Mississippi Today
Mississippi Medicaid: Gender-affirming care for kids is not ‘safe and effective’
Mississippi Medicaid: Gender-affirming care for kids is not ‘safe and effective'
The Mississippi Division of Medicaid is the first state agency to take a public position on gender affirming care to transgender children, stating there is not enough medical literature to support that it is a “safe and effective treatment for gender dysphoria.”
In a letter to managed care companies that contract with Medicaid, Executive Director Drew Snyder wrote that the agency concurs with its counterpart in Florida that there is not enough evidence that “sex reassignment through medical intervention” is safe. Florida's report was released in June of last year.
Snyder did not respond to a call and text to his personal cell phone Thursday afternoon. His letter was addressed to executives of Molina Healthcare of Mississippi, UnitedHealthCare Community & State MS and Magnolia Health Plan. Communications officials with the three companies did not immediately respond to requests for comment.
“As the care coordination organizations for the majority of children and adolescents enrolled in Mississippi Medicaid, your input is welcome on approaches to effectively address any health needs without posing risky side effects or irreversible changes,” he wrote.
It's unclear if Snyder's letter has any effect on what services are currently covered, or why he reached out to the managed care companies instead of providers of gender-affirming care. If the agency does opt to exclude this treatment, it would join a handful of states already doing so. Alaska, Arizona, Arkansas, Florida, Kentucky, Missouri, Nebraska, Ohio, Tennessee and Texas all have Medicaid policies that specifically exclude transgender health coverage, according to the Movement Advancement Project.
The Feb. 15 letter first reported by the Magnolia Tribune comes as a bill is working its way through the Legislature that would ban this kind of treatment for trans minors in Mississippi. House Bill 1125 would prevent the state's roughly 2,400 trans kids and their families from getting hormone therapy or puberty blockers in the state.
Snyder's letter contradicts the advice and position of major medical associations in the U.S. on gender-affirming care. It is evidence-based, and not considered “experimental” by the majority of the medical community.
Also known as the “Regulate Experimental Adolescent Procedures” (REAP) Act, the bill bans Mississippi doctors from performing gender-confirmation surgery or prescribing drugs such as puberty blockers or hormones to those under 18.
The bill would allow for the doctors' licenses to be revoked and create a “civil claim of action” for them to be sued with a 30-year statute of limitations. It would prohibit insurers or Medicaid from reimbursing families for such procedures and would strip doctors who provide them of the state's generous tort claims protections.
READ MORE: What to know about gender-affirming care in Mississippi
Gender-affirming care, or “sex reassignment” as Mississippi officials have called it, refers to a broad range of interventions, from medical treatment to psychological and social support, that aims to affirm an individual's gender identity, especially when it is different from the one they were assigned at birth, according to the World Health Organization.
Decades of research support gender-affirming care as the proper treatment for gender dysphoria, the distress trans people can experience when their physical features do not match their gender identity.
Research has repeatedly shown that gender-affirming care significantly boosts the chances that trans kids will live to see adulthood. A study published last year in the peer-reviewed Journal of the American Medical Association found that over the course of a year, gender-affirming care was associated with 60% reduced odds of moderate to severe depression and 73% less odds of suicidal thoughts.
Stacie Pace, the co-owner of Spectrum: The Other Clinic, said that the two main international medical organizations that write guidelines for gender-affirming care — the World Professional Association for Transgender Health and the Endocrine Society — cite hundreds of references and are easy to find on the internet.
“All it takes is just a quick Google, and all this research is right there in front of you,” she said.
There are three main forms of gender-affirming medical treatment: Puberty blockers, which are only for kids, hormone therapy and gender-confirmation surgery. In Mississippi, there is no clinic that performs any kind of gender-confirmation surgery on minors, according to in-state providers of gender-affirming care.
Puberty blockers are medications that pause puberty in kids. Research has shown the effects are reversible. While hormone therapy can cause some permanent effects, such as a deeper voice, it typically takes at least a year for this to occur, Pace said.
But Pace added that many other side effects of hormone therapy, like increased muscle mass or the development of breast tissue, will disappear over time if a patient ceases treatment.
