Mississippi Today
Former Gov. Steve Beshear: Medicaid expansion changed course of Kentucky history

When former Kentucky Gov. Steve Beshear took office in 2007, the Bluegrass State had many challenges — not the least of which was lack of health care for working folks — and limited resources to address them.
“Kentucky faced a number of fundamental weaknesses, not unlike Mississippi and a lot of other Southern states,” Beshear recently told Mississippi Today. “We had a lack of educational attainment. We had a workforce that wasn’t as trained or agile as the marketplace would demand. We had too many children getting a poor start in life. We had an economy that wasn’t as diversified as it needed to be. And one of the biggest fundamental weaknesses we had was a population that wasn’t healthy.”
“… Governors have a lot of power and a lot of resources at their disposal, but none of us really have the resources locally to make a huge difference in the health of your people,” Beshear said. “We made progress in health care, from 2007 to 2010, but we couldn’t really make any huge changes. Then along came the Affordable Care Act.”
Kentucky, starting in 2014, accepted federal funding to expand Medicaid and has been one of the most successful states in using the ACA to reduce its number of uninsured people. Its creation of a state-run health insurance marketplace has been held as a national role model.
Mississippi Today has interviewed governors in the three Southern states that have expanded Medicaid: Arkansas, Louisiana and Kentucky, all of whom report net positives from the move. Despite numerous polls showing public support for expansion, Mississippi remains one of 10 states rejecting federal money for expansion, led now by Gov. Tate Reeves who has remained steadfastly opposed.
READ MORE: ‘A no-brainer’: Why former Arkansas Gov. Mike Beebe successfully pushed Medicaid expansion
READ MORE: Louisiana Gov. John Bel Edwards: Medicaid expansion ‘easiest big decision I ever made’
Beshear, whose son Andy Beshear is now governor and running for reelection this year, expanded Medicaid by a 2013 executive order. He said Medicaid expansion far exceeded initial projections in number of jobs created, money injected into hospitals, the state’s economy and state budget. The number of uninsured Kentuckians dropped from over 20% to 7.5%. The net positive impact on Kentucky’s economy was $30 billion over eight years.
“Medicaid expansion was the single-most important decision I made in eight years as governor because we changed the course of Kentucky’s history,” Beshear said.
Beshear’s interview with Mississippi Today is below, edited for brevity.
Mississippi Today: Could you give us a quick overview of where things stood in Kentucky in 2013, both health-care wise and politically?
Gov. Steve Beshear: It was estimated that some 640,000 Kentuckians, out of a little over 4 million, had no access to affordable, quality health care. These were folks who would get up every morning and go to work, and just basically roll the dice — just hoping and praying that you don’t get sick or get hurt. They were having to choose between food and medicine at times. They would have to ignore checkups that could catch serious conditions early. They just lived every day knowing that bankruptcy was just one bad diagnosis away.
… Fixing this is an expensive proposition, and a state by itself is just simply not in a position to address it … The Affordable Care Act was passed, and of course immediately became embroiled in litigation. My health care people came to me and we sat down and talked through what it allowed. We realized we had two decisions to make. One was, do we create a state-based exchange or do we go into the federal exchange. And two, do we expand Medicaid.
The first decision was a pretty easy one because basically all of our providers and folks who would be involved felt that we needed to have more flexibility and be able to address Kentucky’s particular needs with a state-based exchange … Ours became sort of the national standard, the gold standard for state-based exchanges … President Obama called me personally to congratulate us and thank us for showing the world that the Affordable Care Act can work.
… Whether to expand Medicaid was a tougher decision. Morally, I felt that we needed to do it because I believe health care is a basic human right and that Kentuckians needed it. The question came down to can we afford it? The opponents of expanding and of the Affordable Care Act were all saying it would bankrupt us.
I felt like we needed to answer that question. I hired PricewaterhouseCoopers — an internationally renowned accounting firm — to come in and analyze what they felt would happen in Kentucky if we expanded Medicaid.
