,” Harkins said. “I just want to make sure we have all the facts in front of people to understand we have a clear picture of how much revenue we’re bringing in.”

Mississippi is already phasing in a major tax cut. After a raucous debate in 2022, lawmakers agreed to phase in an income tax cut. In two years it will leave Mississippi with a flat 4% tax on income over $10,000, one of the lowest rates in the nation.

However, the top two legislative leaders, Lt. Gov. Delbert Hosemann who oversees the Senate and House Speaker Jason White, have both recently said they want legislators to consider new tax cut policies.

Hosemann, the Republican leader of the Senate, has publicly said he would like to see the state’s grocery tax, the highest of its kind in the nation, reduced, though he hasn’t specified how much of a reduction or how long it would take for the cut to be implemented.

White, a Republican from West, said last week that he would like to see the state’s 4% income tax phased out and have the state’s 7% grocery tax cut in half over time.

“We are hoping to construct a tax system that, yes, prioritizes certain needs in our state, but it also protects and rewards taxpayers,” White said last week.

But it’s difficult to collect accurate data on the state’s grocery tax, and state lawmakers must grapple with a laundry list of spending needs and obligations based on testimony from state agency leaders on Monday.

Mississippi currently has a 7% sales tax, which is applied to groceries. The state collects the tax but remits 18.5% back to cities. For many municipalities, the sales tax is a significant source of revenue.

If state lawmakers want to reduce the grocery tax without impacting cities, they could pass a new law to change the diversion amounts or appropriate enough money to make the municipalities whole.

State Revenue Commissioner Chris Graham said the Mississippi Department of Revenue, the agency in charge of collecting state taxes, does not have a mechanism in place for accurately capturing how much money cities collect in grocery taxes. This is because the tax on groceries is the same as non-grocery items.

However, Graham estimates that the state collects roughly $540 million in taxes from grocery items.

The other problem lawmakers would have in implementing significant tax cuts is a growing list of spending needs in Mississippi, a state with abject poverty, water and sewer and other infrastructure woes and some of the worst health metrics in the nation.

Representatives from the Legislative Budget Office, the group that advises lawmakers on tax and spending policy, told senators that lawmakers will also be faced with rising costs in the public employee retirement system, the Medicaid budget, public education, state employee health insurance, and state infrastructure projects.

State agencies, including the employee retirement system, also requested $751 million more for the coming budget year.

“That’s the billion dollar question, I guess,” Senate Appropriations Chairman Briggs Hopson, a Republican from Vicksburg, said. “How we’re able to fund basic government services?”

Harkins and Hopson said the committee would likely meet again before the Legislature convenes for its 2025 session on January 7.

A House committee on tax cuts has also been holding hearings, and White in September held a summit on tax policy.

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

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Mississippi Today

Already dire lack of affordable housing for low-income Mississippians on verge of worsening

Published

7 hours ago

November 4, 2024

Staff Editor

mississippitoday.org – Simeon Gates – 2024-11-04 11:00:00

In Mississippi, where there’s already a dearth of 50,000 or more affordable homes for extremely low-income residents, that number could grow in the next five years.

Housing units available under the federal Low Income Tax Credit program could lose their affordability by 2030 –a number estimated nationwide to be 350,000 with 2,917 in Mississippi, alone; 496 in the state already have.

The federal program responsible for most of the nation’s affordable housing is expiring.

The Low Income Housing Tax Credit, introduced as part of the Tax Reform Act of 1986, provides for developers to buy, build and restore low-income housing units. Under the deal, the housing only needs to stay low-rent for 30 years. Construction began in the early 1990s.

Some LIHTC housing will remain affordable due to other subsidies, nonprofits, state law and individual landlords.

“I think the low-income housing tax credit has done everything that it can to address the need for affordable housing around the state,” said Scott Spivey, executive director of the Mississippi Housing Corporation, a state office that administers the program and works with the state government and those in the affordable housing industry to create and support affordable housing

Spivey supports the proposed Affordable Housing Credit and Improvement Act, a federal bill that would expand upon the low-income housing tax credit in several ways, including giving developers more credit for certain projects for low-income households and changing tenant eligibility rules.

The bill was introduced in the House and the Senate last session, and is co-sponsored by Mississippi Sens. Cindy Hyde-Smith and Roger Wicker and in the House by Reps. Mike Ezell, and Michael Guest. As of this spring, both bills are in committee.

While housing has become a major issue for Americans, getting legislation passed has been challenging. “Everybody knows that housing is an issue, but it gets caught up with everything else…and it kind of gets lost in the shuffle,” said Spivey.

This issue is especially important in Mississippi, where demand for housing is high across all incomes.

“All the market studies that we see that come with the applications tell us that there’s a huge need for affordable housing across the state at all the income bands” said Spivey.

According to the National Low Income Housing Coalition, almost a third of Mississippi renters are extremely low income; 65% of them are severely cost burdened, meaning they spent more than half their income on rent. The majority of these households are seniors, disabled people, single caregivers of young children, people enrolled in school, or other.

Director of Housing Law at the Mississippi Center for Justice, Ashley Richardson said housing problems worsened after Mississippi stopped participating in the federal rental assistance program in 2022.

MCJ’s work on housing includes a statewide eviction hotline, investigating instances of housing discrimination, and more.

