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Republicans vowed a robust post-Roe agenda. Here’s how it’s going.

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Republicans vowed a robust post-Roe agenda. Here's how it's going.

After leading the charge to overturn Roe v. Wade and outlaw abortion in Mississippi, Republican leaders promised to address the inevitable fallout and prioritize support to pregnant women and babies.

Yet many bills filed this legislative session to strengthen the social safety net, fund child care for low-income parents and increase access to resources like contraceptives have all died before lawmakers had a chance to vote on them.

While debate rages over the most visible piece of legislation to improve outcomes for expectant moms, postpartum Medicaid coverage, the help pledged by Mississippi's politicians in the wake of Roe extends far beyond health care. It considers financial and economic stability, improved public assistance policies, family stabilization, streamlined adoption processes and more.

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Gov. Tate Reeves has called this an “ambitious new pro-life agenda.” Mississippi Attorney General Lynn Fitch, who historically defended Mississippi's abortion ban in Dobbs v. Jackson Women's Health Organization before the U.S. Supreme Court, described her mission to “support the whole life and the whole woman.” Speaker of the House Philip Gunn called it “an opportunity to lead the nation in protecting, promoting, and supporting life.”

The programs and initiatives, many of them at the discretion of the Legislature, aim to ensure that women who feel unprepared to become mothers are supported and have access to resources to successfully care for their child. They also try to address the reality that these unwanted or unplanned pregnancies and births could result in more in the state's plagued foster care system, without homes or families.

For Republicans, these goals are met by funding private pregnancy centers, typically faith-based organizations focused on anti-abortion advocacy as opposed to professional social work; cracking down on child support enforcement; and making it easier for people who do not want to be parents to give up their children for adoption.

More Democratic lawmakers and family advocates believe these objectives would be better accomplished by expanding Medicaid; reforming the state's welfare agency; increasing workforce development and workplace protections for women; and funding more child care vouchers for low-income parents. Most of this legislation died without a vote, including more than 15 bills introduced to expand Medicaid.

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There is one niche but impactful policy change that both Reeves and advocates for low-income families support: to remove the child support enforcement requirement within the child care voucher program. Mississippi's Child Care Payment Program, which provides child care vouchers to low-income working families, is funded by the annual federal Child Care Development Block Grant (CCDBG) and administered by the Mississippi Department of Human Services. Mississippi's child care block grant was about $94 million in 2023.

The Legislature has not proposed legislation to do this, but legal experts say that because the requirement is not mandated by state or federal statute, Mississippi Department of Human Services could make the rule change on its own.

Reeves has also thrown his support behind new child care tax credits, increased corporate tax credits for crisis pregnancy centers and a special partnership with an adoption agency called Lifeline Children's Services.

“We must be willing to prove that being pro-life is not simply being anti-abortion,” Reeves said on the Paul Gallo Show on conservative talk radio network SuperTalk on Jan. 11. “Because of that we've initiated a very aggressive new pro-life agenda in our state. We've proposed establishing child tax credits for child care, increasing the first of its kind across America pregnancy resource center tax credit. We want to partner with Lifeline Children's Services to ensure that we're helping the moms and newborn babies.”

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Mississippi Today compiled and analyzed more than 60 pieces of legislation that could satisfy politicians' stated post-Roe agenda. Twenty-six were still alive by early February after the first round of legislative deadlines for general bills.

Access to resources

Republicans are looking to crisis pregnancy centers as the primary support system for women facing an unplanned pregnancy.

House Bill 468, introduced by Gunn, R-Clinton, would increase an existing tax credit for corporations who donate to pregnancy centers from an annual aggregate total of $3.5 million to $10 million. While lawmakers have not taken action on the bill, it remains alive because it is considered a revenue bill, which lawmakers don't have to take up until a Feb. 22 deadline.

The tax credit, which Gov. Reeves supports, was initially created by legislation last year.

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Only centers that align themselves with the statewide organization Choose Life Mississippi, run by ardent anti-abortion activist Terri Herring, are eligible for the tax credit. But the companies that benefit from the program are a mystery – the Mississippi Department of Revenue does not release a list of those that claimed the credit.

Reeves also supports direct taxpayer contributions to these centers.

House Bill 983, which died in committee, would have created the Pregnancy Resources Grant Program under the Mississippi Department of Child Protection Services to award competitive grants to crisis pregnancy centers. A separate appropriations bill to fund the CPS grant program, House Bill 1546, is still alive.

Senate Bill 2781 would create the Mississippi Access to Maternal Assistance Program within the Mississippi State Department of Health. The program would serve as a resource hub, coordinating and promoting information about services for expectant mothers, such as adoption assistance, child care, domestic abuse protection, early intervention, food, clothing, job training and placement, paternity, parenting skills, prenatal and postpartum care. That bill is still alive.

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Other bills to actually pump resources through the health department, instead of just coordinating them, died. House Bill 1085 and House Bill 506 would have required a nurse practitioner to be present at each of the county health departments weekly to provide contraceptive supplies, either for free or on a sliding fee scale. House Bill 1263 would have required county health departments to provide free menstrual hygiene products. House Bill 1372 would have added a line item to the health department's budget for funding to the Child Advocacy Centers, community-based resource centers for children and mothers experiencing abuse, which have recently faced large budget cuts. None of these bills received noticeable attention.

