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The only surviving Medicaid expansion bill in the Legislature passed the Senate Medicaid Committee Wednesday and is headed to the full Senate for a vote. 

But the proposal, as it passed the Senate committee, is not considered traditional “expansion” under the Affordable Care Act, and therefore would not qualify for the enhanced federal funding the law grants to newly-expanded states. It would leave the cost of the expanded coverage up to the state.

The Senate committee passed the House Republican bill with a strike-all, meaning it replaced the bill’s original language with its own plan, which Medicaid Committee Chairman Kevin Blackwell, R-Southaven, refers to as “expansion light.”

Blackwell estimated about 80,000 people would be eligible under this version of expansion, and half of that would apply. The House plan was expected to cover more than 200,000 people.

When a draft of the Senate’s bill was leaked on March 20, Blackwell stressed to Mississippi Today that he and Senate leaders were still tweaking parts of the legislation. However, the legislation that passed the committee is essentially the same as what was outlined in the leaked draft. 

The Senate proposal would:

• Cover working Mississippians up to 99% of the federal poverty level. For an individual, that would be an annual income up to $15,060. For a family of four, that would be an annual income up to $31,200.
• Not cover those making between 100% and 138% of the federal poverty threshold — not even through a private-care option. A plan that doesn’t cover people making up to 138% is not considered “expansion” under the Affordable Care Act, meaning Mississippi wouldn’t qualify for the 90% federal match rate that the Affordable Care Act grants to new expansion states, nor the additional, two-year 5% increase in match rate the federal government provides to newly-expanded states under pandemic relief spending passed by Congress. Instead, as was the case with Georgia, Mississippi would only get its regular federal Medicaid rate of about 77%.
• Leave the health insurance exchange, the online marketplace that offers federally subsidized plans to people who make between 100% and 138% of the federal poverty level, intact. The Senate plan, unlike Arkansas’ Medicaid expansion, would not provide extra subsidies from the state’s federal Medicaid money available from the ACA.
• Include a work requirement mandating at least 120 hours of employment a month in a position for which health insurance is not paid for by the employer. That’s more stringent than Georgia’s plan, which mandates 80 hours a month. There are several exemptions, such as for full-time students or parents who are the primary caregiver of a child under six years old.
• Go into effect 30 days after the federal Centers for Medicare and Medicaid Services approves a waiver necessary for the work requirement. That’s unlikely to happen under the Biden administration, which has rescinded work requirements previously approved for other states during the Trump administration and has not approved new ones. If the federal government denies the waiver, Mississippi would have to wait until a new administration took office, or sue the Biden administration. Georgia remains in litigation with the federal government over the work requirement issue, and has suffered low enrollment and missed out on millions in federal funds by not fully expanding coverage.
• Require anyone who voluntarily dropped private insurance to wait 12 months before applying for Medicaid coverage.

Senate Democrats voiced several concerns about the administrative burden of the work requirement and the 120 hour a month minimum, which is even stricter than Georgia’s plan – currently the strictest expansion plan in the country. 

Sen. David Blount, D-Jackson, asked Blackwell about the enhanced match from the federal government.

“So the federal government paying our match for two years and 90% after the two years – we would not qualify for that?” Blount asked.

Blackwell said that is correct, and they would leave that money on the table.

Sen. John Horhn, D-Jackson, introduced two amendments: one to decrease the recertification requirements from four times a year to twice a year, and the other to reduce the work requirement hours from 120 hours a month to 80 hours a month. 

Both amendments were voted down by Republicans, who make up a majority of the committee’s membership. Despite their amendments getting shot down, the Democrats still voted in favor of the bill. Only three Republican senators in the committee voted against the plan. 

When asked about the administrative burden of enforcing the work requirement, Blackwell said he is not worried and believes the Division of Medicaid has enough employees for its implementation. 

But Georgia, the only state currently with a work requirement in its expansion plan, has spent $26 million taxpayer dollars to ensure a mere 3,500 people to date. More than 90% of that has gone to administrative and consulting costs. 

The bill is expected to be taken to a floor vote as early as Thursday, with a deadline of April 10. 

Since the Senate plan is drastically different than the House proposal – which is a mostly-traditional expansion plan insuring those who make up to 138% of the federal poverty level and would go into effect whether or not the federal government approves a work requirement waiver – a final version will likely be hammered out later in the session in a conference committee.

