Mississippi Today
‘What’s your plan, watch Rome burn?’: Politicians continue to reject solution to growing hospital crisis
‘What’s your plan, watch Rome burn?’: Politicians continue to reject solution to growing hospital crisis
Note: This article is part of Mississippi Today’s ongoing Mississippi Health Care Crisis project.Read more about the project by clicking here.
Mississippi's only burn center has closed. The Delta's only neonatal intensive care unit has closed. A Jackson hospital that serves vulnerable populations is gutting key services to balance its budget. One of the state's largest hospitals is months, if not weeks, from shutting its doors for good.
Mississippi hospitals are in crisis, struggling to keep up with rising industry costs and cover care for the sixth-most uninsured population in America. Six hospitals have closed across the state since 2005, and countless more have reduced services and staff.
Even more sobering, the state's top health care leaders warn that a dozen more hospitals across the state are in imminent danger of closing.
“Things are getting worse, not better,” Dr. Dan Edney, the state’s health officer, said in an October Board of Health meeting. “We know of 10-12 hospitals statewide that may not even be here one year from now … Those of us who are watching this in health care leadership statewide have a lot of concern.”
As the Mississippi health care crisis worsens, the state's political leaders are facing growing pressure from health care professionals to do something they've refused for 12 years: expand Medicaid. Doing so, as 38 states have done, would provide immediate financial relief to the state's hospitals that are struggling to stay alive, countless economic and health care experts have said.
About 12% of Mississippians are uninsured, leaving hospitals with little to no way to recoup the costs of care administered to some of the nation’s poorest and unhealthiest patients. Hospitals are required to provide life-saving care to everyone, regardless of whether they’re insured. In many cases, those costs are bringing hospitals — including Greenwood Leflore Hospital in the Mississippi Delta — to the brink of closing.
Studies, including one from the state economist, have shown Medicaid expansion would provide health care coverage for at least 200,000 primarily working Mississippians who don’t currently have it. More than $1 billion per year would flow to the state after expansion, and hospitals would directly receive hundreds of millions to cover rising costs. The study also showed Medicaid expansion would create more than 11,000 jobs per year from 2022 to 2027.
READ MORE: Mississippi leaving more than $1 billion per year on table by rejecting Medicaid expansion
"When you have major hospital systems in this state that have lost a quarter billion dollars last year, hospitals that have never had losses having them now and others budgeting for major losses for next year — the number of hospitals close to the brink is the most it's ever been,” said Tim Moore, president of the Mississippi Hospital Association, an organization that has for years lobbied for Medicaid expansion.
But Gov. Tate Reeves, Speaker of the House Philip Gunn and several powerful political brokers in Jackson have stood firm against even the suggestion of expansion, ignoring the dozens of economic experts who say the state can afford it and that hospitals would be much better off.
“No, I don't support expanding Medicaid in Mississippi,” Reeves told a Mississippi Today reporter last week during a hospital event in Ocean Springs. “I made, very clear, my position when I was running for governor in 2019. What we've got to do in Mississippi is we've got to continue to focus on economic development, job creation, bringing better and higher paying jobs to our state.”
The health care landscape in Mississippi — and nationwide — has changed dramatically since Reeves first made that campaign promise. The stresses of the pandemic widened the cracks in already struggling hospital systems. Labor and supplies costs have surged, making even traditionally profitable hospitals reassess their budgets and services.
Reeves recently pushed legislation giving $246 million in state-funded incentives to a steel mill promising 1,000 new jobs in 10 years. It is private sector jobs, Reeves said, that will most benefit the state’s health care.
“People who work in the private sector that have private insurance have typically far better coverage,” he said.
But the state’s leaders have repeated that refrain for many years, and little has budged with either job creation or health care outcomes. Meanwhile, hospitals across the state are scrambling to make up for lost revenue.
READ MORE: Who’s opposed to Mississippi Medicaid expansion and why?
One of the state’s largest hospitals, North Mississippi Medical Center in Tupelo, is having to manage higher operating costs while caring for uninsured patients. State Sen. Chad McMahan, a Republican who represents the hospital and surrounding area, stops short of advocating for Medicaid expansion. But unlike many of his GOP colleagues in the Legislature, he wants to debate its merits.
