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Q&A: Feminist author Caroline Criado-Perez talks about the sometimes-deadly lack of data on the female body

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Note: This Q&A first published in Mississippi Today’s InformHer newsletter. Subscribe to our free women and girls newsletter to read stories like this monthly.

Caroline Criado-Perez, a feminist author and public speaker living in London, talked about her latest book, “Invisible Women,” last week at Lemuria Books in Jackson. 

Her book, published in 2019, explores the gender data gap. From frustrating examples of a freezing office or a shelf out of reach, to deadly examples of an undiagnosed heart attack or crashing a car whose safety features don’t account for women’s measurements, Criado-Perez’s book is full of the real-world consequences of a world built without women in mind.

While the lack of research on the female body is an age-old problem, she argues, it becomes all the more pressing with the emergence of artificial intelligence and the increasing reliance on “Big Data.”

Criado-Perez is working on a new book about the reproductive journey of women, and how little science knows about it. She says she plans to use Mississippi as a case study. She sat down for an interview with Mississippi Today.

Editor’s note: This Q&A has been edited for length and clarity.

Mississippi Today: Tell us about the arc of your career and how you got to the point where you were writing your book “Invisible Women.”

Caroline Criado-Perez: Yeah so that’s a question with a very long answer. Really the story of me writing this book is the story of me becoming a feminist. I didn’t grow up as a feminist. I would say I was sort of anti-feminist – I was really quite misogynistic. And I think that was a very normal thing for young women in the ‘90s. I didn’t really identify with women and I just thought, you know, we’re all equal now and everyone should just stop complaining.

And it wasn’t until I went to university – I went as a mature student, I was 25 I think – and it was the first time I had to read any feminist analysis. And I had to read this book called Feminism and Linguistic Theory, which introduced me to the idea of the “generic masculine,” so, using “he” gender-neutrally or “man” gender-neutrally. The author of this book pointed to research that showed that when people hear these words or read these words, they think of men. And that completely blew my mind because it made me realize that I was picturing a man and I was incredibly shocked that I never noticed that, as a woman, that I’m just picturing men all the time.

That really kick-started the whole process for me because having had that realization, I started noticing it in other areas, where we act like we’re speaking gender-neutrally and we’re actually talking about men. So, after my first degree I went and studied feminist and behavioral economics and that is where I sort of discovered the whole economy is built around this mythical man – even though we speak about it being objective like a science. And there were various other bits and pieces I was doing that made me notice it in other areas and then finally I came across it in health, and that was when I was writing my first book. And that was when I started reading some research, the very early stages of my understanding of how much health and our knowledge of the human body is actually knowledge of the male body. That we’re not as good at diagnosing heart attacks in women as in men, and women are 50% more likely to be misdiagnosed if they have a heart attack. And more than anything I just couldn’t believe that this wasn’t on the front page of every newspaper, why did people not know this, why was everyone not talking about this – women are more likely to die if you have a heart attack: what?! And this is because we haven’t researched female bodies?

So that is how it ended up being a book. Essentially because I had all these things going around in my head and I felt like I was going crazy, that everyone was just blithely acting like we were speaking gender-neutrally when I knew we were talking about men. And just the fact that it was a huge, systematic issue, I knew that it wasn’t going to be an article – it had to be a book. Because it was just in everything.

MT: I’m interested in this term you use near the beginning of your book, “absent presence.” What is the experience of being defined by an absence, a negative space, a silence?

CP: I mean, I suppose for someone who recognizes the negative space, it’s intensely frustrating to know that there are all these gaps and all these silences that, as a society, we just skip over and we don’t notice that they’re there.

This is why I start the book with the Simone de Beauvoir quotation about representation being the work of men, and how they describe the world from their own point of view – which they confuse with the absolute truth. I f—–g love that quote so much. Because I feel like it sums up my book in a quotation because it’s not about these men having deliberately described the world and excluded women from it. They think that’s really what it is like. They think they’re really talking about the real world and they don’t see these absent presences, this silent figure of the woman.

But as a woman, you’re constantly knocking up against it, against the ways in which the world has not been designed for you. And having done the research I’ve done, I now experience the world in quite a different way than I did before, and it’s not a more comfortable way – it’s a much more uncomfortable way, because I’m constantly frustrated.

And of course, when it comes to health care it’s something that one thinks about a lot – you know, has this drug been tested in my body, is this the correct dosage for me, do they know how this drug interacts, and what if I’m on contraception, have they actually done any research? And nine times out of 10, no, they haven’t. Or they don’t know how the menstrual cycle might interact with it.

So it’s intensely frustrating and sometimes frightening, I think, to then just experience the world in which, for the most part, we are still speaking gender-neutrally when we’re talking about men.

MT: You talk about how this is an age-old problem – we live in a world made by men with men in mind. Can you tell us why, in a world that increasingly relies on “Big Data,” it matters so much more? How it becomes deadly, even?