Any final plan would realistically need a two-thirds majority from both chambers to show it has the potential to override a potential veto from Republican Gov. Tate Reeves, who has privately told lawmakers he plans to veto any Medicaid expansion bill.

Reeves on Tuesday night hosted around 20 state senators at the Governor’s Mansion in downtown Jackson where he, again, reiterated his opposition to any form of Medicaid expansion, according to multiple people familiar with the situation. 

At the Tuesday night event, Reeves said he would veto the Senate’s expansion plan if it reached his desk, though he reportedly said he approved the Senate’s work requirement provisions. 

Shortly after the committee passed the expansion legislation, Reeves posted on social media that the Senate plan is “still bad policy” and he will oppose it.

“And so I will continue to do what I told the voters I would do – fight Obamacare Medicaid Expansion with every ounce of my being,” Reeves said.  

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The secretary of state’s office and two advocacy groups on Tuesday asked a court to dismiss a lawsuit brought by the state Republican and Libertarian parties seeking to limit the number of  mail-in absentee ballots during the upcoming presidential and congressional election.  

The Mississippi Alliance for Retired Americans and Vet Voice Foundation, two groups who intervened in the suit, and Secretary of State Michael Watson’s office argued in separate briefings that the federal litigation should be dismissed because the political parties lack legal standing to bring the suit.

“The Mississippi Statute does not harm the plaintiff individuals or political parties in any way,” Special Assistant Attorney General Rex Shannon III wrote on behalf of Watson’s office. “It does not conflict with laws that set the election day for federal offices. And it does not impair the plaintiffs’ rights to vote or to stand for office under the First and/or Fourteenth Amendments.” 

The litigation marks a peculiar scenario where the national and state Republican parties have filed suit over a law that passed a GOP-dominated Legislature and was signed into law by Republican Gov. Tate Reeves. 

Watson, a Republican, is the state’s chief elections administrator and is now tasked with fighting his own political party in court using attorneys from Republican Attorney General Lynn Fitch’s office.

The statute in question is a 2020 law requiring local election workers to count mail-in absentee ballots for up to five days after the election date. The Mississippi law currently permits election workers to count mail-in votes only if the ballots were postmarked by the election date.

Legislative leaders at the time pushed for the law because election officials worried they would have an influx of mail-in ballots to process during the peak of the COVID-19 pandemic.

The national and state GOP and the state Libertarian Party argue that the federal judge presiding over the suit should bar election workers from counting mail-in absentee ballots after Election Day because only Congress gets to determine the procedures for federal elections. 

To support the Republican Party’s argument, Mississippi GOP Chairman Frank Bordeaux wrote in a signed declaration that the statute dilutes the weight of ballots cast on Election Day and harms conservative candidates running for office. 

“Mississippi’s mail-in deadline forces the MS GOP to divert resources and spend money on absentee-specific programs and post-election activities,” Bordeaux wrote. “The mail-in deadline effectively forces the MS GOP to run Election Day activities for an additional week after the national Election Day has passed.” 

The Democratic National Committee, Disability Rights Mississippi and the League of Women Voters of Mississippi attempted to intervene in the litigation, but U.S. District Judge Louis Guirola Jr. denied their request. 

Instead, the DNC and the two advocacy organizations filed a “ friend-of-the-court” brief also arguing the suit should be dismissed because the plaintiffs do not have legal standing. 

U.S. District Judge Louis Guirola Jr. ordered all of the parties to file all responses to the pending motions by April 9 and file responses to the replies by April 16. 

While the litigation is pending, the Republican-majority state Senate passed a bill to abolish the five-day window for processing the absentee ballots after Election Day, but it has not yet passed the GOP-controlled House. Senate Elections Chairman Jeremy England, the author of the bill, said the legislation was not a response to the federal litigation.

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Mississippi Today is pleased to announce Michael Guidry as managing editor.

Guidry, who joined the Mississippi Today staff in February 2024, manages the newsroom’s day-to-day reporting and plans broader editorial strategy.

He previously served as managing editor at Mississippi Public Broadcasting, where he developed skills in audio storytelling as a producer, writer and editor. 

“Michael is a perfect fit for what we’re building at Mississippi Today,” said Adam Ganucheau, Mississippi Today’s editor-in-chief. “He’s a proven newsroom leader, and he knows Mississippi. He also brings us a lot of digital and audio skills that readers can expect to see more of pretty quickly.”

