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Medicaid expansion negotiators still far apart after first public meeting

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mississippitoday.org – Bobby Harrison – 2024-04-23 18:14:27

Kevin Blackwell, the main Senate negotiator trying to reach agreement on expanding Medicaid to provide health insurance for primarily the working poor, urged his House counterparts Tuesday to accept the Senate's scaled-down version of Medicaid expansion.

“Both chambers are off the porch” in terms of passing bills to expand Medicaid, Blackwell said. “… Both have taken a step forward. But if your position is my way or the highway, it is going to put us right back on the porch.”

House negotiators, meanwhile, offered a compromise expansion plan to the Senate on Tuesday, but Blackwell and his Senate negotiators did not reciprocate, saying only they would take the House counter back to Lt. Gov. Delbert Hosemann and other Senate leaders for consideration and casting doubt that they can gin up more Senate support.

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Blackwell made his warning Tuesday near the end of the first open-to-the-public conference committee meeting, which was packed to capacity with onlookers eager to witness a key meeting of the Legislature's first-ever earnest debate of Medicaid expansion.

The issue has become the major focus of a contentious 2024 legislative , with hundreds of Mississippians, top business leaders, health officials and even religious leaders publicly advocating at the Capitol for full Medicaid expansion that stands to significantly the poorest, unhealthiest state in the nation.

In the meeting on Tuesday, three House negotiators and three Senate negotiators met to try to hash out the differences between the two chambers on expanding Medicaid as is allowed by federal and covered largely with federal funding.

House Medicaid Chairwoman Missy McGee, the lead House negotiator, said her chamber's goal is to expand Medicaid to the maximum number of poor allowed under federal law and to draw down the maximum amount of federal dollars.

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READ MORE: Experts analyze House, Senate Medicaid expansion proposals, offer compromise plan

She said the Senate plan did not do that. The House would expand Medicaid to cover those earning up to 138% of the federal poverty level or about $20,000 annually for an individual.

The Senate plan would cover those earning less than 100% of the federal poverty level or about $15,000 annually for an individual. McGee pointed out under the Senate plan there would be much less federal money available to pay for expansion. She said the goal should be to cover as many people as possible at the most affordable cost. She said the House plan does that.

But as a compromise, she offered “a hybrid plan” where those earning between 100% and 138% of the federal poverty level would receive health care coverage through private health insurance policies offered on the federal exchange. The costs of the policies, though, would be covered through federal-state Medicaid funds. But under the plan, the federal would pay 90% of the costs.

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Under the Senate plan, the federal government would pay 77% of the costs.

McGee said the House is offering the compromise to cover people through private insurance after Senate leaders said expanding Medicaid to 138% of the federal poverty level would the marketplace in Mississippi by moving people from the marketplace to Medicaid. While senators said they did not want to damage the marketplace, in reality, the marketplace provides polices for people earning much more than 138% of the poverty level and exchanges in the 40 states that have expanded Medicaid have not been harmed.

After McGee and the two other House negotiators offered the “hybrid plan” as a compromise, she urged Blackwell and his two Senate colleagues to take the proposal back to Senate colleagues and to come back in the coming days to possibly offer a counterproposal.

“We feel this is a major compromise,” she said.

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As the meeting ended, Senate conferees said they would take the House's proposed compromise back to Hosemann and other Senate leadership. They urged McGee to also go back and talk with the House speaker and leadership.

“But if your position has not changed, or you haven't offered anything, then I don't have anything to take back,” McGee responded.

Rep. Missy McGee, R-Hattiesburg, in talks regarding Medicaid expansion during a public meeting at the Capitol, Tuesday, April 23, 2023. Credit: Vickie D. King/Mississippi

Blackwell said the Senate wanted to take slow steps while the House was moving forward with “a Ferrari plan.”

He said he does not believe the Senate would agree to such rapid movement after the two chambers had refused for the past decade to even consider Medicaid expansion.

Blackwell said that in other states, the number of people insured through Medicaid expansion and the costs have come in higher than initially estimated.

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When asked after the meeting if he could point to any other state that had seen a great detrimental effect — financially or otherwise — from Medicaid expansion, he paused for a moment.

“I can't answer that,” Blackwell said. “I'm not in those other states,” although he said he met a lawmaker from Kentucky who told him the program had been expensive.

