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Reddit AMA recap: Medicaid expansion in Mississippi with Senior Political Reporter Geoff Pender

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Reddit AMA recap: Medicaid expansion in Mississippi with Senior Political Reporter Geoff Pender

Mississippi's growing health crisis threatens to close at least a dozen hospitals across the and puts Mississippi in the lead nationally for rates of uninsured people.

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READ MORE: ‘What's your plan, watch Rome burn?': Politicians continue to reject solution to growing hospital crisis

Studies have shown and advocates have long touted the benefits of Medicaid expansion, but state leaders remain steadfast in their opposition. As such, Mississippi remains one of only 11 states in the country not to expand the federal-state program.

Mississippi Today launched an ongoing series looking at the impact of the health care crisis on the people and institutions of the state.

As part of that , Senior Political Reporter Geoff Pender answered readers' questions on Reddit about Medicaid expansion (or the lack thereof) in the state. Here's a recap:

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Click to jump to a specific question

Q: Thank you for doing this and continuing to push on this topic.

As I sit here seeing the Greenwood hospital closing while the governor touts tax breaks for companies and the state refuses this aid… I just do not get it.

Unless I think of all of the non-rational reasons for it.

A: Unfortunately, we are hearing from many corners that Greenwood may be the canary in the coal mine right now. We have heard some dire predictions of late from state hospital and other . State Health Officer Dr. Edney recently warned that we're looking at at least half a dozen hospitals on the brink, and others are saying our entire system is troubled. I don't know that Medicaid expansion would be the panacea for all that, but most experts are saying the influx of billions of federal dollars for health care would stave off many of these problems.

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Q: As the Q&A article describes, there are political and economic arguments against expansion, but what in your opinion are the underlying motives for the stance? Are the politicians perhaps more driven by financial incentive from opposition groups in addition to maintaining their political platforms for the sake of the party? And as for general people, do you think it's related to a mentality of being against handouts and of “pulling yourself up by your bootstraps”? What do you think are the underlying feelings and motivations to these stances?

And lastly, how do you think these underlying reasons can be negotiated with to make progress towards achieving expansion?

A: As far as the current drivers of opposition to expansion, I would say they are now more political than economic, and have been so for quite a while. For one thing, we have empirical evidence from other states, including now Louisiana and Arkansas, that show expansion isn't the budget-buster our leaders once feared.

We also have reams of studies and evidence from other states showing we would see net positive benefits – thousands of created, savings of double-digit percentages in uncompensated care for hospitals, more workforce participation (ours is typically lowest in the country), net GDP growth and even projected growth in population. Also, we've seen firsthand over the last two years that Mississippi, with our so heavily dependent on federal spending, sees booming state budget growth when there is an influx of billions of federal dollars. We're sitting on more than $2 billion in basically surplus state money right now, largely the result of the influx of federal pandemic spending.

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And again, this expansion is aimed primarily at the “working poor,” people in the gap between being poor enough for other or being able to afford private insurance or pay medical bills out of pocket. As many have pointed out, a lot of the folks we're talking about with this are working more than one job. As for pulling one's self up by bootstraps, too many folks are one ER visit away from not having any bootstraps, and once someone gets a chronic illness because of lack of preventive care, it costs taxpayers anyway (and more).

No, the opposition now would appear to be more purely political (partisan) and philosophical – not wanting expansion of “Obamacare,” and opposition to expansion of a government program, even if in the long run it's projected to benefit the workforce and private sector.

That opposition to government programs, however, appears to be selective among state leaders. One recent anecdote struck me in particular. Gov. Reeves recently held a press conference to trumpet the state's work on expanding broadband internet across rural Mississippi. This is being funded with federal tax dollars. Instead of lamenting such government largesse, Reeves vowed to see that “we not only get our fare share, but that we get more than our fair share.” It would appear it's OK to take hundreds of millions of federal dollars for internet service to areas where the private sector won't do it, but not OK to take federal money to help keep people alive and well and working.