Economic health

Opponents to legal abortion have also acknowledged the need to improve the economic position of mothers, as well as people who choose to adopt.

One policy that national advocates have recommended for years – a state Earned Income Tax Credit – would provide an income boost to low-income working Mississippians. State Auditor Shad White, who investigated the welfare scandal, supports the tax credit and said the state could use welfare funds to implement the program at no new cost to the state.

“Economists agree that EITCs are one of the best ways to improve the and help working people,” White wrote in a column last year. “The EITC would directly attack a critical problem facing the state. More people working means stronger families, more tax revenue, and a better economy. Policymakers should put money into the hands of working people and get Mississippi moving forward.”

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The Mississippi Legislature has routinely ignored any legislation to start offering a state Earned Income Tax Credit, which models an existing tax credit on the federal side.

House Bill 321 and Senate Bill 2897, both authored by Democrats, are the two Earned Income Tax Credit bills before the Legislature this year.

Other bills introduced by Republicans to create tax credits for child care and adoption expenses might have an easier road ahead this session.

House Bill 130, House Bill 322 and Senate Bill 2898 would provide a new income tax credit to parents for child care expenses.

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“As long as we have an income tax, we should use it to incentivize the responsible raising of children,” Reeves wrote in his budget recommendation. “These policy changes are tangible ways to reduce the costs of raising a family in America today.”

Similarly, House Bill 1268 and Senate Bill 2696, which passed the Senate, would increase tax credits for adoptive parents to pay for adoption-related expenses.

Fitch supports House Bill 505 and Senate Bill 2335, which incentivize employers to offer additional benefits to parents. House Bill 505 provides tax credits to employers who provide maternity and paternity leave for its employees and Senate Bill 2335 provides tax credits to employers who pay for their employees' child care.

All of these are considered revenue bills, so they are still alive, awaiting the later deadline.

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Two bills to strengthen women's standing in the workforce – the Mississippi Pregnant Workers Fairness Act and the Mississippi Paid Family Leave Act – died without consideration.

House Bill 1361 would have prohibited employers from discriminating against women because they are pregnant, and Senate Bill 2286 would have required employers with more than 50 employees to offer 12 weeks of paid leave for childbirth.

Mississippi has among the lowest wages and median household income of any state in the country. Minimum wage in the state, which follows the federal minimum wage of $7.25, has not increased since 2009.

Seven bills to increase the minimum wage – House Bill 96, House Bill 323, House Bill 583, House Bill 810, Senate Bill 2284, Senate Bill 2288 and Senate Bill 2439 – died without a vote.

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Welfare policies

Following revelations about widespread abuse within Mississippi's Temporary Assistance for Needy Families (TANF) program, or welfare, Democratic lawmakers filed several reforms to the Mississippi Department of Human Services.

Currently, Mississippi has over $100 million in TANF funds sitting idle. The department has not answered repeated questions from Mississippi Today about how it plans to use the reserve.

  • House Bill 463, House Bill 774, Senate Bill 2794 would have moved tens of millions of the state's annual TANF block grant to supplement the state's child care voucher program, potentially providing child care to thousands of working parents who might not have it otherwise. The federal government allows states to use 30% of its block grant this way.
  • House Bill 1431, a perennial bill from Rep. Omeria Scott, D-Laurel, would have required the state to use unspent TANF funds on tuition and expenses for nursing students, simultaneously providing workforce training to low-income Mississippians and addressing the state's nursing shortage.
  • House Bill 612 would have required the welfare agency to provide transportation and child care to TANF recipients, to assist them with completing the application process and participating in the required work program.
  • House Bill 613 would have limited TANF programs to serve people below 200% of the federal poverty line.
  • House Bill 502 would have increased the monthly TANF cash assistance by more than $200.
  • House Bill 970 would have prevented the state from using TANF funds for college scholarships to families who are not receiving TANF benefits. Historically, the state has reported its annual appropriations to the state's scholarship programs as TANF spending in order to match the federal grant and pull down the funding. The effect of this is that money that should be going towards anti-poverty programs is actually being used to benefit middle-class families, Mississippi Today first reported in 2019.
  • House Bill 971 would have loosened eligibility for TANF, removing the upfront job search requirement, which significant barriers to applicants.
  • Senate Bill 2331 would have removed the requirement that single moms sue their child's father for child support – the same restriction Reeves supports dismantling in the child care voucher program – in order to qualify for TANF or food assistance through the Supplemental Nutrition Assistance Program.
  • Senate Bill 2806 would have removed the drug testing requirement from the TANF program.

Though all of these bills died without consideration, Democratic lawmakers took the opportunity to discuss these policies when a repealer bill for the Mississippi Department of Human Services – standard legislation that comes up every few years to extend the life of an agency – reached the Senate floor Tuesday.