The main reason he’s publicly bucked his party leaders, McMahan says: His local hospital would benefit.
“I’ll tell you how large the hospital is,” McMahan told Mississippi Today. “The hospital is so large that if it were to close, we’d have to have seven Toyota-sized manufacturing plants to replace the economic value and salaries (of the hospital), which means it would never happen in our lifetime. Values of homes would drop 15% overnight. You better believe I’m for health care. I’m for health care because it's the right thing to do for Mississippians … It’ll sustain our communities, cities and counties.”
Gulfport Memorial Hospital, another major institution whose CEO is a major political donor to Reeves, reported operating costs going up nearly 18% in 2021. They hit operating losses just shy of $67 million for the last fiscal year.
To Gulfport’s east, the Singing River Health System’s CEO is searching for a larger system to buy its publicly-owned Gulf Coast hospitals. The system is not in dire financial straits, but leadership says they’re trying to be proactive before they hit a crisis point.
In his recent announcement of the tax incentives for the steel mill, Reeves did not mention the 600-plus current jobs that are in jeopardy at Greenwood Leflore Hospital. But the major hospital in the Delta could close imminently, leaders warn. They hoped to strike a deal with the state’s only academic hospital – Jackson’s University of Mississippi Medical Center – but those plans dissolved at the beginning of the month.
Greenwood Leflore leaders are trying to stretch their budget to stay open over the next two months with hopes the Mississippi Legislature will step in to save it. Greenwood Leflore interim CEO Gary Marchand has publicly advocated for Medicaid expansion, saying it would go a long way in helping balance the hospital’s budget.
“What’s your plan: To watch Rome burn and to let hospitals close?” said Dr. Gary Wiltz, a Medicaid advocate and the CEO of a system of 19 of rural health clinics in Louisiana. “It goes back to a fundamental question: is health care a right or a privilege?”
Q&A: What is Medicaid expansion, really?
Pioneer Community Hospital of Newton on Thursday, Nov. 10, 2022. The hospital closed in December 2015.
Merit Health Central, a private hospital in Jackson, has moved or is planning to move its cardiovascular services, neonatal intensive care unit and endoscopy to other locations outside of the city. It already closed its burn center – the only in the state to provide specialized care.
Merit Health Central, formerly Hinds General Hospital, has long been a health care and employment hub in south and west Jackson. Merit Health pointed to “the state’s decision to not expand Medicaid” in addition to labor costs and staffing challenges as to why it is scaling back its operations in a statement to Mississippi Today.
Even Mississippi hospitals that may not be in imminent danger of closing are still facing uncovered costs that are beginning to bleed their budgets dry. Masks, surgical supplies, even food and human resource services have all shot up cost – and that’s on top of the charity treatment hospitals incur costs of for patients too poor to pay for care.
Stan Bulger, who serves on the board of directors at Magee General Hospital, said expanding Medicaid would help to offset revenue losses his hospital incurs for uncompensated care.
"We're losing out on about 15% of the revenue we could collect every month," Bulger said. "We're constantly trying to find ways to make that work, but if you think about it, no business can operate long-term with that much loss. Expanding Medicaid would significantly help us cover that hole, and it could legitimately keep us alive."
UMMC, the state’s only academic hospital, had a $7 million loss in its first fiscal quarter – a loss they predicted as they battled rising nursing costs. The hospital system spent $22 million on staffing temporary nurses to fill gaps. These nurses make about two-and-half times the salaries of those nurses actually employed by the hospital.
Singing River has about 200 positions open. That’s staffing they, too, have to fill with pricier contracted labor. Singing River CEO Tiffany Murdock said she supports Medicaid expansion – and that she agrees any revenue would help hospitals fill gaps.
“If they’re just coming into our hospital with those acute care problems, they are a high dollar,” said Murdock. “With (Medicaid expansion) we’d get reimbursement for that expense that right now…we’re not.”
