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How Medicaid expansion could have saved Tim’s leg — and changed his life

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How Medicaid expansion could have saved Tim's leg — and changed his life

Note: This article is part of Mississippi Today's ongoing Mississippi Care Crisis project. Read more about the project by clicking here.

Tim Floyd has never been one to sit still. 

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After being forced to leave community college to move home to Guntown to his mom pay the bills, he landed a job driving a truck in his early 20s. But three or four years later, he was diagnosed with sleep apnea, a dangerous condition for professional drivers because it can lead to fatigue and slow reactions when driving. Just like that, his truck driving career was over.

The health insurance that job had provided him abruptly disappeared — and his has never been the same since.

“It made me no longer insurable to drive the truck, and that's what led me down the path of not being able to find a job with health insurance and not being able to afford (private) insurance with the jobs I had,” said Floyd, now 46 years old.

Since then, Floyd has been trapped in what is called the "health insurance gap": he doesn't qualify for Mississippi's strict and limited program, and he doesn't have private health insurance from an employer. He can't afford a private plan himself. 

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Meanwhile, over the past five years, Floyd's serious health problems have mounted. He's been diagnosed with diabetes. He's lost part of his leg. He's battled cancer. He told Mississippi Today he's sure he has medical debt, but he tries not to think about it: the past few years have just been about surviving each day.

Floyd's conundrum is not unique in Mississippi. The state the nation in both rates of poverty and of uninsured people. Mississippi remains one of 12 states – and will likely soon be one of only 10 – not to accept federal dollars and provide health insurance to hundreds of thousands of Mississippians, many of them working poor.

Studies, including one from the state economist, have shown expanding Medicaid would up to about 230,000 Mississippians making up to 138% of the federal poverty level, or about $30,000 in annual income for a family of three. Floyd would have been covered under expanded Medicaid during the years he worked as a cashier and other low wage jobs, but because Mississippi never expanded, he wasn't.

The study also showed the state would save anywhere from $186 million to $207 million from 2022 through 2027 and create thousands of jobs. 

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Medicaid expansion has also been associated with reductions in mortality in addition to declines in medical debt, which is highest in the South and in lower-income communities. 

But both Speaker of the House Philip Gunn and Gov. Tate Reeves remain unwaveringly opposed to expansion. 

“Extending Medicaid to people who can't afford health insurance would offer them and their families basic financial security to live a healthy life, that includes preventative care. Mississippians shouldn't face financial ruin if they need health care or worry that a lack of preventative health care could cost them their lives,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program. 

After he lost the trucking job, Floyd then worked many other jobs – including multiple at one time – but never landed another that offered health insurance. 

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The combination of jobs wasn't enough to afford private insurance or pay out-of-pocket medical costs. So he remained uninsured and stopped going to the doctor. 

Six in 10 uninsured adults say they have postponed getting health care they needed due to cost, according to KFF. Uninsured adults are also more likely to report skipping recommended tests or treatment due to cost than adults with insurance. 

In 2012, that practice caught up to Floyd. He was working a construction job when a rock got stuck under his inside his boot and created a sore. He put some antibiotic ointment and a Bandaid on it and continued working. But six months later, the sore became infected and his foot swelled up. He used savings to go see a doctor, who referred him to a wound specialist. 

For the next five years, he battled that sore: he would treat it and stay off his feet for a month (which would sometimes cause him to lose whatever job he had at the time), the sore would heal, and he would go back to work. Then the whole cycle repeated again. 

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In 2017, a doctor suggested he have his blood sugar tested. So Floyd, again, dipped into his savings for a basic appointment and test. The results showed he was diabetic, and the sores were diabetic foot ulcers. The infection was now in his bones.   

There was only one option at that point: amputate his leg from the knee down. So again, just like that, his life changed. The program at North Mississippi Medical Center where he received his care covered the costs of the surgery, he said. Six months later, he was fitted for a prosthetic and began the of rebuilding his strength and relearning how to do the things dear to him: basic things like walk, take care of the family's dog, play the drums. 

“It was hard. It was hard not only on me but on the people that cared about me,” he said. “Also, my emotional health wasn't all that great … It took me about another year (after getting the prosthetic) to be able to walk unassisted – no cane or walker or nothing. Then, just building –  going from being pretty active to being very sedentary to trying to get active again took me another year from that before I got my stamina back up to where I could work.”