Richardson praised the LIHTC program, but echoed Spivey’s concerns. “Even with the affordable housing we do have in Mississippi, we are still at a lack,” she said.

The National Housing Preservation Database estimates Mississippi is short 52,421 affordable and available rental homes for low-income people. The National Low Income Housing Coalition puts the figure at 49,478.

Richardson wants the state to deal with issues like providing more tenant protections and rental assistance. There’s also a need to improve homes that are rundown or in poor condition, and many housing nonprofits are running out of funding.

Spivey said people should talk to their property managers and learn about their rights. MHC’s website has resources for homebuyers and renters.

As the housing crisis goes on, there are options for people struggling to find and keep affordable housing and an effort to take action at the federal and state levels.

Some aspiring low-income homeowners may qualify for Habitat for Humanity, a program that builds homes for families in need. Families who qualify work on the homes alongside volunteers, pay an affordable mortgage and receive financial literacy education.

New applicants must meet the qualifications, including a good debt-income ratio, 125 hours of sweat equity and taking classes on financial literacy, home repairs, and being a good neighbor.

Merrill McKewen, executive director for Habitat for Humanity Mississippi Capital Area, emphasized the importance of housing to individuals and communities.

“There are untold studies that have been done that, you’ve gotta have a safe, decent, affordable place to live. The children are better students, the parents are better employees…it grounds you to a community that you can contribute to and be a part of. It is the American dream, to own a home, which is what we’re all about,” she said.

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

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Mississippi Today

Mississippi Election 2024: What will be on Tuesday’s ballot?

Published

8 hours ago

November 4, 2024

Staff Editor

mississippitoday.org – Bobby Harrison – 2024-11-04 10:00:00

Mississippians will go to the polls on Tuesday, Nov. 5, to elect federal and state judicial posts and some local offices, such as for election commissioners and school board members.

Polls will be open from 7 a.m. to 7 p.m. on Tuesday. To find your polling place, use the secretary of state’s locator, or call your local county circuit clerk.

The following is a list of the candidates for federal and judicial posts with brief bios:

President

Kamala Harris, current vice president and Democratic nominee for president. Her running mate is Tim Walz.
Donald Trump, former president and current Republican nominee. His running mate is J.D. Vance.
Robert Kennedy Jr. remains on the ballot in Mississippi even though he has endorsed Trump. His running mate is Nicole Shanahan.
Jill Stein is the Green Party candidate. Her running mate is Rudolph Ware.
Five other candidates will be on the Mississippi ballot for president. For a complete list of presidential candidates, see the sample ballot.

U.S. Senate

Ty Pinkins is the Democratic nominee. He is a Rolling Fork native and attorney, representing, among other clients, those alleging unfair working conditions. He served 21 years in the U.S. Army, including combat stints, other overseas deployment and posts in the White House,
Roger Wicker is the Republican incumbent senator. He resides in Tupelo and has served in the U.S. Senate since late 2007 after first being appointed to fill a vacancy by then-Gov. Haley Barbour. He was elected to the post in 2008. He previously served in the U.S. House and as a state senator. He is an attorney and served in the United States Air Force.

House District 1

Dianne Black is the Democratic nominee. She is a small business owner in Olive Branch in DeSoto County.
Trent Kelly is the Republican incumbent. He was elected to the post in a special election in 2015. He previously served as a district attorney and before then as a prosecuting attorney for the city of Tupelo. He is a major general in the Mississippi Army National Guard.

House District 2

Bennie Thompson is the Democratic incumbent. He was first elected to the post in 1993. Before then, he served as a Hinds County supervisor and as alderman and then as mayor of Bolton.
Ronald Eller is the Republican nominee. He grew up in West Virginia and moved to central Mississippi after retiring from the military. He is a physician assistant and business owner.

House District 3

Michael Guest is the Republican incumbent and is unopposed.

House District 4

Mike Ezell is the Republican incumbent first being elected in 2022. He previously served as Jackson County sheriff.
Craig Raybon is the Democratic nominee. Raybon is from Gulfport and began a nonprofit “focused on helping out the community as a whole.”

Central District Supreme Court

Jenifer Branning currently serves as a member of the state Senate from Neshoba County.
Byron Carter is a Hinds County attorney and previously served as a law clerk for Supreme Court Justice Armis Hawkins.
James Kitchens is the incumbent. He has served on the state’s highest court since 2008.
Ceola James previously served on the Court of Appeals.
Abby Gale Robinson is a Jackson attorney. She previously was a commercial builder.

Southern District Supreme Court

Dawn Beam is the incumbent, having been first appointed in 2016 by then-Gov. Phil Bryant and later winning election to the post. She is a former chancellor for the Hattiesburg area.
David Sullivan is an attorney in Harrison County and has been a municipal judge in D’Iberville since 2019. His father, Michael, previously served on the state Supreme Court.

Northern District Supreme Court seats

Robert Chamberlin of DeSoto County is unopposed.
James Maxwell of Lafayette County is unopposed.

Court of Appeals 5^th District seat

Ian Baker is an assistant district attorney in Harrison County.
Jennifer Schloegel is a Chancery Court judge for Harrison, Hancock and Stone counties.
Amy St. Pe is a Municipal Court judge in Gautier.