Increased health care coverage would also likely lead to better patient outcomes. Typically patients without health care go without a primary care doctor, their health problems getting worse – and more expensive – than if they had access to intervening medical care.
Kilmichael Hospital in Kilmichael on Thursday, Nov. 10, 2022. The hospital closed in January 2015.
Wiltz, the Louisiana doctor and CEO of Teche Action Clinic, saw how health care in Louisiana transformed under Medicaid expansion: diabetes patients who risked limb loss with their disease now under control and people with cancerous polyps removed during colonoscopies they would have likely never had without coverage.
As of October of this year, 750,340 people in Louisiana have enrolled in Medicaid expansion. Since 2017, the state health department reported that 84,651 people received colonoscopies that likely wouldn’t have before expansion. Of that, close to 26,000 got polyps removed that could help prevent colon cancer. Another 131,680 got breast cancer screenings.
Wiltz has an easier time balancing his system’s books to secure their future serving rural residents because of the reliable reimbursements form his patients.
“Thank God Louisiana and our governor had enough integrity and compassion to expand Medicaid,” he said. “I really hope that other states – particularly Mississippi – that sees a similar population as we do would come to that same conclusion.”
But in Mississippi, as health care leaders continue to hope Medicaid expansion could soon get a fair debate at the Capitol, they’re having to live with the financial consequences of politics.
“I've been involved in health care in Mississippi since the early 1970s, and this is the worst, by far, of that span in my 50-year career in medicine in this state — both in terms of stability of hospitals, of having enough nurses and doctors and therapists and specialists to staff our hospitals, and in terms of patients having access to care because they're uninsured,” said Dr. Dan Jones, former chief executive of the University of Mississippi Medical Center who has since become the American Heart Association's national volunteer lead for healthcare expansion.
“People dying and hospitals closing are a real consequence of our failure to take advantage of expanding Medicaid.”
Mississippi Today’s Kate Royals, Geoff Pender and Adam Ganucheau contributed to this report.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Early voting proposal killed on last day of Mississippi legislative session
Mississippi will remain one of only three states without no-excuse early voting or no-excuse absentee voting.
Senate leaders, on the last day of their regular 2025 session, decided not to send a bill to Gov. Tate Reeves that would have expanded pre-Election Day voting options. The governor has been vocally opposed to early voting in Mississippi, and would likely have vetoed the measure.
The House and Senate this week overwhelmingly voted for legislation that established a watered-down version of early voting. The proposal would have required voters to go to a circuit clerk’s office and verify their identity with a photo ID.
The proposal also listed broad excuses that would have allowed many voters an opportunity to cast early ballots.
The measure passed the House unanimously and the Senate approved it 42-7. However, Sen. Jeff Tate, a Republican from Meridian who strongly opposes early voting, held the bill on a procedural motion.
Senate Elections Chairman Jeremy England chose not to dispose of Tate’s motion on Thursday morning, the last day the Senate was in session. This killed the bill and prevented it from going to the governor.
England, a Republican from Vancleave, told reporters he decided to kill the legislation because he believed some of its language needed tweaking.
The other reality is that Republican Gov. Tate Reeves strongly opposes early voting proposals and even attacked England on social media for advancing the proposal out of the Senate chamber.
England said he received word “through some sources” that Reeves would veto the measure.
“I’m not done working on it, though,” England said.
Although Mississippi does not have no-excuse early voting or no-excuse absentee voting, it does have absentee voting.
To vote by absentee, a voter must meet one of around a dozen legal excuses, such as temporarily living outside of their county or being over 65. Mississippi law doesn’t allow people to vote by absentee purely out of convenience or choice.
Several conservative states, such as Texas, Louisiana, Arkansas and Florida, have an in-person early voting system. The Republican National Committee in 2023 urged Republican voters to cast an early ballot in states that have early voting procedures.
Yet some Republican leaders in Mississippi have ardently opposed early voting legislation over concerns that it undermines election security.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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Mississippi Today
Mississippi Legislature approves DEI ban after heated debate
Mississippi lawmakers have reached an agreement to ban diversity, equity and inclusion programs and a list of “divisive concepts” from public schools across the state education system, following the lead of numerous other Republican-controlled states and President Donald Trump’s administration.