As for how this opposition might be overcome – I don't know that anyone has a simple answer to that. One thing I hear all the time, though, even from some who have opposed expansion, is time. I have heard over and again in recent years that it's probably just a matter of time before Mississippi expands Medicaid. Polling in recent years would indicate the populace may already be a bit ahead of our politicians on this policy … and, of course, look at other states relenting, such as Arkansas, Louisiana.

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We attempted to delve into some of this opposition, past and present, here.

READ MORE: Who's opposed to Mississippi Medicaid expansion and why?

Q: Can Medicaid expansion prevent local hospitals from closing?

A: It's unclear if it definitely would — rural hospitals in particular are facing major headwinds with personnel shortages and costs, supplies, , uncompensated care. But most projections by experts have shown net benefits, and we've seen in other states that expansion helped. Particularly, in Louisiana, rural hospitals saw reductions in uncompensated care costs in the 55% range. This alone could give struggling rural hospitals some breathing room.

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This study indicates hospitals in expansion states are less likely to close.

Q: With Medicaid expansion costing far more than initially predicted in other states, it delivering consistently poor health outcomes for those on the program, and it failing to ultimately help save rural providers as seen in Colorado and Indiana…why advocate so intensely for expanding a program that's toward insolvency besides the fact that it will pad the pockets of and expand profits for big hospitals?

A: As for costing more than predicted, as I understand, this has not truly been the case at least on the state level. Some states have seen more people than initially predicted, but that has also been offset by people shifting from their traditional Medicaid to that with the higher match rate from the feds, and other non-direct economic benefits.

As for Colorado, I just recently read a report that rural hospitals there are "about 6 times less likely to close than hospitals in non-expansion states, according to a study by researchers at the of Colorado Anschutz Medical Campus." I'm not sure what you are looking at, but would like to see it if you can forward a link.

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As for poor health outcomes, I'm not sure Mississippi would have anywhere to go but up. Mississippi Medicaid has had poor health outcomes, but that has been primarily because only the sickest of the sick, so to speak, are on its adult population. Proponents say that the working-poor expansion population would receive more preventive care and improve outcomes — but you are right, that has been one major argument against expansion in Mississippi.

I don't know that expansion would pad the pockets and profits of big hospitals. It would help ameliorate the $600 million or so in uncompensated care that is hammering, in particular, smaller rural hospitals.

READ MORE:
The Mississippi Health Care Crisis
Mississippi moms and babies suffer disproportionately. Medicaid expansion could help.
How Medicaid expansion could have saved Tim's leg — and changed his life
Q&A: What is Medicaid expansion, really?

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

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Mississippi Today

Remembering ‘The Gunslinger’ of college football, Archie Cooley

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Archie Cooley, center, with Jerry Rice, left, and Willie Totten when they were honored at Mississippi Valley at an awards function in recent years. ( courtesy of MVSU)

Archie “The Gunslinger” Cooley, the most unconventional of football coaches, has died at the age of 84, and, frankly, I don't even know how to begin to describe him.

So let's begin like this: There will never be another one. Cooley, which is how he referred to himself so often in the third person, was an original. In the mid-1980s, in Mississippi, he wrestled the college football away from Ole Miss, Mississippi State, Southern Miss and Jackson State, his alma mater, and shined it ever so brightly on Mississippi Valley State.

Rick Cleveland

He was a writer's dream. Need a column? Call Cooley. He always delivered. He wore a cowboy hat, usually with a feather in it, and that hat covered a brain that was years and years ahead of all others when it came to offensive football.

Back when most college football teams were running “three-yards-and-cloud-of-dust” offenses, Cooley's MVSU Delta Devils were spreading the field, never huddling, and throwing the ball on every down and then throwing it some more. The stuff you see big-time college and NFL offenses doing now, he was doing then.

The only thing the Valley Delta Devils had more of than passing plays were nicknames. Cooley was The Gunslinger. Jerry Rice was World, short for All World. Willie Totten, the quarterback, was Satellite. The offense was The Satellite Express. The offensive line was known as Tons of Fun. Vincent Brown, the great linebacker, was The Undertaker. Together, they were a blast.

