Mississippi Today

‘The life and breath of communities’: Hospital leaders say Medicaid expansion still needed

Published

1 year ago

February 1, 2024

Gov. Tate Reeves’ Medicaid payment changes, pitched during the eleventh-hour of a heated reelection campaign and his only major health plan during his first four years as governor, delivered $658.2 million to hospitals in January.

Hospital leaders say the influx of federal money is a lifeline, but it’s not enough to forgo Medicaid expansion – a long-term solution that would insure hundreds of thousands of working poor people in one of the country’s sickest states.

Quentin Whitwell owns four hospitals in rural Mississippi. He knows intimately the struggles they face. While the extra federal money Reeves secured is helpful, he said, expansion would go further.

“There is no reason to leave funding on the table to assist rural hospitals that are the life and breath of communities,” he said.

As Mississippi hospitals continue to struggle, expanding Medicaid to cover the working poor has been hotly contested over the last decade, most openly during the last two gubernatorial elections. Reeves, as did two of his GOP predecessors, has remained steadfastly opposed, saying it would make Mississippians more reliant on “welfare.”

Medicaid expansion would increase the income threshold needed to qualify for Medicaid to 138% of the federal poverty level, meaning many more Mississippians would qualify for coverage. For a family of four, that would be an annual income of $43,056.

As it stands, low-income, working-class Mississippians who make just above the poverty level don’t qualify for Medicaid but also can’t afford insurance. Nearly one in five Mississippians is uninsured, contributing to the state’s abysmal public health metrics – such as the lowest life expectancy in the country.

Extensive research underlines the policy’s financial and health benefits, and a majority of Mississippians say they want Medicaid eligibility expanded, as it has been in 40 other states. Researchers estimate the policy would insure between 200,000 and 300,000 Mississippians, generate thousands of jobs, help struggling hospitals and bring billions of dollars into the state.

The money’s needed — one report estimates nearly half of the state’s rural hospitals are at risk of closure, largely due to losses related to caring for uninsured patients.

However, the governor and some other Republican leaders have remained staunchly against the policy.

Weeks before the November election, in which Reeves narrowly defeated Democrat Brandon Presley, the governor announced that the state had requested federal approval of changes to its Medicaid payment policies. The changes, Reeves claimed, would bring in nearly $700 million in total to the state’s hospitals.

Reeves’ plan relies on increased extra payments hospitals get for treating patients on Medicaid. It increases a “bed tax” on Mississippi hospitals, in exchange for them drawing down more in federal Medicaid payments. Hospitals and GOP leaders in the Legislature had pitched roughly the same plan the year before, but Reeves’ own Medicaid administration had told them it wouldn’t work.

At the September press conference announcing his plan, Reeves touted the reforms as an alternative to Medicaid expansion, which he referred to as increasing the state’s “welfare rolls.” He was flanked by various hospital leaders from across the state. Most were from hospitals that had recently left the state hospital association under political pressure after the association’s political action committee made a largee donation to Reeves’ pro-expansion opponent Presley.

Months after his announcement, half of Reeves’ plan has been approved and the bulk of the money has gone out.

And while hospital executives say the money will allow Mississippi hospitals that have been struggling for years to stay above water, the program does nothing to address the egregiously high number of uninsured, working-class Mississippians.

Lee McCall, chief executive officer of Neshoba General Hospital in Philadelphia, said his hospital loses more than $4 million a year on uncompensated care.

“These proceeds are going to help offset that … but it hasn’t done anything to expand access to coverage for Mississippians that are uninsured,” he said. “So yes, we’re still proponents of expansion, in whatever form it could come in, really to help out Mississippians, so that they can seek the care that they need.”

McCall said while he was thankful for the extra money, he acknowledged the governor’s plan gave more money to the state’s larger hospitals, rather than the ones struggling the most in rural parts of the state.

While the reimbursement plan helps hospitals recoup losses they face when caring for uninsured people, Baptist Memorial Health Care’s vice president of government affairs Keith Norman said it doesn’t replace the need for Medicaid expansion, which would insure more people.

“We have never seen the (payment increases) and Medicaid expansion as being exclusive of one another,” Norman said. “We’ve always seen the both-and approach, not either-or. Because when we start talking about Medicaid expansion, we’re talking about covering working Mississippians … and we’re looking to adopt both.”

From a strictly financial perspective, the reimbursement plan is seen by some hospital executives as comparable to the benefits of expansion.

“It is injecting close to $40 million in additional funding for Singing River Health System, which we really needed after the lingering effects of COVID,” said Singing River chief financial officer Jason McNeil. “From our perspective, it’s really doing about the same as if Medicaid were expanded.”