House and Senate lawmakers approved a compromise bill in votes on Tuesday and Wednesday. It will likely head to Republican Gov. Tate Reeves for his signature after it clears a procedural motion.
The agreement between the Republican-dominated chambers followed hours of heated debate in which Democrats, almost all of whom are Black, excoriated the legislation as a setback in the long struggle to make Mississippi a fairer place for minorities. They also said the bill could bog universities down with costly legal fights and erode academic freedom.
Democratic Rep. Bryant Clark, who seldom addresses the entire House chamber from the podium during debates, rose to speak out against the bill on Tuesday. He is the son of the late Robert Clark, the first Black Mississippian elected to the state Legislature since the 1800s and the first Black Mississippian to serve as speaker pro tempore and preside over the House chamber since Reconstruction.
“We are better than this, and all of you know that we don’t need this with Mississippi history,” Clark said. “We should be the ones that say, ‘listen, we may be from Mississippi, we may have a dark past, but you know what, we’re going to be the first to stand up this time and say there is nothing wrong with DEI.'”
Legislative Republicans argued that the measure — which will apply to all public schools from the K-12 level through universities — will elevate merit in education and remove a list of so-called “divisive concepts” from academic settings. More broadly, conservative critics of DEI say the programs divide people into categories of victims and oppressors and infuse left-wing ideology into campus life.
“We are a diverse state. Nowhere in here are we trying to wipe that out,” said Republican Sen. Tyler McCaughn, one of the bill’s authors. “We’re just trying to change the focus back to that of excellence.”
The House and Senate initially passed proposals that differed in who they would impact, what activities they would regulate and how they aim to reshape the inner workings of the state’s education system. Some House leaders wanted the bill to be “semi-vague” in its language and wanted to create a process for withholding state funds based on complaints that almost anyone could lodge. The Senate wanted to pair a DEI ban with a task force to study inefficiencies in the higher education system, a provision the upper chamber later agreed to scrap.
The concepts that will be rooted out from curricula include the idea that gender identity can be a “subjective sense of self, disconnected from biological reality.” The move reflects another effort to align with the Trump administration, which has declared via executive order that there are only two sexes.
The House and Senate disagreed on how to enforce the measure but ultimately settled on an agreement that would empower students, parents of minor students, faculty members and contractors to sue schools for violating the law.
People could only sue after they go through an internal campus review process and a 25-day period when schools could fix the alleged violation. Republican Rep. Joey Hood, one of the House negotiators, said that was a compromise between the chambers. The House wanted to make it possible for almost anyone to file lawsuits over the DEI ban, while Senate negotiators initially bristled at the idea of fast-tracking internal campus disputes to the legal system.
The House ultimately held firm in its position to create a private cause of action, or the right to sue, but it agreed to give schools the ability to conduct an investigative process and potentially resolve the alleged violation before letting people sue in chancery courts.
“You have to go through the administrative process,” said Republican Sen. Nicole Boyd, one of the bill’s lead authors. “Because the whole idea is that, if there is a violation, the school needs to cure the violation. That’s what the purpose is. It’s not to create litigation, it’s to cure violations.”
If people disagree with the findings from that process, they could also ask the attorney general’s office to sue on their behalf.
Under the new law, Mississippi could withhold state funds from schools that don’t comply. Schools would be required to compile reports on all complaints filed in response to the new law.
Trump promised in his 2024 campaign to eliminate DEI in the federal government. One of the first executive orders he signed did that. Some Mississippi lawmakers introduced bills in the 2024 session to restrict DEI, but the proposals never made it out of committee. With the national headwinds at their backs and several other laws in Republican-led states to use as models, Mississippi lawmakers made plans to introduce anti-DEI legislation.
The policy debate also unfolded amid the early stages of a potential Republican primary matchup in the 2027 governor’s race between State Auditor Shad White and Lt. Gov. Delbert Hosemann. White, who has been one of the state’s loudest advocates for banning DEI, had branded Hosemann in the months before the 2025 session “DEI Delbert,” claiming the Senate leader has stood in the way of DEI restrictions passing the Legislature.