While presenting his amendment to the repealer bill, Sen. David Blount, D-Jackson, criticized MDHS for using $30 million in TANF funds each year to supplement the Mississippi Department of Child Protection Services, which he argued should be funded with state appropriations. This is just one example of how the state fails to use these dollars in the most effective way to fight poverty.

“It's all legal but it's wrong,” Blount said. “And we need to fix it.”

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Blount's amendment would have moved $30 million in TANF funds to the child care voucher program. Sen. Derrick Simmons, D-Greenville, also introduced an amendment to remove the drug testing requirement for TANF applicants. Sen. Rod Hickman, D-Macon, noted the extremely low approval rate of TANF applications – as low as 2% in some years – when he introduced a bill that prohibits MDHS from denying assistance to families under 130% of the federal poverty level.

Republican senators killed all three amendments.

“The question posed by the amendments today is: In response to the biggest public scandal involving a state agency in the history of this state, what did the Legislature do? The answer expressed today is nothing. We do nothing. We make no changes,” Blount said. “That attitude is the reason we got in this problem in the first place, because it is the disregard for the politically powerless.”

Mississippi Department of Human Services Director Bob Anderson has asked the Legislature to make one important reform to the department to ensure it runs smoothly so that it can serve all eligible applicants: Remove the bureaucratic red tape created by the Medicaid and Human Services Transparency and Fraud Prevention Act, dubbed the HOPE Act, passed in 2017.

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A bill this session to do this, House Bill 503, died.

Conversely, Republican lawmakers have filed bills to increase restrictions or make it harder still for low-income families to access public assistance.

Sen. Angela Hill, R-Picayune, introduced a bill to require the welfare department to include photo identification on Electronic Benefit Transfer (known as “EBT”) cards — the cards recipients use to spend their Supplemental Nutrition Assistance Program (SNAP), or food stamps, benefits. The bill, which died, would have prevented more than two people in the family from being able to use the card.

Two other dead bills, filed by Sen. Melanie Sojourner, R-Natchez, would have prohibited TANF funds from going to people convicted of several felonies and require TANF recipients to participate in community services.

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Child support & fatherhood

“The Republican Party Platform affirms ‘our moral obligation to assist, rather than penalize, women who face an unplanned pregnancy,” reads a 2022 column in the Hill co-authored by Fitch. “At the urging of then-Treasurer Lynn Fitch, the platform that stands today supports ‘legislation that requires financial responsibility for the child be equally borne by both the mother and father.'”

The strict ban on abortion has brought renewed attention to the state's long-troubled child support program, which provides legal services to help separated custodial parents secure court orders against the noncustodial parent for monthly child support payments. Many of the single moms in the child support program are forced into the system as a condition for receiving public assistance from the state.

The enforcement side of the program, which is run by a private contractor, then helps enforce the order by locating the noncustodial parent, establishing paternity if necessary, garnishing wages, intercepting tax refunds, and in extreme cases, suspending driver's licenses or filing criminal charges in the case of unpaid support.

(The child support privatization contract with Young Williams has come under scrutiny in recent years for failing to require that the contractor meet certain performance-based metrics, something MDHS says it solved in its existing contract. House Bill 177 would have eliminated the contract and brought the program back in-house. It died.)

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Lawmakers filed several bills to tweak the child support program to, as Fitch said, “require fathers carry their equal share of the financial needs of childbearing and child-caring.”

  • House Bill 6, House Bill 1046, House Bill 1083, and Senate Bill 2385 would set up procedures to allow the child support enforcement program to intercept gambling winnings for unpaid child support.
  • House Bill 1114 would increase the cap of how much a person's income goes towards child support. Currently, a person with five or more children under support orders must pay 26% of their income in child support payments. The bill would revise the law so that a person with six or more children pays 30% of their income. Reeves publicly supports this policy change.
  • House Bill 320 and House Bill 1117 would revise the law so that monthly child support payments begin when a woman becomes pregnant, instead of after birth. HB 1117 would also include prenatal and post-natal expenses as part of the order.
  • House Bill 1183 would require Mississippi Department of Human Services to publish the names and photos of people in child support arrearage.

All of these bills died.

The only bills to crack down on child support that remain alive are Senate Bill 2634, filed by Sen. Joey Fililngane, R-Sumrall, on behalf of Fitch's office, and House Bill 1490 by Speaker Gunn.

Fillingane's bill increases the statute of limitations for criminal charges against a person who refuses to pay child support. Currently, a person can be charged with desertion of a child if they are found to have wilfully neglected or refused to pay child support while the child is under 18. The bill would increase that age to 21 and also allow for charges to be pursued for three years after the child turns 21.

A nearly identical bill in the House, House Bill 1112, died.

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Gunn's bill requires the Wildlife, Fisheries and Parks to suspend the license of any person who has not paid child support.

“For too many families, regular and reliable child support payments can be the difference between steady meals and going hungry,” Fitch wrote in her most recent column for World News Group last week. “As four out of five custodial parents are women, too often this falls heavily on the mother. Fathers simply must be held equally responsible for their children financially. Women have borne this burden alone for too long.