“It will take about as long as it took for it to occur, but it will go away,” she said.
Alex Mills, a pharmacist who has worked with trans people, said he was confused by the letter. While a minority of his patients are on Medicaid, he hasn't heard of Medicaid covering prescriptions for hormone therapy for trans adults since he started working in Jackson three years ago. If Medicaid covered prescriptions for his outspoken patients, Mills said they would tell him.
“I feel like they're just kind of jumping on the bandwagon,” he said. “It's an irrelevant comment, because they (Medicaid) haven't been covering (hormone therapy), so I'm just confused why they're even saying this. Just to say it?”
Mills said Medicaid has covered medical visits, but that he doesn't know if it has covered puberty blockers, which can be pricey – up to $1,500 for a single shot that lasts a month. Hormone therapy is cheaper, so Mills recommends patients use GoodRx coupons to make their prescriptions more affordable.
At Spectrum, Pace said just one youth patient is currently on Medicaid. But of the clinic's roughly 1,000 adult patients, about half are Medicaid beneficiaries.
The Division of Medicaid has not taken a stance on other issues being considered by the Legislature. One of those is extending postpartum care from 60 days to one year for new mothers, which Speaker of the House Philip Gunn said he has asked the agency to do.
When a committee tasked with advising Medicaid about health and medical care services voted unanimously in October to recommend that the Legislature extend postpartum coverage, the Division of Medicaid still did not take a stance.
The State Board of Medical Licensure, which would enforce the bill's provision revoking providers' licenses, has not responded to questions from Mississippi Today. The University of Mississippi Medical Center, which has provided gender-affirming care to trans kids at its LGBTQ-focused TEAM Clinic, said earlier this month that “we have no comment for now.”
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=209008
Mississippi Today
Some notable bills that died in the 2024 Mississippi legislative session
As the Mississippi Legislature adjourned its 2024 regular session on Saturday, only a fraction of the thousands of bills introduced by legislators survived to become law.
The most notable item that died during the session was Medicaid expansion, a policy that would have allowed thousands of Mississippians to receive health coverage and potentially give struggling hospitals a needed financial boost.
But several other pieces of legislation such as early voting and overhauling the way the state restores voting rights to people convicted of certain felony offenses also died during the session.
Unless Republican Gov. Tate Reeves calls legislators into a special legislative session, lawmakers will now have to wait until their 2025 session next year to introduce any more legislation this year.
Here are some other bills that died after the 2024 legislative session adjourned on Saturday:
Judicial redistricting
House Bill 722 and Senate Bill 2771 would have redrawn the state's circuit and chancery court districts, but negotiations stalled between the House and the Senate on adopting a final map.
The current court districts have largely remained unchanged for 30 years. Senate Judiciary A Committee Chairman Brice Wiggins, a Republican from Pascagoula who was the Senate's lead negotiator, believed the Legislature should use population data and the number of active court cases in each district to substantively redraw them.
Wiggins sent the House a plan that passed the Senate 32-13. But the House didn't agree to the Senate plan, and it did not reveal its own redistricting proposal.
House Judiciary B Chairman Kevin Horan, a Republican from Grenada and the main House negotiator, said he wanted to agree on a plan this year, but he thought there were too many stakeholders, such as judges, whom he believed did not have their opinions considered in how the new districts should look.
“This issue is too important for them to not have their voices heard,” Horan said.
Both committee leaders told Mississippi Today they intend to conduct hearings in the summer or the fall to hear from judges, district attorneys and officials from the Administrative Office of Courts on what metrics should be considered for new districts.
Lawmakers have until 2025 to agree on a set of new maps. If the two chambers cannot reach a compromise by early next year, Mississippi Supreme Court Chief Justice Michael Randolph will be tasked with redrawing the new chancery and circuit court districts.
Mobile sports betting
House Bill 774, the Mississippi Mobile Sports Wagering Act, would have legalized mobile sports betting and allowed Mississippi to join more than two dozen other states where the practice is legal.
Sports wagering has been legal in Mississippi for years, but online betting has remained illegal in part from fears the move could erode profits of the state's brick and mortar casinos located along the Mississippi River and the Gulf Coast.