But in order for the two programs to have comparable financial benefits, the reimbursement plan would need to recur annually. And while hospital executives are expecting that to be the case the plan doesn’t automatically renew. The current payment arrangement applies through June 30, 2024.

“If we lose access to the program, it’s going to destabilize our operations,” said Greenwood Leflore Hospital's interim chief executive officer Gary Marchand.

Greenwood Leflore's financial struggles have been well-documented — the hospital, once poised to close, has managed to hold on until through the end of its fiscal year.

McCall said that while the expectation is that the money from the reforms will continue to arrive annually, “we won’t know until it's submitted.”

Even assuming it is a permanent change, the plan only benefits hospitals, explained Marchand, and not other forms of care – such as outpatient care and preventative care patients receive at clinics. One of the consequences of the current system of coverage is that the indigent population does not have access to preventative care – leading to tragedies such as widespread amputations among diabetics whose condition went unchecked and untreated.

In addition to the devastating consequences a lack of coverage has for patients, it’s also not cost effective for hospitals. The population not currently covered by Medicaid tends to only have access to health care in the context of an emergency room, which can’t turn anyone away – regardless of insurance coverage. But it’s also the most expensive place to receive health care.

The hospital reimbursement plan helps offset some of the money hospitals lose when caring for uninsured patients. But it’s throwing money at a problem that wouldn’t exist under Medicaid expansion.

“I haven't spoken to anyone in health care or hospital administration that says we're no longer interested in expansion,” McCall said.

Hospital leaders from Merit Health System, Delta Health System in Greenville, North Mississippi Health System in Tupelo and Forrest General Hospital in Hattiesburg declined interviews.

Leaders from the University of Mississippi Medical Center and Gulfport's Memorial Hospital System also refused an interview. South Central Regional Medical Center's chief executive officer Greg Gibbes did not respond to multiple requests for comment. Representatives from all three were part of a cohort of medical leaders that flanked the governor at his September election-time press conference.

A second, smaller part of Reeves’ plan is still pending approval from the federal government. Medicaid expansion will likely be a major policy discussion during the Legislature’s 2024 session, and several Republican legislative leaders have said they’ll devote attention to the topic.

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 1850, Shadrach Minkins escaped from slavery

Published

6 hours ago

May 3, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-05-03 07:00:00

by Jerry Mitchell, Mississippi Today
May 3, 2025

May 3, 1850

Shadrach Minkins, right, worked at the Cornhill Coffee House and Tavern, believed to have been located in the highlighted area.

Shadrach Minkins, already separated from his family, escaped from the Norfolk, Virginia, home, where he was enslaved. He made his way to Boston, where he did odd jobs until he began working as a waiter at Taft’s Cornhill Coffee House.

Months later, Congress passed the Fugitive Slave Act, which gave authorities the power to go into free states and arrest Black Americans who had escaped slavery.

A slave catcher named John Caphart arrived in Boston with papers for Minkins. While serving breakfast at the coffee house, federal authorities arrested Minkins.

Several local lawyers, including Robert Morris, volunteered to represent him. Three days later, a group of abolitionists, led by African-American abolitionist Lewis Hayden, broke into the Boston courthouse and rescued a surprised Minkins.

“The rescuers headed north along Court Street, 200 or more following like the tail of a comet,” author Gary Collison wrote. They guided him across the Charles River to the Cambridge home of the Rev. Joseph C. Lovejoy, whose brother, Elijah, had been lynched by a pro-slavery mob in Illinois in 1837.

Another Black leader, John J. Smith, helped Minkins get a wagon with horses, and from Cambridge, Hayden, Smith and Minkins traveled to Concord, where Minkins stayed with the Bigelow family, which guided him to the Underground Railroad, making his way to Montreal, spending the rest of his life in Canada as a free man.

Abolitionists cheered his escape, and President Millard Fillmore fumed. Morris, Hayden and others were charged, but sympathetic juries acquitted them. Meanwhile in Montreal, Minkins met fellow fugitives, married, had four children and continued to work as a waiter before operating his own restaurants.

He ended his career running a barbershop before dying in 1875. A play performed in Boston in 2016 told the dramatic story of his escape.

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

The post On this day in 1850, Shadrach Minkins escaped from slavery 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: Centrist

The article presents a historical recount of Shadrach Minkins’ escape from slavery and the role abolitionists played in his rescue. The content is fact-based, focusing on a historical event without promoting a particular ideological stance. While it centers on the abolitionist movement and highlights the moral victory of Minkins’ escape, it does so in a narrative style rather than advocating for any contemporary political agenda. The tone is neutral, and the article adheres to factual recounting of historical events, making it centrist in its approach to the subject matter.