CP: Yeah, so I mean, the gap in data for women is already deadly, if you’re thinking anywhere from car design to health care, but the real danger is becoming exponential, because of the introduction of AI into every single part of our world. And the problem with developing AI using bad data, biased data, is that machine learning is not like a human, in that it doesn’t simply reflect our biases back at us – it amplifies them.

I’ve read so many papers since “Invisible Women” came out where researchers will be like, “we’ve developed this AI and it performs better than a radiologist at detecting lung cancer” or “can predict heart attacks five years before they happen,” and then when you look at the paper, not only are the datasets incredibly male-biased, so you’ve got that bias already baked in, but also, they’re not even thinking about sex.

One paper I’m thinking about that came out shortly after “Invisible Women” was published was about predicting heart attacks. And there are sex-specific risk factors. So, if you’re going to be predicting heart attacks in men versus women, you don’t want to have, as this paper did, something like a 70% male dataset, but you even more don’t want to have that data all mixed up together. Because that’s not going to work for men or women. And yet, there was absolutely no mention of sex in the paper. So, that is frightening. Because the problem with that is it could make the situation worse.

When I find AI exciting is when researchers are using AI to address problems that we aren’t addressing otherwise. So, for example, one woman I spoke to was developing AI to detect victims of domestic violence via injury patterns, potentially years in advance of them ultimately having to be taken to a shelter or something. Because of course victims don’t necessarily report, and it’s not something that we’re investing a lot of money in in health care – because there’s not a lot of money in it and doctors don’t necessarily have the time to do the sort of questioning of a victim, et cetera. So there is exciting potential for AI. But if we’re just using it to do what we’re already doing but faster, that’s where the massive pitfalls are.

MT: As a health reporter, I’m interested in the subject of endocrine-disrupting chemicals you bring up in your book. We know that these chemicals are in everything, but they’re especially pervasive in feminine products, such as toiletries and makeup – and even menstrual products that women put inside their bodies. And as you know, not only are they more common in female products – they’re also worse for women, because of how they mimic and disrupt women’s hormones. How do we begin to address the issue? How can data help?

CP: The first thing that needs to change is obviously labeling – that’s a huge one, that people have the right to know what is actually in these products. That is one of the things that makes me most frustrated. I mean, as you can imagine, since writing the book I am scanning product ingredients all the time. If there’s anything that says “fragrance” I’m like “nope, that’s out, not using that.” And it’s amazing how many products just have these random ingredients in them and they don’t have to disclose what they are. Nobody knows. Nobody knows that “fragrance” means they could put anything in there. That’s deeply frustrating.

But my answer is always going to come back to: we have to collect data on this. And that is the thing that we’re not doing. And that is just incredible to me. The problem we have is not only are there endocrine-disrupting chemicals in these products, but also, how are these affecting not only the women who use them but also the women who work with them and the women who produce them.

And, as I say in my work, it’s not just that we haven’t tested them on women – for example, absorption into female skin, which can be different, or the way that it might accumulate in a female body, because of differences in fat in the body – but also the way in which women encounter them. Because it tends not to be in discrete “now I’m going to be exposed to this chemical, and tomorrow to that chemical.” We’re exposed to a cocktail of chemicals, and that’s not how they’re tested. So the way they’re tested is in itself biased against the way women are exposed to them, as well as the fact that we aren’t even testing them on women anyways.

And I feel that this really ties into this attitude that somehow the female workplace is this cozy, safe place, that women are never exposed to any form of danger. Because historically, the sort of headline-grabbing dangerous jobs have been done by men. By the way, because they were high-paying and women were barred from doing them, but let’s not let that get that in the way of the story that “women are lazy and they don’t want to do scary, difficult jobs.” But the female-dominated jobs that are low-paid, we simply have not been measuring how dangerous they are – from the perspective of exposure to chemicals.

MT: So, it seems like the call to action of this book is to begin filling in some of these gaps in data. But if we think of the modern world as being made up of data, then the idea of collecting all this new data can feel almost like building a new world – and that might be intimidating to some. What would you say to people who feel overwhelmed by this imperative?

CP: Well, there’s no getting around the fact that it is a huge job, and it is intimidating. And if you tried to do it all, you would be overwhelmed. But nobody could possibly fix this on their own. It’s like saying “you – go fix patriarchy.” It’s not how it works. Everybody has their own area that they can address. And so, people who work in research can collect sex disaggregated data. That’s a really great thing that people who work in research can do. People who work in HR, there’s a lot that they can do when it comes to looking at how their companies consider diversity, for example, in decision making.

