Mississippi Today
Can a Mississippi governor expand Medicaid on his own? Depends on who you ask.

Editor’s note: Mississippi Today interviewed two Deep South governors about why they chose to champion and pass Medicaid expansion in their states and what the outcomes have been. Those articles will publish on August 24.
Brandon Presley, the Democratic nominee for governor, has at times spoken of expanding Medicaid through executive action without approval of the Republican-controlled Mississippi Legislature should he win the November general election.
“Day 1, I’m going to expand Medicaid so that 220,000 working Mississippians can get access to affordable healthcare,” Presley wrote on social media in July.
At other times, perhaps recognizing the obstacles such a solo effort to expand Medicaid might face, Presley has indicated he would work with the Legislature, which he has said he believes would be amenable to Medicaid expansion.
As nearly half of the state’s rural hospitals are at risk of closing and hospitals across the state are laying off staff or cutting services because of budget problems, Medicaid expansion has become a key campaign issue in 2023.
Forty states and the District of Columbia have expanded Medicaid, a federal opt-in program that provides health care coverage to poor Americans who can’t otherwise afford it themselves. Two of Mississippi’s neighbors, Arkansas and Louisiana, have expanded Medicaid with great success and improved outcomes.
But leaders in Mississippi, the poorest state in America with one of the nation’s highest percentages of uninsured residents, have resisted expansion for more than 10 years — despite the fact that it would bring more than $1 billion per year in new funds to the state and directly help hospitals.
READ MORE: FAQ: What is Medicaid expansion, really?
In some states, such as Louisiana, expansion was done through executive orders instead of by approval of the Legislature. But there are questions about whether a governor in Mississippi could expand Medicaid without legislative approval.
Republican Gov. Tate Reeves, who is seeking reelection and faces Presley in the November general election, has long opposed expanding Medicaid.
The Division of Medicaid, which is under the statutory direction and purview of the governor, takes the position that Medicaid expansion requires legislative approval.
“State law defines who can be eligible for Medicaid in Mississippi. Our understanding is that a governor is not authorized to unilaterally establish a new Medicaid coverage group through an executive order or a federal demonstration waiver,” said Matt Westerfield, a spokesperson for the state’s Division of Medicaid.
State Sen. Kevin Blackwell, R-Southaven, who chairs the Senate’s Medicaid Committee, referred questions about whether a governor could expand Medicaid on his or her own to the Division of Medicaid. His House counterpart, Joey Hood, R-Ackerman, could not be reached for comment.
Former state Rep. Steve Holland, who for years was considered one of the leading authorities in the Legislature on Medicaid issues as the longtime chair of Public Health Committee, said the governor has considerable authority over the Medicaid program. After all, Medicaid is a division within the governor’s office.
Still, Holland said, “We have the most codified Medicaid program in the country. We have put all the eligibility requirements in law … I know Brandon (Presley) as well as anyone. If he is fortunate enough to be elected governor, he is smooth enough and prepared enough to begin immediately to expand Medicaid. And I think he can work with the Legislature to do that.”
READ MORE: Nearly half of rural hospitals at risk of closure in Mississippi, new data shows
The Presley campaign has cited the ability of the Division of Medicaid — hence the governor — to seek a federal waiver to alter the state Medicaid program. A campaign spokesperson said the governor would have authority to seek the waiver under state law, though waivers are granted for only five years and they normally are granted in coordination with the Legislature, which often must provide funding to pay for the waiver.
Holland said state law provides the Division of Medicaid under the governor significant flexibility to seek waivers from the federal government to enact programs that are not codified in state law.
The bottom line is that if there was an effort to expand Medicaid through the waiver program, an appropriation by the Legislature to fund the program most likely still would be needed. But if a governor did expand Medicaid and figure out a way to pay for the program without the Legislature, it likely would result in litigation and be left to the state courts to determine whether it was legal.
Specific sections of state law define who is eligible for Medicaid based on income levels and health issues. In general terms, in Mississippi only poor pregnant women, poor children, the disabled, certain groups of the elderly and some groups who fall into extreme poverty categories and are providing care for family members on Medicaid are eligible for Medicaid coverage.
Most able-bodied people are not eligible for Medicaid in Mississippi.
With Medicaid expansion, those earning up to 138% of the federal poverty level — or about $18,750 annually — would be eligible for coverage. The intent with Medicaid expansion is to provide health care to primarily the working poor who cannot afford private insurance and who are not provided coverage by their employers.
The most clear cut way to expand Medicaid would be for the Legislature to approve a bill to incorporate the new eligibility requirements in state law.
Whether it would be feasible for the Legislature to agree to such a change in state law is the unknown question. If Presley is elected, Mississippians will find out.
At least in the current Legislature, there is a significant appetite to at least consider the merits of expansion. Last legislative session, Mississippi Today surveyed most of the 174 lawmakers and asked them directly if they supported Medicaid expansion.
In response, voting majority in the House said they either supported Medicaid expansion or remained undecided. One vote shy of a voting majority in the Senate said the same.
Just 21 of the House members surveyed, or 18% of the House, said they outright opposed Medicaid expansion. And just 18 of the Senate members surveyed, or 38% of the Senate, said they outright opposed it.
READ MORE: Few Mississippi lawmakers outright oppose Medicaid expansion
Holland, who served in the Legislature until 2020, says he believes Presley could get Medicaid expansion through the Legislature even with a Republican supermajority.
“Tate Reeves and (House Speaker) Philip Gunn were the two blocking it. Period.” said Holland. Gunn is not seeking re-election this year.
“In my final years in the House I had so many Republicans come to me and say expanding Medicaid is the right thing to do,” Holland said.
Another option would be for the Legislature to reauthorize the ballot initiative program that was ruled unconstitutional in 2021 by the state Supreme Court. Through the initiative process, people can gather signatures to bypass the Legislature and place issues directly on the ballot.
When the initiative process was ruled invalid, there was an effort underway to gather the required number of signatures to place Medicaid expansion on the ballot. The Mississippi Hospital Association was one of the sponsors of the Medicaid expansion initiative proposal and had hoped to have enough signatures to place the proposal on the 2022 ballot.
Multiple polls have indicated strong support among Mississippi voters for Medicaid expansion.
So far, legislative efforts to revive the initiative have been unsuccessful.
READ MORE: Mississippi leaving more than $1 billion per year on table by rejecting Medicaid expansion
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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