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Experts analyze House, Senate Medicaid expansion proposals, offer compromise plan

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1 year ago

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As Mississippi lawmakers look for compromise between widely differing House and Senate Mississippi Medicaid expansion plans, experts with a health research group have projected the costs, savings and efficacy of the plans and offered a third, potential compromise plan.

The analysis shows that under each plan, the state would see net annual savings – ranging from tens of millions to hundreds of millions of dollars – by expanding the state-federal Medicaid program to cover working, poor and uninsured Mississippians. The plans, the study says, also vary widely in how many Mississippians would be covered – from around 50,000 to nearly 200,000.

The study was commissioned by the Center for Mississippi Health Policy and conducted by the Hilltop Institute at the University of Maryland, Baltimore County. Hilltop has studied Medicaid expansion nationwide and recently testified before the Mississippi House Medicaid Committee.

“We wanted to get some updated numbers based on publicly available data,” said Morgan Henderson, director of analytics and research for Hilltop. “We really want to make sure folks having these discussions have data points they need.”

The study takes the House and Senate plans at face value, even though both contain elements not likely to be approved by the federal Centers for Medicare and Medicaid Services. The Senate plan, for instance, includes a stringent work requirement for coverage that, besides potentially costing millions in administrative fees, isn’t likely to be approved by CMS.

Both the House and Senate plans contain another potential poison pill that could prevent expansion from being implemented. They have 12-month moratoriums on people who qualify for the expanded Medicaid coverage from dropping private coverage and applying for Medicaid. CMS is highly unlikely to approve this, and such moratoriums would probably not meet constitutional muster in a court.

The options

Mississippi Senate plan

One striking difference between the Senate plan and the House and compromise plans is the Senate one would turn down about $1 billion a year in federal money to cover more expansion costs. It also would forego nearly $700 million over the first two years in enhanced federal funding that some refer to as a “signing bonus” for states that fully expand Medicaid per the federal Affordable Care Act.

The Senate plan would provide coverage to people making up to 100% of the federal poverty level – about $15,000 a year for an individual. Hilltop estimates this plan would cover about 54,000 people, although Senate leaders said they estimate about 40,000 people would sign up.

The Senate plan would require participants to work 120 hours a month or be enrolled as a full-time student or in a workforce training program. It would exempt some from this requirement, including parents of children under 6, people mentally or physically unable to work or those who are caregivers to disabled family members.

Cost

The state’s upfront cost of the Senate plan would be paid by a 3% tax on Medicaid managed care providers.

Hilltop estimates the Senate plan would cost the state a little over $114 million per year, including $15 million in administrative costs. But when these costs are offset by the tax on providers, the economic stimulus of expansion and other offsets or revenue, Hilltop estimates a net savings to the state of $43.4 million a year.

Mississippi House plan

The House plan would provide Medicaid coverage for people making up to 138% of federal poverty level, a little more than $20,00 a year for an individual. Hilltop estimates this would cover about 134,000 Mississippians (again, factoring in the “moratorium” on leaving private coverage).

The House plan calls for work requirements – 20 hours a week or enrollment as a student or in workforce development – but would still go into effect without the requirements if CMS fails to approve them.

Under this plan, Mississippi would draw down about $1 billion a year in increased federal Medicaid payments, and over the first two years, another nearly $700 million in enhanced federal payments.

Cost

The state share of upfront costs for the House plan would be covered by a 4% tax on Medicaid managed care providers.

Hilltop estimates the House plan, with no work requirement approved, would cost a little over $115 million, including $8 million in administrative costs. But when these are offset by the tax on providers, economic stimulus and other offsets or revenue, Hilltop estimates an annual savings for the state of more than $404 million a year for the first two years, then $79.5 million a year for the third year and beyond.

House Speaker Jason White and others have noted that the enhanced federal payments to the state totaling nearly $700 million over the first two years would cover all state costs for the first four years of the House expansion plan. White also noted that the House plan, even if a work requirement is not approved, would require the managed care organizations to track employment and other data from those covered.

Compromise ‘hybrid plan‘

Hilltop’s “Mississippi MarketPlus Hybrid Plan” would offer expanded Medicaid coverage through the state’s managed care program for those making under 100% of the federal poverty level. For those making 100% to 138% (up to $20,000 for an individual) of poverty level, the plan would use federal money to provide assistance for them to buy private insurance plans through Mississippi’s marketplace exchange.

Hilltop estimates this plan would provide coverage for 197,000 Mississippians.

The plan would require managed care companies to provide employment support and require mandatory referral to workforce training. It would also require those covered to pay marketplace insurance co-pays, but would not include a work requirement or moratorium on people leaving private insurance.

