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Studies show that not expanding Medicaid is killing Mississippians

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Study after study details how expanding will create jobs, grow the and provide a boost to Mississippi's beleaguered hospitals.

The issue of expanding Medicaid will be hotly debated in this year's gubernatorial election. Incumbent Republican Gov. Tate Reeves adamantly opposes Medicaid expansion, while Democratic challenger Brandon Presley is an ardent supporter. It seems at times the issue is viewed solely in terms of — whether supporting or opposing Medicaid expansion can help a candidate win elections.

What often is lost in the conversation, though, is the true intent of Medicaid expansion: to improve and save lives. And there are studies that indicate expanding Medicaid does save lives.

States were to start expanding Medicaid to provide health care coverage to primarily the working poor in 2014. A November 2019 study by the national nonprofit Center for Budget and Policy Priorities attributed the premature deaths of 540 Mississippians between the ages of 55 to 64 to the state's refusal to expand Medicaid. The same study said that 19,000 lives had been saved in the states that had expanded Medicaid.

At the time that study was conducted, 16 states had not expanded Medicaid. Today, Mississippi is one of just 10 states refusing to expand Medicaid.

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“Over a four-year period, the lives of 540 older people were lost because Mississippi did not expand Medicaid to low-income adults,” the Center for Budget and Policy Priorities study said.

Yes, the Center for Budget and Policy Priorities is viewed as a progressive but respected group. Several other groups, though, have reached the same conclusion — that expanding Medicaid saves lives.

A 2021 study by the Kaiser Foundation said, “Studies find that expansion was associated with significant declines in mortality related to certain specific conditions, in some instances limited to certain subgroups. These findings include decreased mortality associated with different types of cancer, cardiovascular disease, and liver disease.”

The KFF also said, “A 2020 national study found that expansion was associated with a significant 3.6% decrease in all-cause mortality, the majority of which was accounted for by a significant 1.93% decrease in health care amenable mortality. Another study found that expansion was associated with reductions in health care amenable mortality and in mortality not due to drug overdose.”

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“Health care amenable mortality” is a fancy way of saying deaths that should not have occurred if adequate and timely health care was available.

If a person with high blood pressure and/or high cholesterol receives adequate preventative medical care, he or she is less likely to have a life-threatening stroke or heart attack. Presumably, a person with Medicaid would be more likely to seek out such medical care.

Similar arguments can be made about a host of diseases cancer, diabetes and others.

The study by the Center for Budget and Policy Priorities focused on those aged 55 to 64 – those who, in general terms, are nearing retirement. Those are the people most likely to be impacted by certain diseases and whose lives can be prolonged with proper medical care to combat high blood pressure or other potentially life-threatening conditions.

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“Research shows that Medicaid expansion increased the share of low-income adults using medications to control chronic conditions like heart disease and diabetes,” the Center for Budget and Policy Priorities study found. “The new study finds particularly clear evidence of a drop in mortality from conditions like these, which are amenable to medication and other treatment.”

Common sense also would conclude that if people are getting those treatments they can work longer and pay taxes.

Mississippi is consistently last or next to last among the 50 states in what economists say is the important category of the labor force participation rate that measures the number of people pre-retirement age who are working. According to the latest numbers, Mississippi's labor force participation rate of 54.8% is next to last, leading only Virginia. That labor force participation rate is a drag on the state economy, experts say. The national average is 62.2%.

The issue is exacerbated in Mississippi due to the fact the state also has one of the highest percentage of people who are disabled and most likely not working. It is hard for a person who has had a stroke that left him or her with a physical impairment to do certain jobs.

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Of course, in Mississippi, that person who had been working but is now disabled most likely would not have sought out preventative medical care because he or she could not afford it. They certainly didn't have coverage from Medicaid, which has not been expanded to provide coverage to primarily the working poor.

Because of that lack of medical treatment, those people are more apt to die — according, at least, to many of these studies.