People who have children, there’s so much that they can do to address how the future generation even notices that the “default male” operates. Like, if you look at kids’ TV, kids’ books, it’s “default male” all over the place – all the characters are male and if there’s a female character, her characteristic is that she’s female. I’m not saying that you’re going to be able to protect kids from that, but have a conversation with them. And I wish that had happened to me when I was little, that someone had taken the time to point out “isn’t it weird that in the real world, there’s all these women, and in your stories, it’s all boys?” I think that that’s a really powerful thing and I actually think that that’s something that everyone can do is have these conversations and notice when the “default male” is in operation – because I think that that really is half the battle.

If you think about the car crash stuff, that we have historically used an average male car crash test dummy, as if that’s representative of humans overall – when you say it like that, it obviously sounds ridiculous. But we’re so used to using the male body as the human body that people don’t even notice that it’s happening. As soon as you tell people “by the way, cars have not been tested to be safe for an average female body,” they understandably get really freaked out and start demanding change from car manufacturers – which is something very cool that’s happening in America at the moment. So, a really big part of it is just spreading the word and making the changes you can make.

MT: So, we’re talking about the gap in data around the female body and how that plays out in the health care system. One of the things I’ve noticed is that when people bring up this gap and try to address it – and particularly when talking about the menstrual cycle and how it interacts with medicine or what have you – that people tend to think of it as “woo-woo” or “mystical.” I think the fact that talking about something as fundamental as the menstrual cycle is met with such disbelief sheds light on just how uncommon it is to talk about the female body. Has that been your experience? Why is that?

CP: Right. That’s just sexism. It’s like, “oh, that has to do with ladies.” So, you’re reminding me of this report that came out, and again it was after “Invisible Women” was published, and it was about women and asthma. And there were all these testimonials from women who said “I went to the doctor and told them I feel like I get asthma flare-ups in relation to my menstrual cycle, I can tell where in my menstrual cycle I am, based on my flare-ups.” And the doctors were like “that’s just nonsense, you’re making it up” – because women can’t possibly know what’s going on with our bodies. Anyways, it transpires that actually, yes it is. It is hormonally-linked.

So that is something that, hashtag-not-all-doctors, but that they will say because there is this idea that lingers on somehow, in these people who are trained in science, that women are somehow just hysterical and should be less believed than men. But, I mean, that’s just misogyny.

MT: So you’re writing a new book. Tell us about how it relates to health care and how you’re using Mississippi as a case study.

CP: Yeah, so the book is about a woman’s reproductive journey from the beginning of whether or not she’s going to have children and going through things like pregnancy and how little we know about, firstly, how to treat a pregnant woman for anything, because we don’t do any research on women, let alone pregnant women. And then, how little we know about reproduction, so things like miscarriage and the disorders of pregnancy we know very little about, and of course that ties into abortion.

So that’s the area I’m wanting to focus on while I’m in Mississippi – for the obvious reason of Dobbs, and also my husband is from Mississippi, and also I had a miscarriage in January last year when we were last here, which was briefly scary, particularly as a British person, being here and thinking “if this goes wrong, am I going to be able to get the care I need?”

So I’m just really interested in understanding what it is actually like for a woman whose pregnancy goes wrong in Mississippi right now. Because I know there are these exceptions, but also, they’re never used. So, the focus for that chapter is I want to look at what happens to women who need an abortion and legally, supposedly, can get one, but actually, can’t get one. And then the rest of the book is looking at fertility and infertility through to the menopause.

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

Crooked Letter Sports Podcast

Podcast: The Mississippi Sports Hall of Fame Class of ’25

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mississippitoday.org – @rick_cleveland – 2025-07-09 10:28:00

The MSHOF will induct eight new members on Aug 2. Rick Cleveland has covered them all and he and son Tyler talk about what makes them all special.

Stream all episodes here.


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

The post Podcast: The Mississippi Sports Hall of Fame Class of '25 appeared first on mississippitoday.org

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Mississippi Today

‘You’re not going to be able to do that anymore’: Jackson police chief visits food kitchen to discuss new public sleeping, panhandling laws

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mississippitoday.org – @MSTODAYnews – 2025-07-04 13:00:00


Jackson Police Chief Joseph Wade visited Stewpot Community Services to discuss new Mississippi laws addressing homelessness, which ban public sleeping, panhandling without permits, and camping on public property. The laws include the “Safe Solicitation Act,” requiring permits for panhandling with misdemeanor penalties, and the “Real Property Owners Protection Act,” expediting squatter removal. Wade emphasized respecting constitutional rights while enforcing the laws and noted challenges like managing belongings of those removed and jail capacity concerns. Community leaders support the laws for safety but oppose criminalizing homelessness. Locals highlighted the need for more employment opportunities to address homelessness root causes.

Diners turned watchful eyes to the stage as Jackson Police Chief Joseph Wade took to the podium. He visited Stewpot Community Services during its daily free lunch hour Thursday to discuss new state laws, which took effect two days earlier, targeting Mississippians experiencing homelessness.

“I understand that you are going through some hard times right now. That’s why I’m here,” Wade said to the crowd. “I felt it was important to come out here and speak with you directly.”