Legislation that takes a more punitive approach to child support collections – which some advocates warn may lead to the criminalization of poverty – appears to reverse the national trend.

In 2016, the federal Office of Child Support Enforcement implemented a rule change that required states to enact safe guards so that before a parent is jailed for unpaid child support, there must be evidence that the parent has the funds and is willfully refusing to pay. The federal government gave states until 2022 to comply. The rule in part helps to ensure that states are following the 2011 U.S. Supreme Court in Turner v. Rogers, which said states must determine whether a parent is able to pay the ordered child support before incarcerating them for nonpayment.

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The 2016 rule also prohibits states from allowing child support debts to accrue while a parent is behind bars, but the practice still continues today. As a result of not complying, human services director Bob Anderson told lawmakers that Mississippi is at risk of losing its federal match for the operation of the child support enforcement program – about 66% of the program's budget.

To deal with this, Sen. Brice Wiggins, R-Pascagoula, introduced Senate Bill 2082, which suspends child support arrears from accruing when a person is in prison or involuntarily institutionalized for longer than 180 days. House Bill 1215 would do the same thing. Both are still alive.

Another bill that would have offered leniency to people dinged for not paying child support is Senate Bill 2218, introduced by Sen. Hill, which would have provided temporary driver's licenses for the purpose of employment and worship to people whose licenses were suspended due to unpaid child support. That bill died.

National child support experts have long acknowledged that a punitive approach to child support collections is not necessarily the most beneficial for families. If a father loses his license or goes to jail, for example, he might lose his job, only making it less likely he'll be able to make the monthly payment.

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“It's a very complex question when you're to force a parent to do what he or she ought to do anyway. And you can't legislate everything, but we try to do the best we can,” said Filingane. “Let's take the example of the driver's license being suspended. Well, then, if you're gonna follow the law, and you no longer have a driver's license, how do you expect that person to get to their job to earn the money to then turn around and pay the child support? … There's all these sometimes unintended consequences that happen.”

“And when you criminalize behavior and you end up throwing them in jail, sometimes it does the trick,” he continued. “It's fascinating that sometimes the person who swears up and down that he or she doesn't have a hundred bucks to their name and can't pay it cause they just don't have it, they end up in jail and less than eight hours later it's paid in full.”

The state's efforts to either force or incentivize fathers to participate in child rearing extend beyond the child support program. But information about the efficacy of those efforts is lacking.

Every year for the last several years, Mississippi has spent anywhere from $9 million to $39 million in TANF funds on grants to “Fatherhood and Two Parent Family Formation” programs, according to federal reports, but the department does not provide much information about what those programs entail, nor does it gather any records to show what outcomes the programs achieved.

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House Bill 1146, authored by Rep. Becky Currie, R-Brookhaven – the lawmaker who introduced the abortion ban that overturned Roe v. Wade – would have created the “Mississippi Fatherhood Initiative Fund” to distribute grants to local organizations providing parenting resources to fathers. The bill died.

Auditor White has placed a heavy focus on “fatherlessness” in recent months, releasing a report that aimed to demonstrate the cost of one-parent households on Mississippi taxpayers. One example: the report estimates that 50% of the state's prison population are men who come from “fatherless” homes, and the state spends $180 million annually to incarcerate them. (A bill to provide workforce training to inmates, House Bill 640, died).

The report lays out the purported problem – positioning “fatherlessness” as the root cause of societal ills associated with poverty, as opposed to the other way around – but the proposed are sparse.

White makes one recommendation: expand the JROTC military program in high schools across the state.

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“Countless studies prove our communities and families — along with the average taxpayer — would benefit from strong, engaged fathers and father figures in the lives of Mississippi's children,” the report reads. “One program interrupting the cycle of fatherlessness is the Junior Reserve Officer's Training Corps (JROTC).”

White points to the 100% graduation rate of students in the program. The cost of expanding the program to all high schools is $185 million, according to White's separate 2020 report on JROTC. There has been no legislation introduced this session to do this.

But there have been bills – House Bill 1360, House Bill 1413, House Bill 1414 and House Bill 1419 – to implement various high school dropout prevention and academic performance improvement programs in struggling districts. They all died without consideration.

Reeves supports at least one initiative in this arena: Placing career coaches in high schools across the state. His workforce cabinet began the program last year with $8 million in pandemic relief funding. Reeves recommends doubling it.

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“These coaches will especially be directed toward low-income areas, helping to inspire young Mississippians with the abundance of pathways available for fulfilling careers,” Reeves said.

House Bill 274, authored by Speaker Gunn, would provide $12 million to the Office of Workforce Development, called Accelerate MS, to fund more coaches. The bill is still alive, awaiting the appropriations deadline.

Baby drop off, foster care, and adoption

After the Dobbs ruling, health professionals in Mississippi estimated that the state should prepare itself to handle an additional 5,000 births each year. There are already about 4,000 kids in the state's foster care system – which is still under a decades-long federal court settlement because of its failure to properly care for kids in its care.