Like the House plan, this plan is expected to qualify the state for enhanced federal Medicaid payments and the two-year “signing bonus” of nearly $700 million.

Cost

The plan, like the Senate’s, includes a 3% tax on Medicaid managed care providers to help cover state costs.

Hilltop estimates the upfront cost to the state for this plan would be a little more than $186 million, including $12 million in administrative costs (including work support). But these would be offset by the tax on providers, economic stimulus from expansion and other offsets or revenue. Hilltop estimates a net savings to the state for this plan of more than $356 million a year for the first two years, then $31.3 million a year in savings for years three and up.

The Hilltop study also noted this plan would allow the state to receive a 90% federal match for services currently funded only with state dollars, including hospital services for incarcerated people and some behavioral health services.

Credit: Chart courtesy of The Hilltop Institute at the University of Maryland, Baltimore County

Other findings

Hilltop’s report says that Medicaid work requirements – when they were previously allowed by the feds – have not shown to increase workforce participation. It said, “Moreover, the Arkansas experience demonstrates that the administrative burden in reporting work status can lead to Medicaid coverage loss for the working poor – thus hurting the exact individuals designed to be covered under work requirements.”

A Georgia program similar to the Mississippi Senate’s plan in several regards, has shown that stringent work requirements result in low enrollment and high administrative costs, the Hilltop study notes. As of recently, the Georgia program had enrolled only a few thousand people and over 90% of its costs to-date have been administrative costs and consulting fees. Georgia is still battling the federal government in court over its work requirements.

The Hilltop study found the Senate’s plan “contains high budget risk” to the state. Since the plan eschews extra federal funding available for expansion, “if enrollment exceeds estimates, there would be proportionally greater budget overruns in the Senate version than the alternative plans.” It noted that to protect state coffers, language could be inserted to the House or hybrid plan that rescinds the expansion should the enhanced federal match drop.

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

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Mississippi Today

After 30 years in prison, Mississippi woman dies from cancer she says was preventable

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14 hours ago

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August 4, 2025

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mississippitoday.org – mississippitoday.org – 2025-08-04 17:37:00


Susie Balfour, who spent over 30 years in Mississippi prison, died in 2025 from terminal breast cancer she claimed was preventable. Diagnosed just two weeks before her release in 2021, she alleged prison medical providers failed to follow up on recommended screenings. Balfour’s 2024 lawsuit accused contracted health firms of neglect and cited inmates’ exposure to cancer-linked industrial chemicals during prison work. Her case inspired bipartisan legislation requiring protective gear for inmate workers, though it stalled in the Senate. Advocates say her death highlights systemic prison healthcare failures and the exploitation of incarcerated labor, sparking ongoing calls for reform.

by Mina Corpuz and Michael Goldberg, Mississippi Today
August 4, 2025

Behind Bars, Beyond Care:

A Mississippi Today investigation into suffering, secrecy and the business of prison health care

Susie Balfour, diagnosed with terminal breast cancer two weeks before her release from prison, has died from the disease she alleged past and present prison health care providers failed to catch until it was too late. 

The 64-year-old left the Central Mississippi Correctional Facility in December 2021 after more than 30 years of incarceration. She died on Friday, a representative for her family confirmed.   

Balfour is survived by family members and friends. News of her passing has led to an outpouring of condolences of support shared online from community members, including some she met in prison. 

Instead of getting the chance to rebuild her life, Balfour was released with a death sentence, said Pauline Rogers, executive director of the RECH Foundation.

“Susie didn’t just survive prison, she came out fighting,” Rogers said in a statement. “She spent her final years demanding justice, not just for herself, but for the women still inside. She knew her time was limited, but her courage was limitless.”

Last year, Balfour filed a federal lawsuit against three private medical contractors for the prison system, alleging medical neglect. The lawsuit highlighted how she and other incarcerated women came into contact with raw industrial chemicals during cleaning duty. Some of the chemicals have been linked to an increased risk of cancer in some studies.  

The companies contracted to provide health care to prisoners at the facility over the course of Balfour’s sentence — Wexford Health Sources, Centurion Health and VitalCore, the current medical provider — delayed or failed to schedule follow-up cancer screenings for Balfour even though they had been recommended by prison physicians, the lawsuit says.

“I just want everybody to be held accountable,” Balfour said of her lawsuit. “ … and I just want justice for myself and other ladies and men in there who are dealing with the same situation I am dealing with.”