Wade laid out the three bills that passed earlier this year: House Bill 1197, the “Safe Solicitation Act,” HB 1200, the “Real Property Owners Protection Act” and HB 1203, a bill that prohibits camping on public property. 

“Sleeping and laying in public places, you’re not going to be able to do that anymore,” he said. “There’s a law that has been passed that you can’t just set up encampments on public or private properties where it’s a public nuisance, it’s a problem.”

The “Real Property Owners Protection Act,” authored by Rep. Brent Powell, R-Brandon, is a bill that expedites the process of removing squatters. The “Safe Solicitation Act,” authored by Rep. Shanda Yates, I-Jackson, requires a permit for panhandling and allows people to be charged with a misdemeanor if they violate this law. The offense is punishable by a fine not to exceed $300 and an offender could face up to six months in jail. Wade said he’s currently working with his legal department to determine the best strategy for creating and issuing permits. 

“We’re going to navigate these legal challenges, get some interpretations, not only from our legal department, but the Attorney General’s office to ensure that we are doing it legally and lawfully, because I understand that these are citizens,” he said. “I understand that they deserve to be treated with respect, and I understand that we are going to do this without violating their constitutional rights.” 

Homeless encampment located in the 1700 block of S. Gallatin Street in Jackson, Wednesday, June 2, 2025.

Wade said the Jackson Police Department is steadily fielding reports of squatters in abandoned properties and the law change gives officers new power to remove them more quickly. The added challenge? Figuring out what to do with a person’s belongings. 

“These people are carrying around what they own, but we are not a repository for all of their stuff,” he said. “So, when we make that arrest, we’ve got to have a strategic plan as to what we do with their stuff.” 

Wade said there needs to be a deeper conversation around the issues that lead someone to becoming homeless. 

“A lot of people that we’re running across that are homeless are also suffering from medical conditions, mental health issues, and they’re also suffering from drug addiction and substance abuse. We’ve got to have a strategic approach, but we also can’t log jam our jail down in Raymond,” Wade said. 

He estimates that more than 800 people are currently incarcerated at the Raymond Detention Center, and any increase could strain the system as the laws continue to be enforced.

“I think there’s layers that we have to work through, there’s hurdles that we are going to overcome, but we’ve got to make sure that we do it and make sure that my team and JPD is consistent in how we enforce these laws,” Wade said.

Diners applauded Wade after he spoke, in between bites of fried chicken, salad, corn and 4th of July-themed packaged cakes. Wade offered to answer questions, but no one asked any.

Rev. Jill Buckley, executive director of Stewpot, said that the legislation is a good tool to address issues around homelessness and community needs. She doesn’t want to see people who are homeless be criminalized, but she also wants communities to be safe.

“I support people’s right to self determine, and we can’t impose our choices on other people, but there are some cases in which that impinges on community safety, and so to the extent that anyone who is camping or panhandling or squatting and is a danger to themselves and others, of course, I fully support that kind of law. I don’t support homelessness being criminalized as such,” Buckley said. 

One of the homeless in Jackson panhandles at the intersection of U.S. 80 and Gallatin Street, Wednesday, June 2, 2025.

Many of the people Wade addressed while they ate Thursday said they have housing, don’t panhandle, and shouldn’t be directly impacted by the legislation. But Marcus Willis, 42, said it would make more sense if elected officials wanted to combat the negative impacts of homelessness that they help more people secure employment.

“There ain’t enough jobs,” said Willis, who was having lunch with his girlfriend Amber Ivy.

The two live in an apartment together nearby on Capitol Street, where Ivy landed after her mother, whom Ivy had been living with, suffered a stroke and lost the property. Similarly, Willis started coming to eat at Stewpot after his grandmother, whose house he used to visit for lunch, passed away.

Willis holds odd jobs – cutting grass, home and auto repair – so the income is inconsistent, and every opportunity for stable employment he said he’s found is outside of Jackson in the suburbs. The couple doesn’t have a car.

Making rent every month usually depends on their ability to find someone to help chip in, said Ivy, who is in recovery from substance abuse. She said she’s watched problems surrounding homelessness grow over the years in Jackson. Ivy grew up near Stewpot and has lived in various neighborhoods across the city – except for the times she moved out of state when things got too rough.

“There was just moments where I just had to leave,” Ivy said. “Sometimes if you hit a slump here, there’s almost no way for you to get out of it.”

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

The post 'You're not going to be able to do that anymore': Jackson police chief visits food kitchen to discuss new public sleeping, panhandling laws 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

This article primarily reports on new laws in Jackson, Mississippi, targeting public sleeping, panhandling, and squatting, focusing on statements by Police Chief Joseph Wade and community perspectives. The coverage presents the legislative measures—authored by Republican and independent lawmakers—with a tone that emphasizes law enforcement challenges and community safety, reflecting a conservative approach to homelessness as a public order issue. While it includes voices concerned about criminalization and the need for social support, the overall framing centers on law enforcement and property protection. The article maintains factual reporting without overt editorializing but leans slightly toward a center-right perspective by highlighting legal enforcement as a solution.