Mississippi Today

Ghost town of Orwood residents provide lessons for today by working with scientists in 1800s to combat yellow fever

Published

1 day ago

May 2, 2025

Staff Editor

mississippitoday.org – @BobbyHarrison9 – 2025-05-02 09:36:00

by Shirley Wimbish Gray, Mississippi Today
May 2, 2025

Editor’s note: This essay is part of Mississippi Today Ideas, a platform for thoughtful Mississippians to share fact-based ideas about our state’s past, present and future. You can read more about the section here.

Given recent policy changes threatening the future of medical research and news of Mississippi’s falling childhood vaccination rates, I fear we are ignoring lessons learned the hard way.

One of those lessons occurred during a yellow fever outbreak in the summer of 1898 when a community of honest citizens in Orwood, then a hamlet in southwest Lafayette County, helped a team of physicians change the direction of public health for Mississippi and the rest of the country.

I first heard about their story listening to a documentary about yellow fever with my husband, a virologist, who teaches at the University of Mississippi. The video mentioned an unnamed doctor in Mississippi who had advanced a theory linking mosquitoes and yellow fever.

The story I uncovered models the honesty and trust in medical science we need today to keep our families and communities healthy.

***

Yellow fever was a problem in the South throughout the 1800s. Its initial symptoms — fever, body aches and severe headache — were followed by jaundice and in some cases internal bleeding leading to death. The jaundice left the skin tinged with yellow, thus the name “yellow fever.”

Shirley Gray

In early August 1898, a young woman named Sallie Wilson Gray (no relation to the author) developed chills and a fever while visiting at her uncle’s home in Taylor. Her uncle immediately sent her home to be cared for by her family in Orwood, about 10 miles away.

Days later, Sallie’s uncle in Taylor died from what proved to be yellow fever. Family members wiped black vomit, a sign of internal bleeding, from his body as he lay in his coffin.

Sallie had now brought the same illness home to Orwood.

***

I learned about yellow fever in seventh grade when we studied the 1878 yellow fever epidemic, the worst to strike the Mississippi River Valley. That year, Mississippi reported almost 17,000 cases and more than 4,000 deaths. I didn’t realize, though, how yellow fever continued to appear year after year.

Physicians had a basic understanding of bacteria after the Civil War, but they didn’t recognize viruses, which proved to be the cause of yellow fever, until later in the 1900s. One popular theory suggested yellow fever spread on fomites—inanimate surfaces—like bedding, clothing and furniture. Panic often followed news of a yellow fever outbreak. Health officials established quarantines, closed roads, river ports and train stations, hoping to curb the spread of infections.

The fear of what was not known then about yellow fever reminded me of the early days of the COVID pandemic when fear spread through rumors and unconfirmed anecdotes on social media.

***

Sallie’s sisters and brothers in Orwood soon developed the same symptoms as Sallie. By September, 30-plus people in Taylor and Orwood showed signs of the disease and new cases were reported outside the local area. In response, three interstate railroads shut down and Memphis halted train traffic coming into the city. In Starkville, the president of Mississippi A&M (now Mississippi State University) posted a column of guards along its roads. In mid-October, officials placed all of Mississippi under quarantine as thousands fled the state.

Months earlier, the governor of Mississippi, recognizing the heavy toll yellow fever often brought to his state, had sent a team of Board of Health physicians to Cuba, the center for yellow fever research. There the group met with Dr. Walter Reed, the Army physician directing the American research interests on the island. Reed pursued a theory that mosquitos transmitted the disease, but his experiments to establish that link repeatedly failed. The Mississippi team, including Dr. Henry Gant, a Water Valley doctor, returned home, still hopeful that science could soon solve the yellow fever mystery.

Gant immediately responded when he learned about the outbreak in Taylor. So did Dr. Henry Rose Carter, a field epidemiologist who served as the quarantine officer at Ship Island and who investigated yellow fever outbreaks throughout the South.

Committed to the same rigorous scientific process that epidemiologists use today, Carter looked for patterns in how diseases spread within clusters of people. With yellow fever, he needed to identify the first person to develop the disease in a specific area and then trace everybody and everything that the person came into contact with.

Over and over again, unreliable sources or conflicting pieces of data prevented Carter from finding a pattern. People, suspicious of government intervention and scared of the consequences of yellow fever, often distorted the truth.

Fortunately for us today, the people of Orwood proved to be different. The people, Carter wrote, were “honest enough to tell the truth” and cooperated with efforts to trace the infection of each case.

Working with Carter, Gant moved from house to house in Orwood, instructing families to quarantine at home, though their natural inclination was to care for their neighbors. He also questioned each person, recording data for Gant’s analysis.

Unlike diseases that produce low-grade fevers, an abrupt and high fever often characterizes a case of yellow fever. For that reason, many of the people Gant interviewed reported the day their infections started and also the time their fevers ignited: Mr. G. W. McMillan, sickened on Aug. 29 at noon. Mrs. Rogers, Sept. 4, 10:00 am.