The first time I saw then in person was Sept. 24, 1984, when they came to Jackson to play one of W.C. Gorden's terrific Jackson State teams. Valley had scored 86 points in its opener and 77 points in its second . Rice was catching about 20 passes and four touchdowns a game. Totten's passing stats were so gaudy that the NCAA chief statistician accused Valley sports information director Chuck Prophet of making them up. Prophet sent the NCAA the game films and said, “Correct me if I'm wrong.” He wasn't.

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So Valley came to Jackson, drawing a crowd of more than 50,000, and on the first offensive play, the Devils flanked four wide receivers in single file to the left side and one wide receiver, the one wearing jersey number 88, to the far right. No. 88 was Jerry Rice and Jackson State had only one defensive back to him.

Well, you know what happened next. Rice ran right past the defender, Totten lofted a pass down the field, which Rice caught and gracefully ran to the end zone a good 10 yards ahead of the defender.

Valley won 49-32. During the game's final minutes, Cooley paraded up and down the Valley sideline, waving a green and white Valley banner. Valley had not defeated JSU in 30 years. Afterwards, he led the Valley players in a victory lap around the Memorial Stadium. “We've done the impossible!” Cooley, a former Jackson State All American center and linebacker, shouted.

“Now I know how they've been feeling for the last 30 years,” Cooley said, and he said a lot more.

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“Jackson State said they had to score 30 points to win,” he said. “Ha! They would have had to score 50 because we scored 49. I'm gonna now because they have to live with it for a year.”

Cooley could ever more talk. He could brag and he could back it up. He was from the old Dizzy Dean school of boasters: “It ain't braggin' if you can do it.”

Cooley could do it and did.

He was a Laurel native, a graduate of tradition-rich Oak Park High School, also the alma mater of such famous as Olympic long jumping champion Ralph Boston and world renowned opera soprano Leontyne Price. Cooley grew up with next to nothing. “A lot of times, growing up, I'd open the refrigerator for something to eat, and the only thing in there was water,” Cooley told me. “So, I'd drink a glass of water and go out and play football.”

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He played center and linebacker at Jackson State. He was a defensive coordinator for years at Tennessee State before taking the job at Valley. He said all those years as a defensive coach, he kept a notebook of plays other teams used that he knew he wanted to use when he became a head coach. Clearly, most were passing plays.

And, yes, it helped to have a receiver like Rice and a quarterback like Totten, both now in the College Football Hall of Fame. But Cooley called the shots and he brought the cameras and microphones to Itta Bena, which is Choctaw for “Home in the Woods.” I remember trying to give driving directions from Jackson to Itta Bena to a reporter from The New York Times. He said I lost him at “turn right at the cotton gin.”

That 1984 Valley team was undefeated at the same time SWAC rival Alcorn State was undefeated through mid-October. They were to play in November in Itta Bena. A young Jackson sports columnist – this one – wrote a column that the game should be moved to Jackson where 50,000 more people could see it. So, they moved it to Jackson and played it on a Sunday. More than 64,000 people attended, which made it the biggest pay day in the history of either school. Marino Casem's Alcorn State Braves won 42-28 in a game never to be forgotten by anyone who was there.

Cooley would MVSU after the 1986 season and go on to coach at Arkansas Pine Bluff, Norfolk State and Paul Quinn College in Dallas. His teams never again rose to the prominence of those Valley teams when CBS, NBC, ABC, The New York Times and Sports Illustrated all found their way to Itta Bena, where they told the story of the highest scoring college football team in history and their leader, the self-proclaimed Gunslinger.

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

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https://www.biloxinewsevents.com/?p=351172

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Mississippi Today

Legislative panels will consider restoring some Mississippians’ voting rights

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mississippitoday.org – Taylor Vance – 2024-04-19 13:56:14

The two legislative committee responsible for criminal justice measures say they will move bills forward to restore suffrage for individuals, raising the prospect that some Mississippians will have their voting rights restored. 