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Medicaid cuts could be devastating for the Delta and the rest of rural America

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mississippitoday.org – @GanucheauAdam – 2025-07-03 16:41:00


East Carroll Parish, Louisiana, and neighboring Delta regions face devastating impacts from recent federal Medicaid cuts included in President Trump’s tax and spending bill. Medicaid expansion in Louisiana dramatically lowered uninsured rates, offering a vital lifeline in areas with extreme poverty and scarce jobs. The bill’s cuts and new work-reporting requirements threaten to push millions off coverage, disproportionately harming rural communities struggling with limited transportation, jobs, and internet access. Mississippi, which never expanded Medicaid, could lose billions in funding, risking rural hospital closures. Locals fear losing essential healthcare, worsening poverty and health disparities entrenched by historical neglect and systemic barriers.

Note: This story first published in Stateline, which is part of States Newsroom, the nation’s largest state-focused nonprofit news organization.

LAKE PROVIDENCE, La. — East Carroll Parish sits in the northeastern corner of Louisiana, along the winding Mississippi River. Its seat, Lake Providence, was a thriving agricultural center of the Delta. Now, the town is a shell of its former self. Charred and dilapidated buildings dot the small city center. There are a few gas stations, a handful of restaurants — and little to no industry.

Mayor Bobby Amacker, 79, says at one point “you couldn’t even walk down the street” in Lake Providence’s main business district because “there were so many people.”

“It’s gone down tremendously in the last 50 years,” said Amacker, a Democrat. “The town, it looks like it’s drying up. And it’s almost unstoppable, as far as I can tell.”

Now, East Carroll residents stand to lose even more. Like many people in Louisiana, they received a lifeline when the state expanded Medicaid to more low-income adults in 2016. Expansion drove Louisiana’s uninsured rate to the lowest in the Deep South, at 8% in 2023 for working-age adults, according to state data, despite it having the highest poverty rate in the U.S. that year.

This week, both chambers of Congress approved President Donald Trump’s “big, beautiful” tax and spending bill. It includes more than $1 trillion in cuts to Medicaid, the joint state-federal health insurance program for poor families and individuals, to help pay for tax cuts that mostly benefit the rich. The legislation would cause 11.8 million more Americans to become uninsured by 2034, according to the Congressional Budget Office.

The bill includes new work rules for Medicaid recipients and would require them to verify their eligibility more frequently. It also would limit a financing strategy that states have used to boost Medicaid payments to hospitals.

Republicans say enrollees are taking advantage of the Medicaid program and getting benefits when they shouldn’t be. They say the program costs too much and states are not paying their fair share.

The Delta region, which includes communities in both Louisiana and Mississippi, would suffer under such large cuts. But in Louisiana — where almost half of the state depended on Medicaid in 2023, the Louisiana Department of Health reported — the cuts could be ruinous. Louisiana could lose up to $35 billion in federal Medicaid support over the next decade, according to KFF, a health policy research group. Mississippi, which never expanded Medicaid, could still lose up to $5 billion.

Residents are watching with apprehension, fear and, sometimes, anger, wondering how Congress could be so blind to how much they are struggling.

“If they take that away from us and everyone that really needs it, that’s going to be bad,” said Sherila Ervin, who lives 20 minutes up the road from Lake Providence in Oak Grove and has Medicaid coverage.

Medicaid work requirements and other health care provisions in the bill ignore the reality of living in poorer rural communities, where people struggle to find the jobs, transportation and internet access required to meet the rules, according to interviews with people and providers in the Delta region.

Even though Louisiana and Mississippi have taken very different approaches to Medicaid — one expanded eligibility under the 2010 Affordable Care Act and the other didn’t — both rely heavily on the program to sustain access to medical care for all their residents.

On a hot summer day in June, Ervin walks into the bare-bones 99-cent store in downtown Lake Providence. As she looks over some clothing, she says she’s heard about the potential Medicaid cuts. But she hadn’t heard about the work requirements, and is shocked they’re even on the table.

“I don’t like that. I don’t think they should put a stipulation on that,” Ervin says, exasperated that she would have to report her work hours. It’s hard enough as it is, she says, to thrive in this community.

READ MORE: In the Deep South, health care fights echo civil rights battles

Ervin, 58, has been working at Oak Grove High School in the cafeteria, serving hot plates to children for two decades. She says it’s one of the good, steady jobs available in this area, but her income is only around $1,500 per month.

Ervin’s job offers health benefits, but she can’t afford the premiums on her salary. She relies on Medicaid for care, including medications for her high blood pressure.

In East Carroll Parish, around 46.5% of people live below the poverty level, meaning the area is overwhelmingly poor, at over four times the national poverty rate, with a median income of $28,321. For Black households, the figure is a mere $16,690.