The initial proposal would have required betting companies to contract with casinos, but some lawmakers raised concerns that the legislation did not offer any incentives for major betting companies to partner with smaller casinos.
The two chambers passed different versions of the same bill, and they couldn't reach an accord during the conference committee process.
Senate Gaming Chairman David Blount, a Democrat from Jackson, told Mississippi Today that there was division among casino owners on how the legislation would impact physical casinos and their employees and offered little protection for people who struggle with gambling addiction.
Blount said he hopes casino owners and lawmakers will continue to discuss the issue during the off season and debate the issue more next year.
Replacing Mississippi's white supremacist statues in Washington
Senate Bill 2231 and House Concurrent Resolution 12 would have replaced Mississippi's statutes of J.Z. George and Jefferson Davis, two white supremacists, in the U.S. Capitol in Washington.
Other Southern states such as Alabama, Florida and Arkansas, have replaced their statues of white supremacists, but Mississippi remains the only state in the nation with two Confederate leaders in the National Statuary Hall Collection in Washington.
Federal law allows for states to replace their statues, but a majority of lawmakers in both legislative chambers must vote to approve the replacement, and the state is required to pay for the costs of replacing the statues.
House Rules Chairman Fred Shanks, a Republican from Brandon, previously said he did not know much about the National Statuary Hall Collection, but that he would study the issue.
Early voting
Senate Bill 2580 would have established in-person early voting and let Mississippi join 47 other states that authorize the practice in some form.
The bill would have allowed 15 days of no-excuse early voting before election day and required voters to submit a valid photo ID to cast a ballot. It would have replaced in-person absentee voting.
The bill passed the Senate overwhelmingly, but House Elections Chairman Noah Sanford, a Republican from Collins, said he received concerns about the proposal from some county circuit clerks, the local officials who administer elections.
Instead, Sanford said he would like to conduct some hearings in the summer or fall to examine the issue further and allow circuit clerks and others to present information. He said that after the hearings he would be more open to passing early voting legislation.
Restoring a ballot initiative
For the third straight year, lawmakers could not agree on a way to restore Mississippi's ballot initiative process.
House Concurrent Resolution 11 and Senate Bill 2770 would have created a process for voters to bypass lawmakers and place issues directly on a statewide ballot for consideration. The process would only allow voters to amend laws and not the constitution.
The House passed a proposal that would have created an initiative process that organizers to gather signatures from 8% of the number of registered voters during the last governor's race, which the Secretary of State's office estimated to be around 166,000.
Senate leaders proposed a plan that would have required petitions to gather signatures from 10% of the registered voters from the last presidential election – more than 200,000 signatures of registered voters – to place an issue on the ballot. The Senate chamber rejected that proposal.
Both the House and Senate plans would have restricted voters from considering any initiative related to abortion.
Mississippians have not had an initiative process since 2021, when the Mississippi Supreme Court ruled it invalid because of a technicality over the state's congressional districts.
Felony suffrage overhaul
House Bill 1609 would have automatically restored voting rights to people convicted of nonviolent felony offenses, as long as they had not committed another felony within five years of completing the terms of their sentence.
The legislation passed the House by a bipartisan majority, but Senate Constitution Chairwoman Angela Hill killed the measure by not bringing it up for a vote.
Under the Mississippi Constitution, people convicted of any of 10 felonies — including perjury, arson and bigamy — lose their voting rights for life. A 2009 opinion from the Mississippi Attorney General's Office expanded the list of disenfranchising felonies to 22.
The constitutional provision stems from Jim Crow-era policy where the framers of the 1890 constitution chose disenfranchising crimes thought to be more likely committed by Black people.
Mississippi is one of only a handful of states that does not automatically restore voting rights to people who complete their sentences. Instead, two-thirds of lawmakers in both chambers must agree to restore the suffrage to individuals in a piecemeal fashion.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Bill increasing tax credits for private schools defeated at end of session
Legislation that would have increased the proceeds from state tax credits available to private schools died a quiet death late in the just-completed 2024 session.
The proposal to increase the tax credits available through the Children's Promise Act was defeated in the 52-member Senate with 21 yes votes and 16 no votes. Since the proposal dealt with taxation, it needed a three-fifths majority to pass.