They took about six months and came back, sat down and looked at me across my desk and said, “Governor, you cannot afford not to do this.” Wow. OK. They said because over the next eight years, you’re going to create 17,000 new jobs. You’ll inject about $15 billion into Kentucky’s economy over the next eight years. You’ll protect Kentucky’s hospitals from the impact of cuts in indigent care funding and protect rural hospitals. And, you’ll have about an $800 million positive budget impact over the next eight years.
I was thrilled with that analysis, and we publicly announced that we were going to expand Medicaid as well as have our own state-based exchange. I was fortunate from a political standpoint that I did not have to have legislative approval. At that time I had a Democratic House and and Republican Senate and it would have been difficult, if not impossible, because of the politics surrounding quote-unquote Obamacare. Fortunately, years before, the Legislature had delegated the authority to define Medicaid eligibility under the federal law to our cabinet for Health and Family Services.
Mississippi Today: Did expansion live up to those early projections?
Beshear: The results were a little short of amazing. In the first six months, over 400,000 Kentuckians signed up … most of whom had never had affordable quality health care before. In the first 18 months, our uninsured rate dropped from over 20% to 7.5%. The uncompensated care rate dropped from 25% to less than 5%.
… But the critics would persist, particularly on the affordability of the program. So, after the first year, I went to Deloitte, another internationally known consulting firm, and said, OK, here’s the Pricewaterhouse study done before we implemented it. Take this and look at a year of actual results and numbers and tell me where we are. Were they right?
They did an in-depth study, came back, sat down across my desk, looked me in the eye and said, “Well, governor PricewaterhouseCoopers was wrong. They weren’t optimistic enough. They projected that you would create 17,000 new jobs over eight years. Yeah, you’ve already created 12,000 in the first year, and we project you’ll create 40,000 over eight years.” Wow, that was almost $3 billion in new revenue had gone to providers in the first 18 months. Then there’s a $30 billion positive impact on Kentucky’s economy over eight years … a net impact of $820 million impact on the state general fund over eight years.
Now, we haven’t had a totally smooth history since I was governor. After my eight years, I was followed by a Republican governor who had campaigned on repealing Medicaid expansion. During his four years, he did abolish the state-based exchange and pushed us into the federal exchange. He proposed a waiver to the federal government that would place a lot of complicated work requirements on folks on the Medicaid program. But, fortunately, a fellow named Andy Beshear, who happens to be my son, defeated him in the next election and he has reinstituted the state-based exchange and made it even stronger and just recently announced the expansion of Medicaid even further to cover dental and vision and hearing for adults.
Mississippi Today: What is your take on Mississippi and other states struggling with this issue, and any advice on what we should do?
Beshear: Mississippi is one of what, 10 states now that haven’t expanded? I would predict that the question is not if it ever will, it’s just when will it expand. Because this should not be a political issue. This should not be a partisan argument. Why does anybody want to argue that people shouldn’t have good quality health care?
A lot of the Southern states that are left, that have not expanded Medicaid, tend to fall at the bottom of the list in virtually every ranking that we have now. Sure, Kentucky has also been there, and is still there in some of the rankings, but we’re determined that we are going to move out of that category, instead of a state that’s continually trying to catch up.
This should be an easy decision, for either political party to make. It’s a matter quite honestly of putting people first and partisan politics second. When I was governor and I had to deal with a Republican Senate and Democratic House, I would tell them both, look, our elections are set up on a partisan basis. I understand that. We’ll get out there and fight and scratch and carry on in these elections, but once they’re over, we’re all Kentuckians first … That’s exactly the way I think Mississippi ought to approach an issue like this.
Throw out, throw away the partisan bickering and just look at what’s best for your people. It’s hard to argue that everybody having health care would not make life better for everybody. But there’s also sound evidence, that this is not only affordable for a state to do, this is economically beneficial for a state.
Mississippi Today: You’ve made points very similar to other governors we’ve talked with. They’ve said the decision was relatively easy, and believe it was a hallmark of their administrations.