Expansion was a lifeline for people such as Ervin. Louisiana offers Medicaid to people who earn below 138% of the federal poverty line — currently about $22,000 a year for an individual.

“Sometimes you can work, but then when you work, you still can’t pay to get help,” Ervin said.

It’s a similar economic situation an hour away across the river. Poverty is about three times the national rate in Washington County, Mississippi, where residents in the city of Greenville lament the consequences of not being able to avoid destructive medical debt, which can keep them stuck in a cycle of gig work and of living paycheck to paycheck.

Greenville, the county seat, is among the fastest-shrinking cities in the U.S. It’s still one of the larger rural cities in Mississippi, with coffee shops, restaurants, hotels, a regional hospital and several big-box stores. But the downtown has just a few small businesses and a bank, and residents say jobs are hard to find.

Greenville resident April McNair, 45, remembers giving birth 17 years ago, long before Mississippi extended postpartum Medicaid to a full year. She had Medicaid coverage during pregnancy, but was kicked off shortly after giving birth, despite having post-delivery complications.

April McNair, 45, is a resident of Greenville, Miss. (Photo by Shalina Chatlani/Stateline)

The result was a trip to the emergency room and a $2,500 bill she couldn’t cover. Right after giving birth, McNair looked for work. She said potential employers often told her that she was overqualified because she had a master’s degree.

“I had to kind of figure out how to make my ends meet,” McNair said. “I ended up with a significant bill, all because I did not have Medicaid.”

McNair feels like Mississippi leaders are making a mistake by continuing to reject full Medicaid expansion.

“That’s a selfish move. To me, they’re selfish,” McNair said, adding that now she’s worried for neighbors in Louisiana who may lose the lifeline she wishes she had.

“God forbid, hypothetically speaking, what if one of them meets their demise because of this bill that [Congress] passed?”

Hard to thrive

Mississippi experienced its first taste of equalized access to medicine in the late 1960s.

Delta Health Center, the first federally funded health center in the nation, opened during the peak of the Civil Rights Movement in the all-Black town of Mound Bayou, about an hour north of Greenville. The center vowed to care for anyone regardless of race or ability to pay in a region plagued with poverty, poor health and discrimination — and continues to do so to this day.

It was a significant opportunity for generations of African Americans who had gone without health care, in a place where people had no access to clean drinking water, running sewage systems or even food, said Robin Boyles, chief program planning and development officer at Delta Health Center.

But it wasn’t easy for the clinic to mobilize support, even though it was clearly needed. Before its opening, it faced pushback from politicians and even doctors. In a 1966 clipping from a local newspaper, the white-owned Bolivar Commercial, the editorial board railed against the new clinic, saying it would “lead further to socialized medicine.”

The situation is certainly better in Mississippi and Louisiana than it was in the 1960s, but critics say the Medicaid cuts could reverse hard-fought progress.

People who live in the Delta are fiercely proud of their communities, but conditions there make it hard to thrive.

Black residents, who are the overwhelming majority, have had a particularly hard time. After the Civil War, many were relegated to sharecropping of cotton and corn for subsistence. Meanwhile, an elite white class of plantation owners and investors amassed enormous amounts of wealth.

A 2001 report from the U.S. Commission on Civil Rights described the area as one with “limited economic resources; inadequate employment opportunities; insufficient decent, affordable housing; and poor quality public schools.”

“We have a lot of patients that are one health issue away from either being out of a job or being bankrupt because of a trip to the emergency room,” said Dr. Brent Smith, a physician at a primary care clinic at Delta Health System in Greenville.

Even some of the most vulnerable people, such as new moms in Mississippi, still struggle to get basic care, in part because the state has left billions of dollars in federal funding for Medicaid expansion on the table, said Dr. Lakeisha Richardson, an OB-GYN at Delta Health System.

“There are a lot of maternal [care] deserts in Mississippi where women have to travel 60 miles or more just to get prenatal care and just to get to the closest hospital for delivery,” Richardson said. “And I don’t see that getting any better in Mississippi and in rural areas.”

Richardson says nearly all her patients are working moms, many of whom would really benefit from having Medicaid expansion.

“America doesn’t realize that there are people out here struggling for no reason of their own,” she said.

That’s why Medicaid expansion in Louisiana in 2016, much like the community health center movement in Mississippi, was a bright spot in the rural South, said Smith.

“Louisiana expanded Medicaid, a surprising move in the South to see any state expand,” Smith said. “They saw it for what it was, which was a very real opportunity to assist this specific group of patients.”

Dr. Brent Smith, left, a physician at a primary care clinic at Delta Health System in Greenville, laughs with a co-worker. (Photo by Shalina Chatlani/Stateline)

In Mississippi, 20 rural hospitals are at immediate risk of closure, according to a recent report, more than double the number at risk in Louisiana. In many cases, Medicaid is the largest and most reliable payer for rural hospitals. While Louisiana’s overall uninsured rate plummeted to 8.3% by 2023, in Mississippi it was 10.5%.