Reeves proposes several measures he believes will alleviate issues caused by unplanned births, including increasing the amount of time a parent is to “drop off” a baby without facing consequences; increasing subsidies to adoptive parents; and making modest budget increases to the Mississippi Department of Child Protection Services to hire more personnel and reduce adoption backlogs.

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The court settlement, referred to as Olivia Y, has required Mississippi to periodically increase the public subsidy foster families receive to care for foster children. But the state failed to make similar increases to the adoption subsidy, meaning families are facing a scenario where it makes more financial sense to foster than to adopt.

“It creates an artificial incentive for courts to keep children in state custody for the sole purpose of making sure that family has adequate funding to take care of the child,” Child Protection Services Commissioner Andrea Sanders said at a Legislative appropriations hearing last month.

She asked for an additional $12 million appropriation to fund increases to the adoption subsidy, as recommended by Reeves.

House Bill 510 would create versions of a “Foster Parents Bill of Rights and Responsibilities,” adding several provisions to existing statute that give foster care parents the opportunity to participate in various areas of the child's care, including communicating with the child's school, , guardian ad litem, and others. The Senate version of the bill, Senate Bill 2191, which died, would have also required the court to notify the attorney general's office when changes to a child's long-term care plan occur.

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House Bill 533, which is alive in the house, and Senate Bill 2611, which died, were introduced to ease requirements for parents seeking adoption in hopes to hasten the process. Instead of a compulsory home study before a child is placed for adoption, the bills would leave it up to a judge to determine if a home study is necessary. Additionally, Gunn's House Bill 1342 would create the “Board of Trustees of the Mississippi Adoption Licensure Authority” to regulate adoptions in the state and add new adoption procedures to state statute.

Senate Bill 2377 would enact the Mississippi Safe Haven Law, adding exhaustive measures to the existing statute, spelling out step-by-step the process for a parent to relinquish her child to an emergency medical services provider. This law, as well as House Bill 244, would increase the age a baby may be relinquished from seven days to 30 days. House Bill 1318, which passed the full house, takes this a step further, increasing the age to 90 days. If enacted, Mississippi would have one of the most lenient Safe Haven Laws in the nation with the exception of New Mexico (90 days) and North Dakota (one year), according to a 2021 Charlotte Lozier Institute analysis.

House Bill 634, which died, would have removed the age limit altogether and added “baby box” to the list of allowed drop-off destinations.

Children removed from their families often face challenges into adulthood. A bill to waive tuition at state schools for foster or adopted children, House Bill 127, died.

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The Legislature still has time to find the additional appropriations requested by CPS. But lawmakers face an even bigger budget question if it ever wants to stop using its federal TANF grant to fund the foster care agency – a financial maneuver that has prevented the state from being able to pull down unlimited dollar-for-dollar federal matching funds offered by the 2018 federal Family First Prevention Services Act.

Study Group on Women & Children

Several bills during the 2023 session came out of the Senate Study Group on Women, Children and Families, chaired by Sen. Nicole Boyd, an outspoken proponent of postpartum Medicaid extension.

Senate Bill 2781, Senate Bill 2898, Senate Bill 2696, Senate Bill 219 and Senate Bill 2377, described above, originated from the study group.

The group, which examined a broad range of issues affecting Mississippi families, also resulted in the following legislation, all of which remains alive:

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  • Senate Bill 2167: Create the Mississippi Early Intervention Pilot Project at Mississippi State 's TK Martin Center and create an Early Intervention Task Force to work on issues related to early childhood screenings and therapeutic services for children.
  • Senate Bill 2384: Create the Mississippi Task Force on Foster Care and Adoption to study and make recommendations for improving state laws related to foster care and adoption.
  • Senate Bill 2485: Revise qualifications for personnel under the Early Intervention Act for Infants and Toddlers to address shortages.
  • Senate Bill 2192: Clarify circumstances under which a presumed father cannot further contest paternity.

Finally, a bill to repeal Mississippi's abortion ban and put the issue to a statewide vote, House Bill 1385, died.

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

Mississippi Today

On this day in 1884

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May 4, 1884

of Ida B. Wells, circa 1893 Credit: Courtesy of National Park Service

Crusading journalist Ida B. Wells, an African-American native of Holly Springs, Mississippi, was riding a train from Memphis to Woodstock, Tennessee, where she worked as a teacher, when a white railroad conductor ordered her to move to another car. She refused.

When the conductor grabbed her by the arm, “I fastened my teeth in the back of his hand,” she wrote.

The conductor got from others, who dragged her off the train.

In response, she sued the railroad, saying the company forced Black Americans to ride in “separate but unequal” coaches. A local judge agreed, awarding her $500 in damages.

But the Tennessee Supreme Court reversed that ruling three years later. The upended her belief in the court system.

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“I have firmly believed all along that the was on our side and would, when we appealed it, give us justice,” she said. “I feel shorn of that belief and utterly discouraged, and just now, if it were possible, would gather my race in my arms and fly away with them.”

Wells knew about caring for others. At age 16, she raised her younger siblings after her and a brother died in a yellow fever epidemic. She became a teacher to her .