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 1951

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April 28, 1951

Ruby Hurley Credit: Wikipedia

Ruby Hurley opened the first permanent office of the NAACP in the South.

Her introduction to activism began when she helped organize Marian Anderson's 1939 concert at the Lincoln Memorial. Four years later, she became national youth secretary for the NAACP. In 1951, she opened the organization's office in Birmingham to grow memberships in Alabama, Florida, Georgia, Mississippi and Tennessee.

When she arrived in Mississippi, there were only 800 NAACP members. After the governor made remarks she disagreed with, she wrote a letter to the editor that was published in a Mississippi newspaper. After that step in courage, membership grew to 4,000.

“They were surprised and glad to find someone to the governor,” she told the Chicago Defender. “No Negro had ever challenged the governor before.”

She helped Medgar Evers investigate the 1955 murder of Emmett Till and other violence against Black Americans. Despite threats, she pushed on.

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“When you're in the middle of these situations, there's no room for fear,” she said. “If you have fear in your heart or mind, you can't do a good job.”

After an all-white jury acquitted Till's killers, she appeared on the front of Jet magazine with the headline, “Most Militant Negro Woman in the South.”

Months later, she helped Autherine Lucy become the first Black student at the of Alabama.

For her work, she received many threats, a bombing attempt on her home. She opened an NAACP office in Atlanta, where she served as a mentor for civil rights leader Vernon Jordan, with whom she worked extensively and who went on to serve as an adviser to President Bill Clinton.

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After learning of Evers' assassination in 1963, she became overwhelmed with sorrow. “I cried for three hours,” she said. “I shall always remember that pool of blood in which he lay and that spattered blood over the car where he tried to drag himself into the house.”

She died two years after retiring from the NAACP in 1978, and the U.S. Post Office recognized her work in the Civil Rights Pioneers stamp . In 2022, she was portrayed in the ABC miniseries, “Women of the Movement.”

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

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Mississippi Today

Rare open negotiations occur on important Medicaid expansion issue

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mississippitoday.org – Bobby Harrison – 2024-04-28 06:00:00

The curtain was pulled back last for the first time in years on the Mississippi Legislature's often mysterious conferencing .

A conference committee consists of three representatives and three senators appointed to try to reach agreement when the two chambers pass differing versions of the same bill. Last week, a conference committee formed to try to reach agreement on expansion caused a stir by meeting in a public setting.

Even though the joint rules of the Mississippi Legislature call for an open conferencing process, the conferees seldom meet in public. They usually meet and negotiate their differences near the end of the session behind closed doors.

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That was not always the case.

For a period in the late 1990s and early 2000s, the Legislature, under intense pressure from the Mississippi Press Association, made open conference committees the norm.

Some major issues have been played out in public conference committees. Notable open conferences include:

  • The infamous, excruciatingly long special session in 2002 where businesses received more protection from lawsuits.
  • Budget fights when Haley Barbour was governor when legislators often would reach an impasse in the negotiations process and spend the bulk of their time talking about their cars and eating candy.
  • The major rewrite of the 's economic development package under then-Gov. Ronnie Musgrove called Advantage Mississippi.
  • The Mississippi Adequate Education Program, which for decades has provided the state's share for the basic operation of local school districts. It was hammered out in an open conference process in 1997 even before the joint rules mandated the open process.

Then-state Sen. Musgrove and former House Speaker Billy McCoy deserve credit or blame, according to one's perspective, for proving the open conference process could work. When they chaired their respective chamber's education committees, they insisted on an open conference process.

But in more recent years, open conference committees have been few and far between. The joint rule has been largely ignored.

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The fact that the three House and three Senate conferees agreed to meet at least once in public on Medicaid expansion — one of the most pivotal issues facing the Legislature in recent years — drew considerable attention.

If nothing else, the open conference committee provided a raw and unedited view of how far apart the two chambers were at the time on an issue that would additional care coverage to primarily the working poor.