“Unlike a lot of our Southern peers, we have not had the same level of closures of facilities,” said Courtney Foster, senior policy adviser for Medicaid, with the nonprofit Invest in Louisiana.

“Medicaid was like a real lifeline for people in transition. Oftentimes it was people who had lost their jobs and were just looking to get back on their feet.”

Now, the new work and reporting requirements could put that progress at risk.

In East Carroll Parish, finding a job — let alone a good-paying one with health benefits — is difficult, says Rosie Brown, executive director at the East Carroll Community Action Agency, a nonprofit that helps low-income people with their rent and utility bills. Many of the jobs available in town pay minimum wage, just $7.25 an hour.

Brown loves living in Lake Providence; this is where her family is. She doesn’t want to move but wishes the government would invest more in her community — not take away benefits that help people who are hanging on by a thread.

“We have one bank. We have one supermarket,” she said. “Transportation isn’t easy either.”

Local infrastructure is so limited, she’s even heard of some people charging residents $20 for a ride to Walmart. Some people have to hitch a ride an hour away to go to work, she said.

“There’s nowhere to go,” Brown said.

Dominique Jones works at the local library, where she helps roughly 75 to 85 people per month apply for programs such as Medicaid and food assistance. Many of the residents she helps don’t have access to the internet or even a computer, a real barrier for people who’d be required to report their working hours to state Medicaid officials.

“This town right here is made up of a lot of old people that need Medicaid and Medicare. And without it, they wouldn’t have any kind of health care at all,” Mayor Amacker said.

Even a job in local government in Lake Providence doesn’t offer affordable health insurance.

Nevada Qualls, 25, sits across from Amacker’s office. She earns just $12 an hour as a cashier at city hall. The low pay means she qualifies for Medicaid expansion coverage, which is good because she can’t afford the premiums for private insurance.

“I feel like there should be a higher threshold for people that can get Medicaid, because they’re still struggling,” she said.

At the 99-cent store, school district worker Ervin wonders whether state and federal leaders understand what it’s like to live in her community, urging them to visit and see for themselves.

“They want to do stuff for the rich people that’s already rich,” she said. “What are they doing? It’s almost like there’s no common sense with them.”

‘The tremble factors’

While leaders in the U.S. Senate were working into the night this past weekend debating Trump’s tax and spending bill, Greenville resident Jennifer Morris was praying for the pain to stay away.

Morris, 44, has hemicrania continua, a headache disorder that causes constant pain on one side of her head. There’s no underlying trigger and no cure. Her doctors help her keep the pain to a minimum with regular treatments that include dozens of injections into her head.

“It doesn’t take the pain away,” she said during a late-night gathering in Greenville’s Greater Mount Olivet Missionary Baptist Church in June. “It does reduce the pain so that I’m able to function. But it’s rough.”

Morris is worried about the looming Medicaid cuts. She qualifies for Mississippi Medicaid because her condition counts as a disability, and she depends on the coverage to afford her medications.

Morris’ Medicaid may be safer than that of her Delta neighbors in Lake Providence, as some of the most dramatic Medicaid changes being considered — such as work requirements — target Medicaid expansion states only.

But Mississippi could be hurt by a provision in the Senate bill that would target a strategy states have used to boost the Medicaid dollars they get from the federal government.

Mississippi could see a major hit to its Medicaid funds, which “would be a tremendous decrease in revenue for the state,” harming “services and access to care,” says Mitchell Adcock, executive director at the Center for Mississippi Health Policy.

“It would be just the opposite of expansion. It would be a contraction for the Medicaid program in the state,” he said.

Leonard Favorite, a pastor who was attending the same event at Mount Olivet Church, as Morris, says he grew up on a plantation in Louisiana and worked his way out of poverty by joining the Air Force. This type of journey is hard, he said, when you’re already starting from so far behind. He thinks the “big, beautiful bill” will create more roadblocks for poor people.

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“You have people who are already living below the poverty line and they will certainly be submerged into poverty at unspeakable levels,” said Favorite, 70.“ That seems to be the trend of this administration from the point of view of looking from the outside.

“Poor people are beginning to feel the tremble factors of an administration that caters toward the rich.”

National researchers estimate that up to 132,000 Louisianans who gained health insurance under expansion could lose it under work rules.

But national reports that rely on census data likely underestimate the potential Medicaid losses. For example, while 2023 census data show 47% of East Carroll Parish was on Medicaid, state health data reviewed by Stateline and Public Health Watch suggests the number is more like 64%. Similarly statewide, census data showed about a third of Louisianans were on Medicaid. State data shows that percentage is closer to 46.5%.

Experts such as Joan Alker at the Georgetown Center for Children and Families say the undercounts nationally are a well-known issue among researchers, but it’s difficult to correct because the quality of state reporting can be so uneven.