A native of Destrehan, Louisiana, Guidry moved to Mississippi to attend Millsaps College, where he earned a dual Bachelor of Arts in History and Theatre. After graduating, he worked as a public school teacher for more than a decade.

While at MPB, Guidry helped lead a team that received recognitions from the Radio Television Digital News Association, the Mississippi Association of Broadcasters and the Public Media Journalists Association.

MPB’s special feature on Confederate Memorial Day – which he co-produced and co-narrated – received the 2023 Region 9 Edward R Murrow Award for Excellence in Diversity, Equity and Inclusion.

Guidry continues to host MPB’s weekly politics show @Issue.

“As someone who spent years in a space adjacent to Mississippi Today, it became evident the newsroom was quickly becoming a leader in local, nonprofit news,” Guidry said. “I could not be more excited to join a publication dedicated to elevating the voices of Mississippians while holding power to account.”

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Mississippi Today is pleased to announce Geoff Pender as Politics and Government Editor.

Pender, who first joined the Mississippi Today staff as senior political reporter in May 2020, will oversee the day-to-day reporting of Mississippi Today’s politics team.

He brings more than 30 years of experience covering Mississippi politics to the new role.

“If you follow Mississippi politics, you know Geoff Pender,” said Adam Ganucheau, Mississippi Today’s editor-in-chief. “He’s been a vital member of our politics team since 2020, and we couldn’t be more excited for him to now lead it. He’s been a mentor to so many of our reporters, and he’s led several impactful investigations for us. Readers can expect more of that from him in this new job— and if you’re wondering, you’ll also continue to see plenty of his analysis of the state’s biggest stories.”

Before joining Mississippi Today, Pender was political and investigative editor at the Clarion Ledger, where he also penned a popular political column. He previously served as an investigative reporter and political editor at the Sun Herald, where he was a member of the Pulitzer Prize-winning team for Hurricane Katrina coverage. 

A native of Florence, Pender is a journalism graduate of the University of Southern Mississippi and has received numerous awards throughout his career for reporting, columns and freedom of information efforts.

“I truly appreciate this opportunity and appreciate being able to continue working with the great team of journalists at Mississippi Today providing in-depth news coverage at such a crucial time for the state,” Pender said.

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Gov. Tate Reeves’ nominations for the immensely powerful governing board of Mississippi’s public universities do not include a graduate of the state’s historically Black colleges and universities. 

The 12-member Institutions of Higher Learning Board of Trustees will be left with just one alumnus of an HBCU in Mississippi if the Senate approves Reeves’ nominations. Currently, the board has two. 

Also not represented by Reeves’ picks or on the IHL board is Mississippi University for Women, which recently fended off a surprise Senate bill earlier this legislative session to merge it with Mississippi State University. 

A spokesperson for Reeves’ office did not return inquiries from Mississippi Today about how the governor identified the four nominees and if he considered any candidates who had graduated from an HBCU in Mississippi. 

“I’d like to thank the outgoing IHL board members for their years of distinguished public service and many contributions to our state,” Reeves said in a press release. “I wish them all the best in their future endeavors.” 

Reeves’ nominations will seek to fill vacancies left by four of former Gov. Phil Bryant’s IHL appointees who will roll off the board in May. Those include Dr. Alfred McNair, a gastroenterologist who graduated from Tougaloo College. Dr. Steven Cunningham, a radiologist who attended Jackson State University, will be the board’s sole HBCU alum. 

The nominations are already drawing criticism from some lawmakers in the Senate for not equitably representing the state of Mississippi. And the stakes could be high: Lawmakers this session have proposed measures to close three universities or to study efficiency in the state’s university system. 

“Time and time again, the governor speaks about being a governor for all of Mississippi,” said Senate Minority Leader Derrick Simmons, a Democrat from Greenville and a graduate of Jackson State. “These recent appointments show that he is not holding true to the words that he himself speaks.” 

Reeves’ picks may not face significant pushback as the last time the Senate rejected a governor’s nomination for the IHL board was in 1996. 

Appointments to the IHL board come with significant responsibility and power over Mississippi’s public university system. The trustees oversee eight universities that educate more than 86,000 students and support almost as many jobs, according to an economic impact study. 

But historically, IHL has not not always used that power to the benefit of all eight institutions. The board was subject to a long-running lawsuit, settled in 2002, that alleged it had violated the 14th Amendment by not providing adequate funds to Mississippi’s three HBCUs. 