The House wanted to provide coverage to those earning up to 138% of the federal poverty level, or about $20,000 annually for an individual, while the Senate had proposed providing coverage to those earning less than 100% of the federal poverty level, or about $15,000 per year.

According to various experts, the House plan would provide coverage to many more working and cost less to the state than would the Senate plan. The reason for the lower cost to the state is that when expanding to 138%, the federal will pay 90% of the costs and provide the state an additional roughly $700 million over two years as an enticement to expand.

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Under the Senate plan, the federal government will pay 77% of the cost and offer no incentives. It is important to understand that in the expensive world of health care, the difference in 77% of the cost and 90% means tens of millions to Mississippi state coffers.

The House conferees repeatedly pointed out those numbers — their plan covering more at less cost — during last week's open conference committee.

One of the reasons legislators through the years have not been enamored with an open conference process is that it has often turned into efforts by the negotiators to sell their position to the public.

Once the open conference process starts, the side that feels the most comfortable with its position wants to meet more often in full view of the public to make sure the public understands where each side stands.

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For whatever it is worth, the House conferees were more enthusiastic about continuing the open process after the initial Medicaid expansion conference committee.

And after that initial open conference, the Senate offered a compromise to those earning up to 138% of the federal poverty level — just as the House proposed.

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

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Mississippi Today

Legislation to strip key power of PERS Board passes both chambers

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mississippitoday.org – Bobby Harrison – 2024-04-27 15:39:23

Legislation that strips significant power from the board that governs the state's public employee pension program has passed both chambers of the Legislature.

Under the legislation set to go to Gov. Tate Reeves during the final days of the 2024 , the Public Employees Retirement System Board would no longer have the authority to increase the contribution rate levied on governments (both on the state and local level) to pay for the massive retirement system.

The legislation, which passed both chambers in recent days, was a reaction to the decision by the board to increase by 5% over a three-year period the amount local governments contribute to each employee's paycheck for their retirement. Under the PERS Board plan, the employer contribution rate would have been increased to 22.4% over three years, starting with a 2% increase on July 1.

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The board said the increase was needed to ensure the long-term financial stability of the system that pays retirement for most public employees on the state and local levels, staff of local school districts and universities and community colleges.

City and county government in particular argued that the 5% increase would force them to cut government services and lay off employees.

Under the bill passed by the Legislature there still would be a 2.5% increase over five years — a .5% increase in the employer contribution rate each year for five years.

In addition, legislative leaders said they plan to put another $100 million or more in state tax dollars into the retirement system in the coming days during the appropriations .

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Under current , the PERS Board can act unilaterally to increase the amount of money governmental entities must contribute to the system. But under the new bill that passed both chambers, the board can only make a recommendation to the Legislature on increasing the employer contribution rate.

The PERS Board also would be required to include an analysis by its actuary and independent actuaries on the reason the increase was needed and the impact the increase would have on governmental entities.

In the 52-member Senate, 14 Democrats voted against the bill. Only one House member voted against the proposal.

Sen. David Blount, D-, said the bill failed to address the financial issues facing the system. He said a permanent stream is needed.

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Blount said, “You are moving in the wrong direction and weakening the system” with the bill the Legislature approved. “Is it painful? Is it going to cost more money? Yes, but we need to do it” to fix the system.

The system has assets of about $32 , but debt of about $25 billion. But Sen. Daniel Sparks, R-Belmont, and others argued that the debt was “a snapshot” that could be reduced by strong performance from the stock market. The system depends on its investments and contributions from employers and employees as sources of revenue.

The system has about 360,000 members including current public employees and former employees and retirees.

The legislation states that no changes would be made for current members of the system. The legislation does reference looking at possibly changing the system for new employees. But that would be debated in future legislative sessions.

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The bill does not include an earlier House proposal to dissolve the PERS Board, which consists primarily of people elected by the members of the system, and replace them with political appointees.

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

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