Beshear: … It was an easy decision to make from the question of whether it was the right thing to do, or whether it would economically benefit Kentucky. It was a hard decision to make politically. In Kentucky at the time, President Obama had a 30% approval rating. Some of my advisors said, governor, do not touch the Affordable Care Act with a 10-foot pole, it will kill you.
But I felt, number one, how many times do you ever get to make a decision that will change the course of, change the history of your state for the good? You know that, and you can’t turn your back on that, you have to step up and do the right thing … Medicaid expansion was the single-most important decision I made in eight years as governor because we changed the course of Kentucky’s history.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1850, Shadrach Minkins escaped from slavery
May 3, 1850

Shadrach Minkins, already separated from his family, escaped from the Norfolk, Virginia, home, where he was enslaved. He made his way to Boston, where he did odd jobs until he began working as a waiter at Taft’s Cornhill Coffee House.
Months later, Congress passed the Fugitive Slave Act, which gave authorities the power to go into free states and arrest Black Americans who had escaped slavery.
A slave catcher named John Caphart arrived in Boston with papers for Minkins. While serving breakfast at the coffee house, federal authorities arrested Minkins.
Several local lawyers, including Robert Morris, volunteered to represent him. Three days later, a group of abolitionists, led by African-American abolitionist Lewis Hayden, broke into the Boston courthouse and rescued a surprised Minkins.
“The rescuers headed north along Court Street, 200 or more following like the tail of a comet,” author Gary Collison wrote. They guided him across the Charles River to the Cambridge home of the Rev. Joseph C. Lovejoy, whose brother, Elijah, had been lynched by a pro-slavery mob in Illinois in 1837.
Another Black leader, John J. Smith, helped Minkins get a wagon with horses, and from Cambridge, Hayden, Smith and Minkins traveled to Concord, where Minkins stayed with the Bigelow family, which guided him to the Underground Railroad, making his way to Montreal, spending the rest of his life in Canada as a free man.
Abolitionists cheered his escape, and President Millard Fillmore fumed. Morris, Hayden and others were charged, but sympathetic juries acquitted them. Meanwhile in Montreal, Minkins met fellow fugitives, married, had four children and continued to work as a waiter before operating his own restaurants.
He ended his career running a barbershop before dying in 1875. A play performed in Boston in 2016 told the dramatic story of his escape.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post On this day in 1850, Shadrach Minkins escaped from slavery appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
The article presents a historical recount of Shadrach Minkins’ escape from slavery and the role abolitionists played in his rescue. The content is fact-based, focusing on a historical event without promoting a particular ideological stance. While it centers on the abolitionist movement and highlights the moral victory of Minkins’ escape, it does so in a narrative style rather than advocating for any contemporary political agenda. The tone is neutral, and the article adheres to factual recounting of historical events, making it centrist in its approach to the subject matter.
Mississippi Today
Ghost town of Orwood residents provide lessons for today by working with scientists in 1800s to combat yellow fever
Editor’s note: This essay is part of Mississippi Today Ideas, a platform for thoughtful Mississippians to share fact-based ideas about our state’s past, present and future. You can read more about the section here.
Given recent policy changes threatening the future of medical research and news of Mississippi’s falling childhood vaccination rates, I fear we are ignoring lessons learned the hard way.
One of those lessons occurred during a yellow fever outbreak in the summer of 1898 when a community of honest citizens in Orwood, then a hamlet in southwest Lafayette County, helped a team of physicians change the direction of public health for Mississippi and the rest of the country.
I first heard about their story listening to a documentary about yellow fever with my husband, a virologist, who teaches at the University of Mississippi. The video mentioned an unnamed doctor in Mississippi who had advanced a theory linking mosquitoes and yellow fever.
The story I uncovered models the honesty and trust in medical science we need today to keep our families and communities healthy.