If the House would accept the Senate proposal, Blackwell said in the coming years the two chambers could work to expand upon it.

The first full conference committee on the pivotal issue occurred less than a week before the deadline for the conference committee to reach an agreement to offer to the two chambers for possible passage during the final week of the 2024 session.

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McGee pointed out 40 other states, many governed by Republicans, have expanded Medicaid and none of those have tried to repeal the program. Blackwell argued that the expansion has cost more in those states than initial studies said it would cost.

McGee said the House plan had a four-year “repealer” and would be cost neutral through that time, according to various studies, which also indicate little or no cost to the state after those initial four years. After those four years, the two chambers would have to vote to continue the program or it would be repealed.

“It is almost as if we have a four-year pilot program paid for by the federal government,” McGee said.

But Blackwell warned that if the Legislature is unable to pass any version of expansion this year, he did not believe it would be possible in upcoming years.

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“If it dies this year, it gets harder next and then it becomes almost impossible after that,” Blackwell predicted.

The two sides also at odds on other issues. For instance, the Senate does not want to expand Medicaid if the federal government will not allow a work requirement.

READ MORE: Top Mississippi business leaders endorse full Medicaid expansion

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 1917

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mississippitoday.org – Jerry Mitchell – 2024-05-05 07:00:00

May 5, 1917

Eugene Jacques Bullard, seen here in uniform in World War I, was the first African-American combat pilot. Credit: Wikipedia

Eugene Jacques Bullard became the first Black American combat pilot. 

After the near lynching of his father and hearing that Great Britain lacked such racism, the 12-year-old Georgia native stowed away on a ship headed for Scotland. From there, he moved to Liverpool, England, where he handled odd before becoming a boxer, traveling across Europe before he settled in Paris. 

“It seems to me that the French democracy influenced the minds of both White and Black Americans there and helped us all to act like brothers as near as possible,” he said. “It convinced me, too, that God really did create all equal, and it was easy to that way.” 

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When World War I began, he was too young to fight for his adopted country, so he and other American expatriates joined the French Foreign Legion. Through a series of battles, he was wounded, and believed he would never walk again. 

No longer able to serve in the infantry, an American friend bet him $2,000 that he could not get into aviation. Taking on the , he earned his “wings” and began fighting for the French Aéronautique Militaire. 

He addressed racism with words on his plane, “All Blood Runs Red,” and he nicknamed himself, “The Black Swallow of Death.” 

On his flights, he reportedly took along a Rhesus monkey named “Jimmy.” He tried to join the U.S. Service, only to be turned away because he was Black. He became one of France's most decorated war heroes, earning the French Legion of Honor. 

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After the war he bought a Paris nightclub, where Josephine Baker and Louis Armstrong performed and eventually helped French ferret out Nazi sympathizers. After World War II ended, he moved to Harlem, but his widespread fame never followed him back to the U.S. 

In 1960, when French President Charles de Gaulle visited, he told officials that he wanted to see his old friend, Bullard. No one in the government knew where Bullard was, and the FBI finally found him in an unexpected place — working as an elevator operator at the Rockefeller Center in New York

After de Gaulle's visit, he appeared on “The Today Show,” which was shot in the same building where he worked. 

Upon his death from cancer in 1961, he was buried with honors in the French War Veterans' section of the Flushing Cemetery in Queens, New York. 

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A sculpture of Bullard can be viewed in the Smithsonian National and Air Museum in Washington, D.C., a statue of him can be found outside the Museum of Aviation, and an exhibit on him can be seen inside the National Museum of the U.S. Air Force, which posthumously gave him the rank of a second lieutenant. He is loosely portrayed in the 2006 film, “Flyboys.”

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

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Mississippi Today

A seat at table for Democrats might have gotten Medicaid expansion across the finish line

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mississippitoday.org – Bobby Harrison – 2024-05-05 06:00:00

The Mississippi Capitol is 171,000 square feet, granted a massive structure, but when it comes to communication between the two legislative chambers that occupy the building, it might as well be as big as the cosmos.

Such was the case in recent days during the intense and often combustible process that eventually led to the death of expansion and with that the loss of the opportunity to provide care for 200,000 working poor with the federal paying the bulk of the cost.