Since 2020, private schools have been receiving money through the tax credits with limited state scrutiny or accountability, according to the Department of Revenue, which certifies schools that can participate in the program.
In response to written requests from legislators, the Department of Revenue recently reported, “DOR does not know how the funds were used.”
When asked the number of children served through the Children's Promise Act, DOR said, “This information may be provided with the original application but is not updated annually or maintained by DOR.”
In the original application, “DOR reviews the information provided and issues a letter ruling advising whether they qualify or not. The original request is covered under confidentiality statues.”
Under the Children's Promise Act, a person or corporation can make a donation to one of the private schools certified by the Department of Revenue and receive a dollar-for-dollar tax credit for up to 50% of the donor's state tax liability.
The maximum a private school currently can receive through the program is $405,000 a year.
The program was initiated in 2019 and billed as a mechanism to provide additional money to non-profits that care for foster children. But a provision to provide tax credits to private schools was tucked into the bill.
Currently under the law a total of $9 million a year in tax credit money can be doled out to private schools.
Original legislation filed during the 2024 session by House Ways and Means Chairman Trey Lamar, R-Senatobia, would have significantly increased the amount of the tax credit money the private schools could have received. The original House plan would add another $6 million for the current year and then would reach a total of $24 million for 2025.
But in negotiations with Senae leaders during the final days of the session, an agreement was reached where the private schools would have been able to receive an additional $3 million, for a total of $12 million. But that compromise was voted down in the Senate. After it was defeated in the Senate, Lamar did not bring up the compromise for a vote in the House.
Under the current law, private schools are eligible for the tax credits if they educate:
- Children in the foster care system.
- Children who have a chronic illness or physical, intellectual, developmental or emotional disability.
- Children eligible for free or reduced meals.
Nancy Loome, executive director of the Parents Campaign, said technically if the school has one student with a speech impediment, for instance, it could receive the tax credit money.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Read Mississippi Today’s Pulitzer Prize finalist series ‘’Unfettered Power: Mississippi Sheriffs”
Mississippi Today's “Unfettered Power: Mississippi Sheriffs” investigation has been named a finalist for the 2024 Pulitzer Prize for Local Reporting.
The 2023 investigation from the Mississippi Center for Investigative Reporting at Mississippi Today and The New York Times' Local Investigations Fellowship revealed how Mississippi sheriffs rule like kings, wielding vast power, exploiting and abusing the very people they are called to protect with no one stopping them.
Sign up for our free, daily newsletter and get news that holds power to account.
The seven-part 2023 series, which has continued into 2024, included new details about the Rankin County “Goon Squad.”
Click the links below to read the Pulitzer Prize-recognized series.
Sex Abuse, Beatings and an Untouchable Mississippi Sheriff
Where the Sheriff is King, These Women Say He Coerced Them Into Sex
New Evidence Raises Questions in Controversial Mississippi Law Enforcement Killing
The Sheriff, His Girlfriend and His Illegal Subpoenas
How a ‘Goon Squad' of Deputies Got Away With Years of Brutality
Days After Rankin's ‘Goon Squad' Tortured Two Men, Supervisors Gave the Sheriff a Pay Boost
Who Investigates the Sheriff? In Mississippi, Often No One.
READ MORE: The complete “Unfettered Power: Mississippi Sheriffs” series
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
-
SuperTalk FM5 days ago
Driver’s education set to become mandatory in Mississippi as bill passes
-
SuperTalk FM4 days ago
State approves $160M to expand Highway 7 to four lanes in Lafayette County
-
Mississippi Business6 days ago
Geartek expanding operations in Alcorn County
-
Mississippi News7 days ago
Two women accused of shoplifting across southeast captured in Mississippi
-
Mississippi Today2 days ago
On this day in 1917
-
Mississippi News5 days ago
Altercation at Mississippi police department leads to officer-involved shooting
-
Mississippi News2 days ago
LCSO wants people aware of a scam circling the area
-
Mississippi News2 days ago
Winston Co. Sheriff’s Office investigates shooting at Dave’s Club