***
Yellow fever was a problem in the South throughout the 1800s. Its initial symptoms — fever, body aches and severe headache — were followed by jaundice and in some cases internal bleeding leading to death. The jaundice left the skin tinged with yellow, thus the name “yellow fever.”
In early August 1898, a young woman named Sallie Wilson Gray (no relation to the author) developed chills and a fever while visiting at her uncle’s home in Taylor. Her uncle immediately sent her home to be cared for by her family in Orwood, about 10 miles away.
Days later, Sallie’s uncle in Taylor died from what proved to be yellow fever. Family members wiped black vomit, a sign of internal bleeding, from his body as he lay in his coffin.
Sallie had now brought the same illness home to Orwood.
***
I learned about yellow fever in seventh grade when we studied the 1878 yellow fever epidemic, the worst to strike the Mississippi River Valley. That year, Mississippi reported almost 17,000 cases and more than 4,000 deaths. I didn’t realize, though, how yellow fever continued to appear year after year.
Physicians had a basic understanding of bacteria after the Civil War, but they didn’t recognize viruses, which proved to be the cause of yellow fever, until later in the 1900s. One popular theory suggested yellow fever spread on fomites—inanimate surfaces—like bedding, clothing and furniture. Panic often followed news of a yellow fever outbreak. Health officials established quarantines, closed roads, river ports and train stations, hoping to curb the spread of infections.
The fear of what was not known then about yellow fever reminded me of the early days of the COVID pandemic when fear spread through rumors and unconfirmed anecdotes on social media.
***
Sallie’s sisters and brothers in Orwood soon developed the same symptoms as Sallie. By September, 30-plus people in Taylor and Orwood showed signs of the disease and new cases were reported outside the local area. In response, three interstate railroads shut down and Memphis halted train traffic coming into the city. In Starkville, the president of Mississippi A&M (now Mississippi State University) posted a column of guards along its roads. In mid-October, officials placed all of Mississippi under quarantine as thousands fled the state.
Months earlier, the governor of Mississippi, recognizing the heavy toll yellow fever often brought to his state, had sent a team of Board of Health physicians to Cuba, the center for yellow fever research. There the group met with Dr. Walter Reed, the Army physician directing the American research interests on the island. Reed pursued a theory that mosquitos transmitted the disease, but his experiments to establish that link repeatedly failed. The Mississippi team, including Dr. Henry Gant, a Water Valley doctor, returned home, still hopeful that science could soon solve the yellow fever mystery.
Gant immediately responded when he learned about the outbreak in Taylor. So did Dr. Henry Rose Carter, a field epidemiologist who served as the quarantine officer at Ship Island and who investigated yellow fever outbreaks throughout the South.
Committed to the same rigorous scientific process that epidemiologists use today, Carter looked for patterns in how diseases spread within clusters of people. With yellow fever, he needed to identify the first person to develop the disease in a specific area and then trace everybody and everything that the person came into contact with.
Over and over again, unreliable sources or conflicting pieces of data prevented Carter from finding a pattern. People, suspicious of government intervention and scared of the consequences of yellow fever, often distorted the truth.
Fortunately for us today, the people of Orwood proved to be different. The people, Carter wrote, were “honest enough to tell the truth” and cooperated with efforts to trace the infection of each case.
Working with Carter, Gant moved from house to house in Orwood, instructing families to quarantine at home, though their natural inclination was to care for their neighbors. He also questioned each person, recording data for Gant’s analysis.
Unlike diseases that produce low-grade fevers, an abrupt and high fever often characterizes a case of yellow fever. For that reason, many of the people Gant interviewed reported the day their infections started and also the time their fevers ignited: Mr. G. W. McMillan, sickened on Aug. 29 at noon. Mrs. Rogers, Sept. 4, 10:00 am.
Collecting this detailed information about time proved essential for Carter’s study and he cheered Gant’s ability to gather such reliable data. “A greater tribute to the good faith of the community, or to its confidence in Dr. Gant, can scarcely be given,” he wrote.