Tim Floyd, left, listens as his father, Macky Floyd, plays the guitar at their home in Guntown, Miss., Friday, Nov. 4, 2022.

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The Tupelo hospital – a hub for health care and employment in north Mississippi – offers a financial assistance program for uninsured and underinsured patients like Floyd who need emergency or medically necessary care. The hospital and its subsidiaries spent over $190 million in fiscal year 2021 in charity care and uninsured discounts.

The hospital is situated in the district of Sen. Chad McMahan, a Republican who also lives in Floyd's same small hometown of Guntown. McMahan drew criticism from Republican counterparts in 2021 when he indicated he was willing to discuss Medicaid expansion “and look at what (it) might look like.”

Today, he still maintains he sympathizes with people who work but are uninsured. He says he's not for Medicaid expansion, per se, but does believe it should be discussed and that the health care system in Mississippi needs to be reformed.

“I think everything has to be on the table – whether or not we're going to have Medicaid enhancements or Medicaid expansion or if we're going to have a modernization of the way prices, menu prices, are put out from hospitals,” or how insurance companies operate, he said. 

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McMahan said he regularly speaks with administrators at the hospital that employs nearly 9,000 people. 

“For the hospital system I represent, they have annual salaries of half a billion a year and then an annual income revenue stream of 1 billion-plus. Last year, they gave away 19% in charity,” he said. “… It's unsustainable. In what other business can you give away 19% (and survive)?” 

Beyond the economics of Medicaid expansion and health care reform, McMahan, who grew up without health insurance as the son of a carpenter and a clerk, says he feels for Floyd and identifies with him.

“In the 9th grade I got hurt, and my parents didn't have insurance … I remember seeing the fear in my family's eyes and hearing discussions at the dinner table when my parents would be discussing what we were going to eliminate from the family budget that month to pay for the $20,000 hospital bill I had,” he said. 

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“I'm sympathetic to him (Floyd) because I was like that myself … If we're going to do any type of Medicaid overhaul, there has to be a work requirement. I'm not for anyone getting a public service unless they're in a position to contribute.”

Tim Floyd plays the djembe drum at a in Amory, Miss. in 2021.

Finally recovered from losing his leg, Floyd started submitting job applications again in 2020 – right as the U.S. began reporting its first COVID-19 cases and the country subsequently shut down. 

Floyd, still uninsured and ineligible for disability, discovered a knot on his neck. He went to the doctor and was diagnosed with an ear infection and prescribed antibiotics. Floyd said the doctor didn't mention any further testing. 

“You know, actually, most doctors that I've dealt with understand my situation. Because I am uninsured, they don't even bring that stuff (additional testing) up,” he said about. 

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Over the next year, the lump got bigger. He returned to the same doctor, who at that time recommended a biopsy. The biopsy, which the hospital's charity care program again covered, revealed he had stage II Hodgkin's lymphoma.

The oncologist told him if it had been diagnosed earlier, it would've been caught at stage I and required less rigorous treatment, he said.

He went through six weeks each of chemotherapy and radiation, which burned his vocal chords. Until now, his health conditions hadn't kept him from his musical talents: singing and playing the drums in a band called Proximity Rule. But for a while, he couldn't sing, and it was difficult to even speak.

Floyd, who has been in remission since May of 2021, is now on disability, which pays him about $800 a month. The cancer and amputated leg didn't qualify him for the government assistance – but the later addition of a severe carpal tunnel diagnosis did. 

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Looking back, he says, the logic of state leaders who have refused to expand Medicaid is baffling. 

“It would make a lot more sense to find people like me … and (give) them Medicaid for a short period of time to get back healthy so they can continue working and continue providing for their family ….,” he said. “Because if they don't have health insurance, they don't go to the doctor and get seen, eventually they're gonna be just like me, and we're on the hook for them for the rest of their life.”

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

Mississippi Today

A company wanted to store carbon under US forests. It may get its wish.

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mississippitoday.org – Pam Radtke, Floodlight – 2024-07-26 09:53:20

After it was twice denied permission to store carbon dioxide under U.S. Forest Service lands, a company looking to store millions of tons of the greenhouse gas in the Southeast made a strategic : Keep pushing.