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

Did you miss our previous article…
https://www.biloxinewsevents.com/?p=355325

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Mississippi Today

From dummy bill to Hail Marys: How Mississippi’s Medicaid expansion efforts failed

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mississippitoday.org – Geoff Pender – 2024-05-04 06:00:00

As the 2024 Mississippi legislative gaveled open in January, it appeared to be the start of a new era. Many Capitol observers expected it to mark an end of several years of intense GOP in-fighting between the House and Senate — led by former Speaker Philip Gunn and Lt. Gov. Delbert Hosemann, respectively.

It also appeared a boon for an issue that had loomed for a decade over Mississippi's poor, sickly population and struggling hospitals: Medicaid expansion and the billions of federal dollars available to address this, but for red-meat Republican “anti-Obamacare” led by Gunn and Gov. Tate Reeves.

Newly-elected House Speaker Jason White said Medicaid expansion would be on the table in his House and vetted with pragmatism, not politics. This appeared to align with Hosemann's stated openness to such policy. For years he had been the lone statewide Republican leader to even leave the Medicaid expansion door open, and he had suffered political slings and arrows from Gunn and Reeves and others in his own party. He had to fend off a serious primary from the right last year that appeared to have tacit approval from Reeves.

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Now it appeared two like-minded, reasonable Republican politicians would together, eschew the far-right politics that had hamstrung efforts to address the state's health care crisis for years and work something out.

That didn't happen.

Early on, it became clear the two leaders and their lieutenants were not communicating much on Medicaid expansion (and other issues). They were on different trajectories and not only not on the same page, but not in the same book. And Reeves was working to sabotage any expansion efforts, particularly with rank-and-file members of the Senate over which he had presided as lieutenant governor for eight years.

The House held an open hearing on Medicaid expansion with testimony from experts — a sea change for a topic that had been taboo for legislative Republicans for much of the last decade. In February, with an overwhelming bipartisan vote, the House passed a Medicaid expansion plan, calling it a “moral imperative.”

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But the Senate was circumspect and secretive about whatever work it might be doing on Medicaid expansion. It had an expansion bill, but it was only a “dummy” bill containing law code sections and no details. Right up to a mid-March deadline for its passage, the Senate leadership refused to detail any plans, leaving members, the House and the public in the dark and health experts worried whatever the Senate came up with could include elements that were unfeasible, costly and counterproductive.

It appeared that, despite Hosemann for years saying he was open to discussion on expansion, the Senate had not laid much groundwork for it.

As the clock ticked into late March, the Senate let its own dummy bill die, but eventually released details of its own proposal, which it used as a “strike-all” to rewrite its own version into the still-alive House bill a full month after the House had passed it.

READ MORE: Speaker White on Medicaid expansion negotiations: ‘Come for the savings, stay for the compassion'

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‘Expansion lite' with a poison pill

The Senate proposed what it called “Medicaid expansion lite” in late March. It would only the poorest of the poor — about 40,000 compared to the 200,000 or so the House plan would cover. It would not meet federal criteria for Medicaid expansion, so the Senate plan would continue to turn down over $1 billion a year in federal Medicaid money Mississippi could use for the program, plus another nearly $700 million over the first two years to help set it up and cover any state costs.

The Senate plan also contained what experts quickly pointed out would be a poison pill — a strict work requirement for enrollees with bureaucracy to police it. The federal government under the Biden administration had struck down previously approved work requirements and refused to grant any new ones. The Trump administration had granted some, but only as a means to rein in participation in already expanded Medicaid programs, not as a means to implement new expansion states.

The House plan had also included a work requirement, but House leaders realized it would likely never fly, so its plan would allow expanded coverage for the working poor to take effect even if the feds didn't approve the work stipulation.

READ MORE: ‘A matter of life and death': Hundreds rally at Capitol for full Medicaid expansion 

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Hosemann and his Senate Medicaid Chairman Kevin Blackwell quickly made clear, publicly, that the Senate would not budge on a strict work requirement. They appeared to paint the Senate into this corner even as experts were saying it could prevent expanding Medicaid coverage indefinitely. Blackwell repeatedly said, “No work requirement, no expansion.”

They also, at least for a while, appeared pretty firm on only expanding coverage to those below the federal poverty level, thus ensuring the state would not receive billions of extra federal Medicaid dollars.

Hosemann, Blackwell and other Senate leaders expressed optimism that the Biden administration would be so pleased with longtime Medicaid expansion holdout Mississippi making an effort that it would approve a work requirement, or that the conservative federal 5th Circuit Court would approve it if litigated. Or, that Trump would be reelected and his administration approve it — never mind that this would mean anti-Medicaid expansion Trump expanding Medicaid in Mississippi over the wishes of its Republican governor, whom he supports.

Senate leaders made clear early on they barely had sufficient votes for their plan, and would not be able to pass anything nearly as expansive as the House proposal. Vote counting and whipping on the issue was important. An expansion bill would require a three-fifths vote of both chambers to pass, and more realistically a two-thirds vote to be able to override a threatened Reeves veto. Both the House and Senate have a three-fifths or better majority of Republicans, but with Medicaid expansion, a few far right members in each would never be onboard, meaning both White and Hosemann needed Democrats onboard as well.