House and Senate Judiciary B Chairmen Kevin Horan and Joey Fillingane announced Friday that they will have hearings on Monday to consider the suffrage bills. 

The House earlier in the passed a substantial restoration bill that would have automatically restored suffrage to people convicted of nonviolent felony offenses, but Senate Constitution Chairwoman Angela Burks Hill killed it without bringing it up for debate.

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Lawmakers, however, can still consider individual bills to restore suffrage to people who have been convicted of disenfranchising felony offenses, though only a small number of those bills typically survive the legislation .

Horan, a Republican from Grenada, said the House will not restore suffrage to people convicted of violent offenses or those previously convicted of embezzling public money. Additionally, Horan said people must have completed the terms of their sentence and not have been convicted of another felony offense for at least five years to be considered. 

Fillingane, a Republican from Sumrall, said the Senate also will likely only restore voting rights to people previously convicted of nonviolent felony offenses – not violent crimes such as murder or rape. 

The Lamar County lawmaker also said the amount of time after someone has completed their sentencing terms is not a major factor in his to advance a suffrage bill out of committee or not. 

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“The further out the better, but the time since completing the sentence doesn't really matter,” Fillingane said. 

Under the Mississippi Constitution, people convicted of any of 10 felonies — perjury, arson and bigamy — lose their voting rights for . Opinions from the Mississippi Attorney General's Office have since expanded the list of disenfranchising felonies to 23.

READ MORE: ‘If you can't vote, you're nobody:' Lawmakers hear from rehabilitated felons who still can't exercise right

About 55,000 names are on the Secretary of 's voter disenfranchisement list as of March 19. The list, provided to through a public records request, goes back to 1992 for felony convictions in state court. 

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The state constitution gives lawmakers the power to restore suffrage to citizens, but the process is burdensome. It requires two-thirds of lawmakers in both legislative chambers to vote in favor of restoring suffrage in individual cases. 

“We have a process in the Legislature that helps to restore individuals' voting rights, but it is a terrible process,” Democratic Rep. Zakiya Summers of said on Wednesday. “And it's a cumbersome process. And there really is no easy way to navigate it.” 

The Legislature last year did not pass any suffrage restoration bills, but a willingness from both of the relevant committee chairs to push some of the bills forward could mean lawmakers will approve some bills this year.

Lawmakers have until the final days of the session to vote on suffrage bills, and legislators are coming to the end of their regular session, but it's unclear when they will adjourn. 

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Legislators still have major items they can consider, expansion legislation, addressing the public retirement system and rewriting the public K-12 funding formula. 

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

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Mississippi Today

Look for the “why” when engaging in disagreement

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“Bought sense is better than borrowed sense” lives in my memory, rent-free. I've always cringed at it because, at every stage of life, some lessons have been costly to learn.

At the Alluvial Collective, we show up to the office, on the screen, or in a community with one overarching challenge: to create or deepen the connections that will support collective thriving. That is our “For what.” We get to show up with wisdom purchased over our organization's last 25 years of work and with wisdom borrowed from many generations and traditions. In most traditions, self-reflection and stories reveal the path to where we should go and how we should travel.

As you engage in the National of Conversation, here are a of stories and a few to help you show up for each other, our communities, and our country.

What Do You Need

The first story emerges from a book called “Getting To Yes,” about negotiating.

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Two people were arguing over an orange, and after some time, they decided to split it in half, feeling that equal parts were fair, like in elementary school. Before splitting the orange, they never asked each other the reason the other wanted it. As it turns out, one wanted the orange peel to flavor a cake, and the other wanted the orange's “meat” to eat.

In another story, an arriving house guest is deeply offended by their host's demand that they remove their shoes upon entering their home. The visit goes off the rails and probably off the porch, too.

Each of these stories reminds you of tensions and dilemmas that are all too familiar in our families, towns, and – for me – our leadership discourse.  We have notions about what the other person, or people, want, but at critical points, we need more humanizing insight into what makes it essential to them.