The company, CapturePoint , leased property adjacent to forest service land in Mississippi for a there. It started a program teaching carbon management at a school system near Forest Service land in Louisiana. And then, more than a year after it received its first denial, CapturePoint invited federal on an informational tour to discuss storing carbon under forest service land.

USFS officials are now considering a draft rule to allow carbon capture under U.S-owned land. The agency insists the company's requests did not influence its decision to draft the rule — and that no one from the Forest Service attended the informational tour.

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“We always felt and believed that the Forest Service was not following (Federal Land Policy and Management Act), and therefore continued our efforts,” said a CapturePoint spokesperson who asked not to be named.

That law allows some federal lands to be used for energy, gas. Environmental groups argue the 1976 law does not carbon dioxide storage. They are concerned that CO2 could leak from the ground, injuring or killing people and animals and damaging the forest. Injecting the carbon underground, they say, amounts to an industrialization of federal land.

While it is technically possible for such a leak to occur, the chances of a leak from storage more than a mile underground are “extremely remote,” CapturePoint Tracy Evans told Floodlight.

Visitors can ride their horses on one of many multiple-use trails on Sam Houston National Forest, Texas. ExxonMobil had sought to inject carbon under the forest, which is not allowed under U.S. Forest Service regulations. A draft agency rule, if finalized, would allow such sequestration. Credit: Preston Keres / U.S. Forest Service

Agency records reveal various requests

CapturePoint's efforts were detailed in public records obtained from the Forest Service by CURE, a Minnesota-based nonprofit, and shared with Floodlight. CURE is opposed to carbon pipelines in Minnesota and is concerned about carbon storage under Forest Service land in its state. The records also reveal inquiries in 2022 by ExxonMobil to stash carbon under the Sam Houston National Forest in Texas.

The Carbon Capture Coalition says the United States won't be able to meet 2050 greenhouse gas reduction targets unless it allows federal land to be used for carbon storage. The pro-carbon capture coalition of more than 100 companies, unions, conservation and environmental policy organizations estimates about 130 million acres of federal lands overlay suitable geology for the secure storage of captured carbon dioxide. The Forest Service manages 21% of that land.

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CapturePoint applied to inject carbon under the Kisatchie National Forest in central Louisiana in 2021 under its previous corporate name, Authentic Reductions. CapturePoint also applied to inject carbon under the Delta National Forest in Mississippi in 2022.

The applications were rejected for the same reason — such a permit would allow a permanent use of Forest Service land, something the agency has historically not allowed.

The U.S. Forest Service owns 173 million acres of land. It is proposing that some land under its forests be used to store carbon captured from industries to prevent it from being released into the atmosphere. Credit: U.S. Forest Service

New carbon capture rule on tap

Now, more than three years after the company began its push, the Forest Service is in the middle of changes that could allow the storage of the greenhouse gas under millions of acres of Forest Service land indefinitely.

The comment period for the draft rule ended in January. The Forest Service is currently reviewing the comments, agency spokesperson Catherine McRae said.

Both CapturePoint and the Forest Service agree: No agency employees ended up attending the tour the company held of the Kisatchie and Delta forests in 2022. CapturePoint said it had no direct input on the creation of the draft rules. And McRae said the company's requests did not prompt the Forest Service to propose the draft rule.

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The email correspondence in the records obtained by CURE included draft applications from CapturePoint to inject carbon under the two forests. In both, CapturePoint offered $1 per ton of injected carbon. In the Kisatchie National Forest, CapturePoint proposed injecting up to 50 million tons over a 12- to 20-year period — which it said is equivalent to removing the emissions from 10 million cars a year. In the Delta forest, the company said it wanted to inject 6-12 million tons over 12 years.

The Inflation Reduction Act offers companies that capture and store carbon dioxide from $60 to $180 per ton in tax credits. Evans told Floodlight $1 per ton was offered when subsidies were lower, but there are mechanisms in place to increase the payments if subdies increased.

“Some of the lobbying was sort of surprising,” said Hudson Kingston, legal director of CURE. He said the company “sucked up to” federal employees by offering to take them on the tour. “It's how regulatory capture works.”

Victoria Bogdan Tejeda, an attorney with the Center for Biological Diversity, had a similar reaction.

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“One could really infer that there was a lot of industry pressure or influence to try to get access to this pore (underground) space,” Bogdan Tejeda said. “And that, so far, they were successful, at least with getting a rule out there that would make their applications possible.”