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Following Georgia's (bad) example?

Mississippi is one of the last 10 holdout states on Medicaid expansion. Lawmakers here had 40 other states, including 20 by Republicans, to look to for best practices and tips on expansion and stacks of studies. There's a saying among health experts: If you've seen one state's Medicaid program, you've seen one state's Medicaid program.

The initial House proposal had a few minor twists, but otherwise was pretty standard fare for expansion, implementing many things other states have successfully done and, importantly, taking advantage of the billions of federal dollars available to health care for poor Mississippians.

The Senate, however, did not appear to emulate any other expansion states' plans or consult much with experts. Instead, it appeared to more closely model Georgia, whose efforts at an expansion-lite plan have been deemed by health experts and advocates a disastrous, expensive failure to date.

Senate Medicaid Committee Chairman Sen. Kevin Blackwell, R-Southaven, left, confers with Mississippi House Medicaid Committee Chairman Rep. Missy McGee, R-Hattiesburg, center, and a Senate legislative attorney on Wednesday, May 1, 2024, in the hallways of the state Capitol in , Miss. (AP Photo/Rogelio V. Solis)

The Peach State attempted to cover only some of its poorest citizens — thus not receiving enhanced federal Medicaid money — and its insistence on a work requirement has it tied up in court against the federal government. To date, the program is providing coverage to only a few thousand of the 400,000 Georgians who lack health coverage. And of the millions spent so far, more than 90% has gone to administrative and consulting fees for setting up its work requirement monitoring bureaucracy and on legal fees, but not on providing health care.

The initial Mississippi Senate plan, experts said, closely resembled Georgia's, except for being a little worse — more strict on work monitoring. As health experts and Mississippi House leaders have noted, insuring people with income over the federal poverty level pretty much means they or someone in their household has a job, hence the income.

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So, the Mississippi House and Senate got a late start on negotiations, largely due to the Senate dragging its feet on getting a proposal out. And they started out very far apart.

For those thinking House and Senate relations would be better with the new administrations taking office, they weren't. The GOP leaders in both chambers openly sparred over numerous major pieces of legislation and recriminations had been flying. Some lawmakers on both sides said it was the worst they had seen in years, although many lawmakers and observers say that most every session.

READ MORE: Hospitals, business leaders suffering FOT — Fear of Tate — on Medicaid expansion

The final nine days of negotiations

Both White and Hosemann had vowed to have negotiations on a final Medicaid expansion bill open to press and public, given its monumental importance.

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The first conference meeting between House and Senate negotiators was held in public on April 23 — just six days before an April 29 deadline to agree a plan.

Senators Nicole Boyd, R-Oxford (center) and chairman Kevin Blackwell (right), listens as Sen. Brice Wiggins, R-Pascagoula, makes a point on the cost of Medicaid expansion, during a public meeting held at the state Capitol, Tuesday, April 23, 2024. Credit: Vickie D. King/

Blackwell, speaking for the Senate, warned House negotiators not to take a my-way-or-the-highway stance. They didn't. They offered a compromise, a “hybrid” plan drafted with help of consultants in effort to allay Senate concerns that expansion would pull people off the federal private insurance exchange. Similar to what some other states have done, the House compromise would cover the poorest Mississippians with traditional Medicaid, but use government subsidized private insurance on the exchange to cover the balance of working poor people.

The compromise would still allow the state to draw down the billions of federal Medicaid dollars available for expansion.

The Senate negotiators didn't reciprocate with any counter offer of compromise, saying only they would take the House counter back to Hosemann and other Senate leaders for consideration and casting doubt that they could gin up support for it.

That was the last of the open to the public negotiation hearings on expansion. House Medicaid Chairwoman Missy McGee scheduled another one, hoping for more public parlay with Senate negotiators and to get response on the House's counter proposal, but Senate negotiators didn't show up for the meeting.

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The clock continued ticking on deadlines for passing legislation and the end of the Legislature's four-month session closing in.

READ MORE: House agrees to work requirement, Senate concedes covering more people in Medicaid expansion deal

Pingpong and Hail Marys

The Senate responded with its first counter offer, a hybrid similar to what the House had pitched that would garner the extra billions from the feds, but still with a strict work requirement. And despite offering a “compromise” to the House that he and two other Senate negotiators agreed to, Blackwell expressed doubt it could garner enough votes in the GOP supermajority Senate.

The House countered with a plan that would expand Medicaid with or without the work requirement, but would require the state continue to try to get such a requirement implemented. The Senate demurred.

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In all the pingponging back and forth, the Senate would not back down on its demand for a work requirement, even if it prevented coverage from ever being expanded.

With only minutes to spare before an April 29 at 8 p.m. deadline to file an agreement, the House GOP leadership caved on the work requirement. It appeared a final deal had been struck.

But this angered the House Democratic Caucus, whose members said they had been clear with the leadership they would not go along with this. Most of the caucus — reportedly at least 29 members — vowed to vote against the proposal, enough to endanger its passage.