Collecting this detailed information about time proved essential for Carter’s study and he cheered Gant’s ability to gather such reliable data. “A greater tribute to the good faith of the community, or to its confidence in Dr. Gant, can scarcely be given,” he wrote.

Studying the Orwood data, Carter recognized a consistent time interval between cases, about two weeks between the first case and the development of secondary cases. This meant that the infection did not immediately spread from person-to-person but required time to incubate. He called this the period of extrinsic incubation.

I’ve read Carter’s scientific report with the results of the Orwood study, the same report that persuaded Walter Reed to alter his experimental process. Waiting 10-14 days before introducing infected mosquitos to healthy volunteers, Reed successfully demonstrated the transmission of yellow fever from mosquito to human.

With the development of mosquito control procedures, the fever soon vanished in the U.S. and Caribbean. Today a vaccine can protect those travelling or living where the disease remains a threat.

***

Sallie and her siblings were among the lucky, surviving their infections with only lingering weakness and fatigue. When frosts fell in north Mississippi in early November 1898, the number of fever cases quickly fell. In total, officials confirmed 2,478 cases across the state. Those who died totaled 114.

Reed later acknowledged that the “work in Mississippi did more to impress me with the importance of an intermediate host in yellow fever than everything else put together.”

***

My husband and I drove from our home in Oxford to Taylor and then Orwood on a hot muggy day in August, probably experiencing the same weather conditions as Sallie. Orwood is a ghost town today, but we found the cemetery where Sallie’s uncle is buried, adjacent to the wood-planked Presbyterian Church that still stands.

Walking those grounds emphasized for me what the neighbors who once lived in Orwood taught us. Honesty and rigorous scientific inquiry — and not political rhetoric or unproven claims — are the tools we must trust to combat disease and dispel fear.

Bio: Shirley Wimbish Gray lives in Oxford. A retired writing instructor and science editor, she writes about what is often overlooked or forgotten, particularly in the American South. Her recent essays have appeared in Earth Island, Brevity Blog and Persimmon Tree.

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

The post Ghost town of Orwood residents provide lessons for today by working with scientists in 1800s to combat yellow fever appeared first on mississippitoday.org

Political Bias Rating: Centrist

This article does not present a clear ideological stance but rather focuses on a historical account of a yellow fever outbreak in 1898 and its connection to scientific advancements. The content emphasizes the importance of honesty, scientific inquiry, and collaboration, contrasting it with political rhetoric and unproven claims. The mention of contemporary issues, like Mississippi’s falling childhood vaccination rates and recent policy changes affecting medical research, introduces a subtle critique of current trends in public health. However, the tone remains balanced, and the piece refrains from offering a partisan viewpoint, focusing instead on lessons learned from history and the value of scientific rigor. The discussion of current events is presented more as a concern for public health rather than a partisan critique.

Mississippi Today

On this day in 1964, Klan killed Henry Dee and Charles Moore

Published

1 day ago

May 2, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-05-02 07:00:00

by Jerry Mitchell, Mississippi Today
May 2, 2025

May 2, 1964

Thomas Moore is holding a 1964 photograph of him and his younger brother, Charles, shortly before his brother was kidnapped and killed by Klansmen, along with Henry Hezekiah Dee.

Henry Hezekiah Dee and Charles Eddie Moore, two 19-year-old Black Americans, were simply trying to get a ride back home. Instead, Klansmen abducted them, took them to the Homochitto National Forest, where they beat the pair and then drowned them in the Mississippi River.

When their bodies were found in an old part of the river, FBI agents initially thought they had found the bodies of three missing civil rights workers, James Chaney, Andrew Goodman and Michael Schwerner.

Thanks to the work of Moore’s brother, Thomas, and Canadian filmmaker David Ridgen, federal authorities reopened the case in 2005. Two years later, a federal jury convicted James Ford Seale. He received three life sentences and died in prison.

Ridgen did a podcast on the case for the CBC series, “Somebody Knows Something.”

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

The post On this day in 1964, Klan killed Henry Dee and Charles Moore appeared first on mississippitoday.org

Political Bias Rating: Centrist

This article presents historical facts about the 1964 kidnapping and murder of two Black Americans by Klansmen. It provides an account of the tragic event, recounting the abduction, the subsequent investigation, and the eventual conviction of one of the perpetrators. The article sticks to reporting the details of the case, including the efforts of Thomas Moore and filmmaker David Ridgen to reopen the case and bring justice. While the subject matter is deeply tied to civil rights, the tone of the article remains neutral, focusing on factual events without pushing a particular ideological stance. The language used is factual and matter-of-fact, presenting the events as they happened rather than offering opinion or judgment, making the content centrist in its approach.