CapturePoint doesn't see it that way. Evans argued that storing carbon under Forest Service and other federal lands makes sense given the federal government's “desire to have CCS move forward.”

Visitors enjoy riding one of many multiple-use trails on Sam Houston National Forest, Texas.
(USDA Forest Service photo by Preston Keres) Credit: Preston Keres / U.S. Forest Service

Feds already allow some carbon storage

In addition to approaching the Forest Service, CapturePoint also inquired about storing carbon under a U.S. Army base in central Louisiana, he said.

Some federal agencies, including the of Land Management, already allow carbon to be stored under their lands under the federal land management law. In 2022, the BLM granted its first approval to ExxonMobil to permanently store carbon under land in Wyoming, a project that remains controversial.

While CapturePoint says the law should also apply to the Forest Service, Bogdan Tejeda said it's not that straightforward. The law does not mention carbon dioxide or permanent storage, and historically, the Forest Service has interpreted its own authority as barring any permanent use, she said.

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November's draft rule by the Forest Service surprised many agency observers, who say it bucks precedent. While there are leases on Forest Service for oil and gas drilling, for instance, those leases are for a set number of years, not for a permanent use, Bogdan Tejeda said.

“I'm not seeing anything in the rule that they (USFS) issued, showing why that would change,” she said.

Among the concerns over storing carbon under forest service land is the potential to endanger tribes' access to fish and other food, which the federal government agreed to protect in exchange for seizing vast tracts of Native American land, according to the Confederated Tribes of the Umatilla Indian Reservation in Oregon.

Boaters head out onto Lake Conroe on Sam Houston National Forest, Texas. Credit: USDA Forest Service photo by Preston Keres

Bogdan Tejeda still has a lot of questions, including who will monitor the stored carbon after CapturePoint is gone — and who will be liable if something goes wrong.

“It gives industry essentially a place to dump their carbon dioxide waste, benefit from the tax credits, and they don't have to deal with the messiness of trying to get permission from property owners and eminent domain.”

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The federal government says, ‘Hey, just on over here,' ” she said, “and that's a form of a subsidy.”

Floodlight is a nonprofit newsroom that partners with local and national outlets to investigate the powerful interests stalling climate action.

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

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Mississippi Today

Let the Olympics begin, but nothing will top what Ruthie Bolton did in 1996

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The opening ceremonies of the Summer Olympics are tonight in Paris, and my thoughts immediately go back to the only time I covered the Olympic , 1996 in Atlanta.

My first thought: Has it really been 28 years?

Rick Cleveland

Yes, it has, but in so many ways it seems as if it were only last week. It remains one of the highlights of my more than half century writing about sports. The memories are vivid, poignant and many. There was Muhammad Ali lighting the Olympic flame with trembling hands. There was then-Hattiesburg Angel Martino, a swimmer, winning the first American medal and then three more. There was the bomb that went off in Centennial Park, adjacent to Olympic headquarters, putting a 24-hour hold on the Olympics and causing this sports writer to work a 36-hour shift. There were Skip Bertman and Ron Polk coaching Team USA , puffing on huge Honduran cigars all the while. There was a human blur named Michael Johnson who shattered in the 200- and 400-meter sprints. There was all that and so much more.

Most memorable of all, there was Ruthie Bolton and, by extension, the Rev. Linwood Bolton, Ruthie's daddy. For me, they became the best story of those Olympic Games and gave this Mississippi reporter more than he ever dreamed he could write home about. You could not make their story up.

Ruthie, from the tiny town of McLain, was the point guard for the gold medal-winning USA women's basketball team that pretty much stole the Olympic from Michael Jordan, Charles Barkley and the USA men's Dream Team. The American women also included such stars as Lisa Leslie, Sheryl Swoopes and Rebecca Lobo, but little Ruthie Bolton was the team's engine. She made them go, both offensively and defensively. Her story was fascinating and as Mississippi as it gets.

Start with this: Ruthie was the smallest of the 20 children born to the Rev. Linwood Bolton and his wife, Leola, who lived on a farm near McLain in Greene County, 34 miles south of Hattiesburg. Leola Bolton had died of cancer the year before the Olympics. Linwood, who at the age of 73 still pastored four south Mississippi churches, watched the first week or so at home on TV, then came to Atlanta for the last week of the games. Meeting and interviewing him was a highlight. He had lost the love of his and much of his hearing, but his handshake was firm and he still possessed the sunny, effervescent personality of a much younger man.