Rep. Becky Currie, who chairs the House Corrections Committee, spoke to Balfour last week, just days before her death. Until the very end, Balfour was focused on ensuring her story would outlive her, that it would drive reforms protecting others from suffering the same fate, Currie said.  

“She wanted to talk to me on her deathbed. She could hardly speak, but she wanted to make sure nobody goes through what she went through,” Currie said. “I told her she would be in a better place soon, and I told her I would do my best to make sure nobody else goes through this.”

During Mississippi’s 2025 legislative session, Balfour’s story inspired Rep. Justis Gibbs, a Democrat from Jackson, to introduce legislation requiring state prisons to provide inmates on work assignments with protective gear. 

Gibbs said over 10 other Mississippi inmates have come down with cancer or become seriously ill after they were exposed to chemicals while on work assignments. In a statement on Monday, Gibbs said the bill was a critical step toward showing that Mississippi does not tolerate human rights abuses.

“It is sad to hear of multiple incarcerated individuals passing away this summer due to continued exposure of harsh chemicals,” Gibbs said. “We worked very hard last session to get this bill past the finish line. I am appreciative of Speaker Jason White and the House Corrections Committee for understanding how vital this bill is and passing it out of committee. Every one of my house colleagues voted yes. We cannot allow politics between chambers on unrelated matters to stop the passage of good common-sense legislation.”

The bill passed the House in a bipartisan vote before dying in the Senate. Currie told Mississippi Today on Monday that she plans on marshalling the bill through the House again next session. 

Currie, a Republican from Brookhaven, said Balfour’s case shows that prison medical contractors don’t have strong enough incentives to offer preventive care or treat illnesses like cancer.  

In response to an ongoing Mississippi Today investigation into prison health care and in comments on the House floor, Currie has said prisoners are sometimes denied life saving treatments. A high-ranking former corrections official also came forward and told the news outlet that Mississippi’s prison system is rife with medical neglect and mismanagement. 

Mississippi Today also obtained text messages between current and former corrections department officials showing that the same year the state agreed to pay VitalCore $100 million in taxpayer funds to provide healthcare to people incarcerated in Mississippi prisons, a top official at the Department remarked that the company “sucks.”

Balfour was first convicted of murdering a police officer during a robbery in north Mississippi, and she was sentenced to death. The Mississippi Supreme Court reversed the conviction in 1992, finding that her constitutional rights were violated in trial. She reached a plea agreement for a lesser charge, her attorney said. 

As of Monday, the lawsuit remains active, according to court records. Late last year Balfour’s attorneys asked for her to be able to give a deposition with the intent of preserving her testimony. She was scheduled to give one in Southaven in March. 

Rogers said Balfour’s death is a tragic reminder of systemic failures in the prison system where routine medical care is denied, their labor is exploited and too many who are released die from conditions that went untreated while they were in state custody. 

Her legacy is one RECH Foundation will honor by continuing to fight for justice, dignity and systemic reform, said Rogers, who was formerly incarcerated herself. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post After 30 years in prison, Mississippi woman dies from cancer she says was preventable 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: Center-Left

This article presents a critical view of the Mississippi prison health care system, highlighting systemic failures and medical neglect that led to the death of a formerly incarcerated woman. The tone and framing focus on social justice issues, prisoner rights, and the need for government accountability and reform, which align with Center-Left values emphasizing government responsibility for vulnerable populations. While the article is largely investigative and fact-based, its emphasis on advocacy for reform, criticism of privatized prison health contractors, and highlighting bipartisan legislative efforts suggest a Center-Left leaning perspective rather than neutral reporting.

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Mississippi Today

FBI concocted a bribery scheme that wasn’t, ex-interim Hinds sheriff says in appeal

Published

19 hours ago

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August 4, 2025

By

mississippitoday.org – @MSTODAYnews – 2025-08-04 13:16:00


Former interim Hinds County sheriff Marshand Crisler is appealing his 2021 bribery and ammunition convictions, arguing the FBI entrapped him by exploiting his prior relationship with donor Tonarri Moore. Crisler’s attorney contends that without Moore’s requests, there was no quid pro quo and thus no bribery. Moore, who became an informant to avoid prosecution for guns and drugs, recorded meetings where he gave Crisler $9,500 in exchange for favors like moving a cousin in jail and job placement. Crisler maintains accepting campaign donations is normal political activity, not bribery without explicit promises of official acts. The appeal asks the 5th Circuit to overturn his conviction.

by Mina Corpuz, Mississippi Today
August 4, 2025

Former interim Hinds County sheriff Marshand Crisler is appealing bribery and ammunition charges stemming from his 2021 campaign, arguing that the federal government played on his relationship with a former supporter to entrap him. 