During the first Senate floor debate over the chamber’s DEI legislation during this year’s legislative session, Hosemann seemed to be conscious of these political attacks. He walked over to staff members and asked how many people were watching the debate live on YouTube.
As the DEI debate cleared one of its final hurdles Wednesday afternoon, the House and Senate remained at loggerheads over the state budget amid Republican infighting. It appeared likely the Legislature would end its session Wednesday or Thursday without passing a $7 billion budget to fund state agencies, potentially threatening a government shutdown.
“It is my understanding that we don’t have a budget and will likely leave here without a budget. But this piece of legislation …which I don’t think remedies any of Mississippi’s issues, this has become one of the top priorities that we had to get done,” said Democratic Sen. Rod Hickman. “I just want to say, if we put that much work into everything else we did, Mississippi might be a much better place.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
House gives Senate 5 p.m. deadline to come to table, or legislative session ends with no state budget
The House on Wednesday attempted one final time to revive negotiations between it and the Senate over passing a state budget.
Otherwise, the two Republican-led chambers will likely end their session without funding government services for the next fiscal year and potentially jeopardize state agencies.
The House on Wednesday unanimously passed a measure to extend the legislative session and revive budget bills that had died on legislative deadlines last weekend.
House Speaker Jason White said he did not have any prior commitment that the Senate would agree to the proposal, but he wanted to extend one last offer to pass the budget. White, a Republican from West, said if he did not hear from the Senate by 5 p.m. on Wednesday, his chamber would end its regular session.
“The ball is in their court,” White said of the Senate. “Every indication has been that they would not agree to extend the deadlines for purposes of doing the budget. I don’t know why that is. We did it last year, and we’ve done it most years.”
But it did not appear likely Wednesday afternoon that the Senate would comply.
The Mississippi Legislature has not left Jackson without setting at least most of the state budget since 2009, when then Gov. Haley Barbour had to force them back to set one to avoid a government shutdown.
The House measure to extend the session is now before the Senate for consideration. To pass, it would require a two-thirds majority vote of senators. But that might prove impossible. Numerous senators on both sides of the aisle vowed to vote against extending the current session, and Lt. Gov. Delbert Hosemann who oversees the chamber said such an extension likely couldn’t pass.
Senate leadership seemed surprised at the news that the House passed the resolution to negotiate a budget, and several senators earlier on Wednesday made passing references to ending the session without passing a budget.
“We’ll look at it after it passes the full House,” Senate President Pro Tempore Dean Kirby said.
The House and Senate, each having a Republican supermajority, have fought over many issues since the legislative session began early January.
But the battle over a tax overhaul plan, including elimination of the state individual income tax, appeared to cause a major rift. Lawmakers did pass a tax overhaul, which the governor has signed into law, but Senate leaders cried foul over how it passed, with the House seizing on typos in the Senate’s proposal that accidentally resembled the House’s more aggressive elimination plan.
The Senate had urged caution in eliminating the income tax, and had economic growth triggers that would have likely phased in the elimination over many years. But the typos essentially negated the triggers, and the House and governor ran with it.
The two chambers have also recently fought over the budget. White said he communicated directly with Senate leaders that the House would stand firm on not passing a budget late in the session.
But Senate leaders said they had trouble getting the House to meet with them to haggle out the final budget.
On the normally scheduled “conference weekend” with a deadline to agree to a budget last Saturday, the House did not show, taking the weekend off. This angered Hosemann and the Senate. All the budget bills died, requiring a vote to extend the session, or the governor forcing them into a special session.
If the Legislature ends its regular session without adopting a budget, the only option to fund state agencies before their budgets expire on June 30 is for Gov. Tate Reeves to call lawmakers back into a special session later.
“There really isn’t any other option (than the governor calling a special session),” Lt. Gov. Delbert Hosemann previously said.
If Reeves calls a special session, he gets to set the Legislature’s agenda. A special session call gives an otherwise constitutionally weak Mississippi governor more power over the Legislature.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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