Democratic House leaders said they would not vote for a program that might never go into effect and would be “Medicaid expansion in name only.” They also shrugged off Republican efforts to blame Democrats for killing expansion, saying they were not to blame for the Republican supermajority not being able to work together or get a major initiative passed.

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READ MORE: Why many House Democrats say they'll vote against a bill that is ‘Medicaid expansion in name only'

Speaker White said he would still have had the votes in the House to pass the compromise, even with the loss of a significant number of Democrats. But the speaker said he opted to send the proposal back to negotiations after being told by Senate leaders that the Senate only had 28 votes — not enough to pass it by a needed three-fifths majority. 

This prompted a GOP Hail Mary. The House and Senate both voted to recommit the measure on May 1, which bought another 24 hours to try to negotiate a deal. Then on that same night, Speaker White and the House leadership floated a new proposal: Let voters decide the issue. Put it to a statewide referendum, and let voters decide not only whether to expand Medicaid, but also whether to try to include a work requirement.

READ MORE: These Republicans wanted a Medicaid work requirement but couldn't get approval. So they got creative.

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But late Wednesday night, Hosemann threw cold water on that proposal. He said the idea of a referendum had been run by senators and “was not well received.” He also appeared to call the issue dead for this year, issuing a better-luck-next-year statement.

But with the leadership expecting to end the 2024 legislative session as early as Friday, House Democrats tried one last Hail Mary on Thursday. House Minority Leader Robert Johnson III met directly with Senate Republican leaders and offered a final compromise.

Instead of the Senate's most recent plan, which would have required the state to request a federal waiver to implement a work requirement every year until it is approved, Johnson said House Democrats would agree to mandate the waiver request for just one year. Instead of potentially keeping expansion in limbo indefinitely with a work requirement, if it were to be rejected once, Johnson reasoned, lawmakers could revisit the issue.

But Johnson's last ditch pitch wasn't picked up by the Republican leadership in either chamber.

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The final negotiations — to use that term loosely — on Medicaid expansion appeared to suffer from the same lack of communication between the House and Senate that the early efforts saw.

The Medicaid expansion measure, House Bill 1725, died Thursday night at an 8 p.m. deadline as the 2024 session neared its end.

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

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Mississippi Today

Legislature, flush with cash, passes budget, completing work for 2024 session

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mississippitoday.org – Bobby Harrison – 2024-05-03 16:56:24

The Mississippi completed its work for the 2024 on Friday with the passage of a $7 billion budget – 5.8% larger than the budget it passed last year.

The $7 billion reflects the amount spent on recurring expenses. The budget last year, one-time funds, federal relief funds and other one-time money for specific projects, actually was more than the budget passed this year.

The completion of the budget late Friday ended the bulk of lawmakers' work for the 2024 session, but legislators will return briefly Saturday to take care of procedural issues. Plus, the Legislature might reconvene on May 14 to deal with any veto from Gov. Tate Reeves.

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One of the final actions on Friday was approving a massive bill that provides state money for projects throughout the state. The legislation funds projects, work on local governmental office buildings and other projects for individual legislators.

Th total amount of the projects was $227.4 million.

In the past, projects were often funded by borrowing. But in recent years, thanks in large part to an infusion of federal COVID-19 funds and other federal funds, Mississippi, like most other states, has been flush with cash, allowing those projects to be funded with cash instead of long-term debt.

Senate Finance Chair Josh Harkins, R-Flowood, told senators paying for the projects with cash will not continue in future years. State revenue has begun to slow.

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Harkins told senators there were more than $1 billion in requests on the local level for projects.

Sen. Angela Turner Ford, D- Point, asked Harkins how it was decided which projects to fund.

Harkins said the focus was on projects and other projects where it was viewed the greatest need was.

 In addition to the pet projects for lawmakers, other capital spending included:

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  • $110 million for university projects.
  • $45 million for community college projects.
  • $160 million for work on improving state Highway 7 in Lafayette County.
  • $90 million for work on U.S. I-55 in DeSoto County.
  • $50 million for work on state office buildings throughout the state.

In total, $820 million was committed in surplus funds for building projects throughout the state. Plus, $110 million in surplus funds was pumped into the Public Employees Retirement System to help shore up the government pension plan.

In terms of the budget to operate agencies, House Appropriations Chair John Read, R-Gautier, said state agencies are receiving an average 5% year-over-year increase in funding.

That increase includes money to pay for increases in the premiums for the state employee health plan and to pay for a .5% increase for each state agency in the contribution to the state retirement plan.

Lt. Gov. Delbert Hosemann said before the session began that dealing with financial issues facing PERS was one of the top priorities.

“We tackled the PERS issue,” Hosemann said, though, some argued that the legislative solution did not resolve all the financial issues facing the system.

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Senate Appropriations Chair Briggs Hopson, R-Vicksburg, said the state budget provides funds to allow state agencies to deal with .

“The budget is reflective of the times,” Hopson said. “State agencies are not immune to inflation. In order to services at the same level, we have to spend additional funds.”

The budget includes an additional $240 million in funding for K-12 schools.

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

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