Crisler had asked Tonarri Moore, who donated to past campaigns, for a financial contribution for the sheriff’s race. Moore said he would donate if Crisler helped with several requests. Without the previous relationship, Crisler would not have acted, his attorney argues, and Crisler had no reason to believe he was being bribed. 

“The government, having concocted a bribery scheme to entrap Crisler, then had to contrive a corresponding quid pro quo to support the scenario with which to entrap him,” attorney John Holliman wrote in a Saturday appellant brief. 

Crisler is asking the U.S. 5th Circuit Court of Appeals to reverse his conviction and render its own rulings on both counts. 

He was convicted in federal court in November after a three-day trial and sentenced earlier this year to 2 ½ years in prison. Crisler is serving time in FCI Beckley in West Virginia. 

The day before Crisler reached out to Moore to ask for support for his campaign for sheriff, Drug and Enforcement Administration agents raided Moore’s home and found guns and drugs. An FBI agent called to the scene looked through Moore’s phone and saw Crisler had called. 

According to the appellant brief, the agent asked Moore what Crisler would do if offered money, and if Moore was bribing him. Moore said he wasn’t bribing Crisler, and the agent asked if Moore would do it. 

At that time, there weren’t reasonable grounds to start a bribery investigation into Crisler, his attorney argues, nor was there reason to believe he was seeking a bribe. 

Moore agreed to become an informant for the FBI, in exchange for the government not prosecuting him for the guns and drugs. 

The FBI fitted him with a wire to record Crisler during meetings, which began that day. The meetings included one inside Moore’s night club and a cigarette lounge in Jackson. Agents provided Moore with the $9,500 he gave to Crisler between September and November 2021.

Crisler’s 2023 indictment came as he campaigned again for sheriff and months before the primary election. He remained in the race and lost to the incumbent who he faced in 2021. 

At trial, the government argued the exchange of money were attempts to bribe because Moore made several requests of Crisler: to move his cousin to a different part of the Hinds County Detention Center, to get him a job in the sheriff’s office and for Crisler to let Moore know if law enforcement was looking into his activities. 

In closing arguments, Assistant U.S. Attorney Charles Kirkham pointed to examples of quid pro quo in recordings, including one where Moore said to Crisler, “You scratch my back, I scratch yours” and Crisler replied “Hello!” in a tone that the government saw as agreement. 

The appellant’s brief argues that without Moore’s requests, the government lacked a way to show quid pro quo, a requirement of bribery charge: that Crisler committed or agreed to commit an official act in exchange for funds. 

Moore also asked Crisler to give him bullets despite being a convicted felon, which is prohibited under federal law. The brief notes how the government directed Moore to come up with a story for needing the bullets and to ask Crisler to give them to him.

In response, Crisler told Moore he could buy bullets at several sporting goods stores. Moore said they ran out, and eventually Crisler gave him bullets. 

Crisler also argues that the government prosecuted routine political behavior. Specifically, accepting campaign donations is not illegal, and can not constitute bribery unless there is an explicit promise to perform or not perform an official act in exchange for money. 

“Our political system relies on interactions between citizens and politicians with requests being made for this or that which is within the power of the elected official to do,” the brief states. “This does not constitute a bribery scheme. It is the normal working of our political system.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post FBI concocted a bribery scheme that wasn’t, ex-interim Hinds sheriff says in appeal 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: Center-Right

The article presents the legal appeal of former interim Hinds County sheriff Marshand Crisler with a focus on his argument that the FBI orchestrated an entrapment scheme. The language is largely factual and centers on the defense’s claims and legal standards for bribery, emphasizing normal political behavior versus illegal conduct. While the article reports on the government’s position, it gives significant space to Crisler’s defense and critiques of federal prosecution tactics. This framing, highlighting skepticism toward federal law enforcement and emphasizing the defense perspective, suggests a slight center-right leaning, reflecting a cautious stance on government overreach without overt ideological language.

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Mississippi Today

Political stumping mild at Neshoba County Fair

Published

1 day ago

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August 4, 2025

By

mississippitoday.org – @GeoffPender – 2025-08-04 06:30:00

by Geoff Pender, Michael Goldberg and Taylor Vance, Mississippi Today
August 4, 2025

Mississippi Today’s politics team recaps the 2025 Neshoba County Fair. This year’s political speaking lacked some of the fire and brimstone of big election years, but state leaders laid out some major policy plans sure to dominate debate in the next legislative session.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post Political stumping mild at Neshoba County Fair appeared first on mississippitoday.org

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