The Cost of Wisdom

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In the second story, the home's foyer had a large rug on its floor that had been in the family for generations. Understanding that, I would have offered to remove my shoes.

We benefit from being curious about the interests, the “for what” the other person engages with, rather than just the “what” or their position. It may seem inefficient, but it pales to the value curiosity brings to relationships. Good relationships are win-win; our team leans on telling and hearing stories to build relationships. They are the wellspring of “for whats” and “whys.”

The truthful stories that your neighbor or coworker tells to you and themselves comprise reality as they see it.  Your stories teach your in-laws and teammates history from your the learned or experienced vantage point. Dialogue and stories make our actions and attitudes make sense.  This is where trust begins to form.

Dialogue over Debates and Diatribes.

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As you begin your week, remember that how we engage matters as much as why. Diatribes and speeches don't make us good neighbors, and debates require someone to lose. We like authentic connections and hearing familiar themes in the stories of others. This week, open and honest dialogue is the strategy; to thrive together should always be the goal. We've paid too much for everything else.

Talk more; proclaim less. It's one of our mottos here at The Center for Practical Ethics (TCPE). Put another way, we might say our goal is to foster conversations rather than diatribes. This task is more difficult than most realize. What we know as ethicists is that merely having conversations isn't enough. There's a wide variety of skills needed for fruitful dialogue to take place, and some are harder to by than others.

The ideal conversation partner is curious and humble, able to actively listen, knowledgeable about his or her own positions, familiar with basic principles of logical argument, charitable when interpreting claims, and—most importantly—willing to be wrong. Our work centers around equipping with these skills and helping them navigate the complex ethical issues within our society's most contentious disagreements.

This year, National Week of Conversations (NWoC) coincided with Ethics Week here at the University of Mississippi (UM). Many of our are conversation-based because dialogue is the best way to evaluate the ideas of others and open ourselves up to new information and interpretation of facts, while gaining a better understanding of our own views.

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Two of our events in particular are worth examining more closely to see why NWoC and the work we do at TCPE are critical for sustaining civil society and the myriad public goods we all take for granted. First is our signature Just Conversations . Students are placed in small groups and given a couple of ethical dilemmas to discuss. Trained student moderators guide the discussion to point out important aspects of the dilemmas, such as logical fallacies, analysis of stakeholders, ethical concepts and assumptions, and varying methods to achieve goals. Students often discover they agree with others—on the dilemma outcome and the details—far more than they expected.

Second, we have invited free speech scholar Sigal Ben-Porath to give a talk about her new book Cancel Wars: How Universities Can Foster Free Speech, Promote Inclusion, and Renew Democracy. Ben-Porath contends that universities are laboratories of democracy where students must learn to engage with disagreement. If the university is to be a place where truth is discovered, it must take seriously its historic social and educational obligation to train students in the skills needed for civil discourse and critical thinking. Her work is especially relevant in our ever more polarized times.

What these events demonstrate is that conversations—that is, engaged and fruitful conversations—must take place at all levels. Students must learn to talk to students just as much as faculty must learn to talk to faculty and administrators to administrators. What's more, these groups must talk to each other because while each of us have a role within academia (faculty, staff, student, dean, vice chancellor, etc.), we are also all citizens who work and live together.

Policies must be made, votes cast, businesses founded, churches attended, friendships established, and life lived. TCPE focuses on the skills of civil discourse by providing opportunities to cultivate those skills through Ethics Week, and highlights conversations that ask us to reflect on the role of universities as part of the NWoC.

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Join us at Noon on Friday, April 19 for a VIRTUAL lunch and learn exploring tools to make us better listeners, and in turn, better equipped to engage in meaningful conversations across differences.

The session will be led by Dr. Graham Bodie, professor and Interim Chair of the Department of Media and Communication in the School of Journalism and New Media at the University of Mississippi.

This event is free and open to the public. Register to receive more information.

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

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