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Ruthie and Rev. Linwood Bolton in 1996.

“Yes,” he answered, he was “mighty, mighty proud of Ruthie. The rest of them are bigger, but little Ruthie was a little different from the rest,” Rev. Bolton said. “She was the quiet one, but she had a fire inside. Ruthie was the fighter. She was always so determined. When she had a goal, nothing was going to stand in the way.”

On the Bolton farm, the grew corn, peas, beens, greens, okra and tomatoes. They raised cattle, hogs and chickens. Everyone pitched in with the chores, and, said Linwood, Ruthie always chose the most difficult work of all.

All that hard work on the farm somehow translated to the basketball court. For Team USA, Ruthie always got the most difficult defensive assignment. She nearly always defended the other team's best player and she led the team in steals. Offensively, she ran the show, scoring 13 points a game and leading the team in assists.

In the championship game against Brazil, played before 33,000 in the Georgia Dome, Ruthie scored 15 points, passed out five assists and made five steals. On Team USA's first offensive possession, she swished a 3-pointer from four steps beyond the 3-point line. More importantly, she was given the assignment of covering “Magic Paula” Silva, Brazil's legendary star, who scored only seven points and made her only field goal when Ruthie was taking a breather.

Afterward, I asked Ruthie how she did it. Her answer: “I was in her pants, that's how. I was all over her. If she had gone to the bathroom, I was going with her.”

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It reached the point where a Mississippi sports writer – covering a Mississippi woman in the biggest sporting event in the world – felt sorry for the star player from Brazil.

The medal presentation afterward was one never to be forgotten. There was Rev. Linwood Bolton, holding up a of his deceased wife, while his daughter, watching, smiled through tears, a gold medal draped around her neck while the Star Spangled Banner played. Again, you couldn't make this up.

Over the next weeks, many compelling Olympic stories will unfold on the courts, fields and in the pools of Gay Paree. None will be more compelling than what happened 28 years ago when Ruthie Bolton, the 16th of 20 born to Linwood and Leola Bolton, displayed more grit and will than imaginable.

The rest of the story? Rev. Bolton died in 1998. Ruthie went on to play the first seven seasons of the WNBA's existence, was a two-time all-star and has been inducted into both the Women's Basketball Hall of Fame and the Mississippi Sports Hall of Fame. She has long since retired and recently has moved back to McLain where her daughter, Hope, will play basketball as a ninth grader this next season.

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And Ruthie's best memories of those Atlanta Olympics?

“On the floor, it had to be guarding that girl from Brazil in the gold medal game,” Ruthie told me. “Off the floor, just being supported by my family, all of them. I mean, have you ever gone into an Atlanta restaurant and asked for a table for 28?”

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

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Mississippi Today

On this day in 1948

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mississippitoday.org – Jerry Mitchell – 2024-07-26 07:00:00

JULY 26, 1948

President Harry Truman shakes hands with Force Staff Sgt. Edward Williams, right, of St. Louis, Missouri, just two years after Truman issued Executive Order 9981. Credit: President Harry S. Truman Library and

President Harry Truman issued Executive Order 9981, which abolished racial discrimination in the United States Armed Forces, eventually leading to segregation's end in the services. The order came after he saw many returning Black soldiers become victims of violence. 

“My stomach turned over when I learned that Negro soldiers, just back from overseas, were being dumped out of army trucks in Mississippi and beaten,” he said. “I shall fight to end evils like this.” 

He formed the President's Committee on , which asked for an end to discrimination in the armed forces, and later said in a speech at the Lincoln Memorial, “We have reached a turning point in the long history of our country's efforts to guarantee and equality to all of our citizens.” 

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Throughout the early history of the U.S. military, minorities had been segregated into separate units. Often given menial tasks, they rarely saw combat. But when they had been to fight on the battlefield, they had proven their patriotism and their mettle. Many of the military brass resisted the change, and the last segregated units didn't disband until 1954. Exactly 15 years later, Defense Secretary Robert McNamara instructed military commanders to boycott private facilities used by soldiers or their families that discriminated against Black Americans.

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

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