State Medicaid funding is also at risk. For years, both Mississippi and Louisiana have relied on revenue generated through a financing tool — known as a provider tax — to draw down more federal dollars and boost Medicaid reimbursements to providers. But congressional Republicans hope to limit states’ ability to collect those taxes.

Depending on how Congress restricts provider taxes, Mississippi could lose hundreds of millions in federal Medicaid funding, crucial in a state with such a high uninsured rate, said Richard Roberson, president and CEO of the Mississippi Hospital Association.

“It’s unavoidable that when you’re taking that much money out of the system, that there’s not going to be some repercussions felt even in non-Medicaid expansion states like Mississippi,” Roberson said.

Last week, the Louisiana Hospital Association signed a statement calling the package of Medicaid cuts before Congress “historic in their devastation.”

From her small, sunny office in East Carroll Parish, nurse Jennifer Newton can’t understand the attacks on Medicaid.

Newton, who grew up one parish over in West Carroll, is executive director of the Family Medical Clinic, a community health center in Lake Providence and one of the few health providers in town. She says 50% of the clinic’s patients have Medicaid insurance.

Newton has worked in health care in the area for decades and watched as Medicaid expansion made it possible for more patients to access and afford health care they desperately needed, including preventive services. “It’s absolutely helped,” she said. “Absolutely.”

In 2015, the year before Louisiana expanded Medicaid, the uninsured rate among working-age adults in East Carroll Parish was nearly 35%. By 2021, that number was 12.7%.

“Why are we going back?” Newton asked. “We’ve made so much progress.”

Republican supporters of work requirements, including Louisiana representative and U.S. House Speaker Mike Johnson, argue they will encourage people to find jobs and ensure Medicaid goes to people who need it most. But according to KFF, a majority of Louisiana adults with Medicaid — 69% — already work.

Brian Blase, president of the Paragon Health Institute, a conservative policy group that is working with Republicans to formulate Medicaid cuts, is not concerned about eligible people losing coverage, as has happened under previous work requirement efforts. He says the bill has built in exceptions for certain people and requirements “can be met by not just work,” so “concerns seem pretty overstated.”

Medicaid recipients also can meet the requirement by volunteering or attending school for 80 hours per month.

“It’s hard for me to understand that there are areas in the country where there’s not jobs. There’s always work to be done,” Blase told Stateline. Blase said he believes Medicaid is “the government conditioning welfare for able-bodied working-age adults.”

But advocates and experts predict East Carroll, where internet access is notoriously bad, would experience results similar to when Arkansas instituted Medicaid work requirements in 2018: People disenrolled because of lack of awareness and confusion over the policy, as well as paperwork errors — not because they weren’t working enough.

“Unless the beneficiary can navigate that red tape, they’re going to lose coverage and become uninsured,” said Benjamin Sommers, a health economist at Harvard T.H. Chan School of Public Health.

Data shows Arkansas’ experiment did not increase employment, Sommers said, and instead led to more people reporting medical debt and delaying care because of cost.

‘Take a step back’

People in the Delta — where the legacy of government neglect and discrimination are all around — want politicians to visit their towns and see the barriers people face trying to improve their lives and stay healthy.

“People spent their lives uninsured,” said Amy Hale, a nurse practitioner at East Carroll Medical clinic. “Medicaid expansion allowed them to get in here and be treated.”

Lake Providence residents are scared they may find themselves in a similar situation as McNair and other people across the river in Greenville: working, uninsured, and too poor to access health care.

Recent estimates show up to 317,000 Louisianans could lose Medicaid health insurance under Trump’s tax bill. Nearly 33,000 in Mississippi.

“People are actually trying,” McNair said. “I really wish [lawmakers] would look at it from a different lens. What if it was their kid? Or they didn’t have the salaries they have now and your baby is ill. … Like really take a step back and think about what it is that you’re doing.”

This story is part of “Uninsured in America,” a project led by Public Health Watch that focuses on life in America’s health coverage gap and the 10 states that haven’t expanded Medicaid under the Affordable Care Act.

Stateline reporter Shalina Chatlani can be reached at schatlani@stateline.org. Public Health Watch reporter Kim Krisberg can be reached at kkrisberg@publichealthwatch.org.

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

The post Medicaid cuts could be devastating for the Delta and the rest of rural America 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

The article presents a clear perspective sympathetic to low-income and rural communities affected by Medicaid cuts. It highlights the hardships faced by residents in Louisiana’s and Mississippi’s Delta regions, emphasizing poverty, limited job opportunities, and the critical role Medicaid plays in health access. While it reports Republicans’ arguments for work requirements and cost control, the language and framing focus more on the negative consequences of cuts and the struggles of vulnerable populations. This tone and focus suggest a center-left bias, favoring expanded social safety nets and critical of policies perceived to harm the poor.

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