Democrats in the House came under intense pressure and criticism for blocking a Medicaid expansion compromise reached by Republican House and Senate negotiators.

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First of all, it would be disingenuous to argue that Democrats, who compose less than one-third of the membership of either chamber, blocked any proposal. Truth be known, Republicans should be able to pass anything they want without a solitary Democratic vote.

But on this particular issue, the Republican legislative leadership who finally decided that Medicaid expansion would be good for the state needed the votes of the minority party, which incidentally had been working for 10 years to pass Medicaid expansion. The reason their votes were needed is that many Republicans, despite the wishes of their , still oppose Medicaid expansion.

The in the process could be attributed to the decision of the two presiding officers, House Speaker Jason White and Lt. Gov. Delbert Hosemann in the Senate, not to appoint a single Democrat to the all-important conference committee.

Conference committees are formed of three senators and three House members who work out the differences between the two chambers on a bill. Considering that Democratic votes were needed in both chambers to pass Medicaid expansion, and considering Democrats had been working on the issue for a decade while Republicans blocked it, it would have made sense that they had a seat at the table in the final negotiations process.

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One Democrat from each chamber on the conference committee could not have altered the outcome of the negotiations. But the two Democrats could have provided input on what their fellow legislative Democrats would accept and vote for.

In the eyes of the Democrats, the compromise reached without their voice being heard was unworkable and would not have resulted in Medicaid expansion.

The Republican compromise said Medicaid would not be expanded until the federal government provided a waiver mandating those on Medicaid expansion were working. Similar work requirement requests by other states have been denied. Under the compromise, if the work requirement was rejected by federal officials, Medicaid expansion would not occur in Mississippi.

After voicing strong objections to the work requirement, House Minority Leader Rep. Robert Johnson, recognizing the Senate would not budge from the work requirement, offered a compromise. The Johnson compromise to the compromise was to remove a provision mandating the state apply annually with federal officials for the work requirement.

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Instead, under Johnson's proposal, state Medicaid officials would be mandated to apply just once for the work requirement. If it was rejected, Medicaid expansion would not occur, but hopefully that would compel the to take up the issue of the work requirement and perhaps remove it.

“We just want the Legislature to come back and have a conversation next year if the federal government doesn't approve the work requirement. It's as simple as that,” Johnson said.

Senate leaders agreed that Johnson's proposal was a simple ask and something they might consider.

But Lt. Gov. Delbert Hosemann, who presides over the Senate, said he never heard Johnson's proposal until late in the process — too late in the process, as it turned out.

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Speaker Jason White, R-, also said he never heard the proposal, though Johnson said he repeatedly discussed it with House leaders. He certainly was relaying the information to the during the final hectic days before Medicaid expansion died.

And perhaps if Johnson or one of his Democratic colleagues had been on the conference committee, that information would have been heard by the right legislative people and perhaps Medicaid expansion would not have died.

After all, a conference room or an office where negotiators are meeting to hammer out a compromise is much smaller than the massive state Capitol, where communications often get lost in the cosmos.

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 1884

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May 4, 1884

of Ida B. Wells, circa 1893 Credit: Courtesy of National Park Service

Crusading journalist Ida B. Wells, an African-American native of Holly Springs, Mississippi, was riding a train from Memphis to Woodstock, Tennessee, where she worked as a teacher, when a white railroad conductor ordered her to move to another car. She refused.

When the conductor grabbed her by the arm, “I fastened my teeth in the back of his hand,” she wrote.

The conductor got from others, who dragged her off the train.

In response, she sued the railroad, saying the company forced Black Americans to ride in “separate but unequal” coaches. A local judge agreed, awarding her $500 in damages.

But the Tennessee Supreme Court reversed that ruling three years later. The upended her belief in the court system.

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“I have firmly believed all along that the was on our side and would, when we appealed it, give us justice,” she said. “I feel shorn of that belief and utterly discouraged, and just now, if it were possible, would gather my race in my arms and fly away with them.”

Wells knew about caring for others. At age 16, she raised her younger siblings after her and a brother died in a yellow fever epidemic. She became a teacher to her .

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

Did you miss our previous article…
https://www.biloxinewsevents.com/?p=355325

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