Studying the Orwood data, Carter recognized a consistent time interval between cases, about two weeks between the first case and the development of secondary cases. This meant that the infection did not immediately spread from person-to-person but required time to incubate. He called this the period of extrinsic incubation.
I’ve read Carter’s scientific report with the results of the Orwood study, the same report that persuaded Walter Reed to alter his experimental process. Waiting 10-14 days before introducing infected mosquitos to healthy volunteers, Reed successfully demonstrated the transmission of yellow fever from mosquito to human.
With the development of mosquito control procedures, the fever soon vanished in the U.S. and Caribbean. Today a vaccine can protect those travelling or living where the disease remains a threat.
***
Sallie and her siblings were among the lucky, surviving their infections with only lingering weakness and fatigue. When frosts fell in north Mississippi in early November 1898, the number of fever cases quickly fell. In total, officials confirmed 2,478 cases across the state. Those who died totaled 114.
Reed later acknowledged that the “work in Mississippi did more to impress me with the importance of an intermediate host in yellow fever than everything else put together.”
***
My husband and I drove from our home in Oxford to Taylor and then Orwood on a hot muggy day in August, probably experiencing the same weather conditions as Sallie. Orwood is a ghost town today, but we found the cemetery where Sallie’s uncle is buried, adjacent to the wood-planked Presbyterian Church that still stands.
Walking those grounds emphasized for me what the neighbors who once lived in Orwood taught us. Honesty and rigorous scientific inquiry — and not political rhetoric or unproven claims — are the tools we must trust to combat disease and dispel fear.
Bio: Shirley Wimbish Gray lives in Oxford. A retired writing instructor and science editor, she writes about what is often overlooked or forgotten, particularly in the American South. Her recent essays have appeared in Earth Island, Brevity Blog and Persimmon Tree.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Ghost town of Orwood residents provide lessons for today by working with scientists in 1800s to combat yellow fever appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
This article does not present a clear ideological stance but rather focuses on a historical account of a yellow fever outbreak in 1898 and its connection to scientific advancements. The content emphasizes the importance of honesty, scientific inquiry, and collaboration, contrasting it with political rhetoric and unproven claims. The mention of contemporary issues, like Mississippi’s falling childhood vaccination rates and recent policy changes affecting medical research, introduces a subtle critique of current trends in public health. However, the tone remains balanced, and the piece refrains from offering a partisan viewpoint, focusing instead on lessons learned from history and the value of scientific rigor. The discussion of current events is presented more as a concern for public health rather than a partisan critique.
Mississippi Today
On this day in 1964, Klan killed Henry Dee and Charles Moore
May 2, 1964

Henry Hezekiah Dee and Charles Eddie Moore, two 19-year-old Black Americans, were simply trying to get a ride back home. Instead, Klansmen abducted them, took them to the Homochitto National Forest, where they beat the pair and then drowned them in the Mississippi River.
When their bodies were found in an old part of the river, FBI agents initially thought they had found the bodies of three missing civil rights workers, James Chaney, Andrew Goodman and Michael Schwerner.
Thanks to the work of Moore’s brother, Thomas, and Canadian filmmaker David Ridgen, federal authorities reopened the case in 2005. Two years later, a federal jury convicted James Ford Seale. He received three life sentences and died in prison.
Ridgen did a podcast on the case for the CBC series, “Somebody Knows Something.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post On this day in 1964, Klan killed Henry Dee and Charles Moore appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
This article presents historical facts about the 1964 kidnapping and murder of two Black Americans by Klansmen. It provides an account of the tragic event, recounting the abduction, the subsequent investigation, and the eventual conviction of one of the perpetrators. The article sticks to reporting the details of the case, including the efforts of Thomas Moore and filmmaker David Ridgen to reopen the case and bring justice. While the subject matter is deeply tied to civil rights, the tone of the article remains neutral, focusing on factual events without pushing a particular ideological stance. The language used is factual and matter-of-fact, presenting the events as they happened rather than offering opinion or judgment, making the content centrist in its approach.
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