And just last fall, the Biden administration calculated the state of Mississippi owes Alcorn State University more than $250 million over the last 30 years alone. As an 1890 land-grant institution, Alcorn State is supposed to receive equitable funds to the state’s other agriculture college, Mississippi State University. 

Reeves is not the first governor to face criticism for largely appointing graduates of the state’s predominantly white institutions. His appointments hew to a pattern set by his predecessors: IHL appointees traditionally do not have higher education experience and are usually accomplished, and well-connected, attorneys, doctors and business owners. 

They are also often campaign donors. Reeves’ four nominations, whose names and biographies were announced in a press release Tuesday, are no exception and include: 

• Donald Clark, a graduate of the University of Southern Mississippi and the University of Mississippi School of Law, is an attorney at Butler Snow and the law firm’s former chairman. 
• The founding partner of Heidelberg, Steinberger, Burrow & Armer, James “Jimmy” Heidelberg previously sat on the Mississippi Oil and Gas Board and attended the same institutions as Clark. 
• Charles “Charlie” Stephenson serves as the president of the Mississippi State Bulldog Club Board of Directors and graduated from Mississippi State University. 
• Jerry Griffith, who served on the Mississippi Gaming Commission, attended Delta State University. 

Mississippi Today was able to confirm through a database the news organization created last year that at least two of Reeves’ nominations — Clark, Heidelberg and Stephenson — are campaign donors to the governor. Calls to those three nominees were not returned by press time. 

Griffith told Mississippi Today he was on deadline for some articles and could not speak substantively about his nomination until next week but added that “it’s an honor to be appointed by the governor.”

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With both the men’s and women’s NCAA basketball tournaments in full swing, it feels like the women are stealing the show. Caitlin Clark, Juju Watson and Mississippi’s own Madison Booker are quickly becoming household names nationwide. The Cleveland boys weigh in from Breckenridge, where it won’t stop snowing.

Stream all episodes here.

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The House, with one dissenting vote, passed legislation Tuesday that would continue to provide Mississippi private schools millions of dollars from state tax credits to educate foster children and students with a chronic illness or a disability, though the author of the bill could not say how many of those children are actually being educated.

The bill will increase from $18 million a year to $48 million a year the amount of money from tax credits that private schools and charitable organizations that serve foster children can receive. Half of the money would go to the charitable organizations that provide services to foster children and the other half would go to the private schools. A person can make a donation to a private school and receive a dollar-for-dollar tax credit.

According to the Department of Revenue web site, the private schools receiving funds through the tax credits in past years include:

• Jackson Academy, $341,000
• Madison Ridgeland Academy, 397,720
• Canton Academy, 349,295
• Tupelo Christian Preparatory School, 308,900
• Parklane Academy in McComb, $196,500
• Tunica Academy, $141,800
• LeFlore Christian School, $7,500

A long list of private schools receiving funds from the program can be found on the Department of Revenue web site. But what cannot be found is the number of children being helped through the Children’s Promise Act.

When the bill was passed five years ago, it was touted as a method to help foster children and to save the state money by keeping them out of the state foster care system. But the legislation, when it passed, had another section providing the tax credit option to go to schools that educate children “who have a chronic illness or physical, intellectual, developmental or emotional disability” or  who are economically disadvantaged.

Rep. Daryl Porter, D-Summit, asked House Ways and Means Chair Trey Lamar, R-Senatobia, how many children fitting into one of those categories were being educated in the private schools. Lamar, the author of the bill, said he did not have that information but would get it to him.

Lamar said the program has saved the state millions of dollars by keeping foster children out of the state system. He said it had helped countless children.

“It has been a very successful tax credit program,” he said.

Rep. Robert Johnson, D-Natchez, who unsuccessfully offered amendments to try to direct more of the money toward the charities helping foster children and toward poor children, said one of the problems with the legislation is that no one seemed to be able answer to Porter’s question, which is how many students in the underserved categories were attending the private academies.

“Do you know whether they are or are not providing these services in addition to being a traditional private schools?” Rep. Shanda Yates, I-Jackson, asked Johnson.

 “Nobody has made that clear to me. I don’t have anything to show that they do,” said Johnson.

“But you don’t have anything to show they aren’t,” said Yates, who like most of the House voted for the bill.

All of the legislators with the exception of Rep. Jeramey Anderson, D-Moss Point, either voted for the bill or did not vote. Many voted for it because of the foster child component.

But after the vote, Johnson held the bill on a motion to reconsider, offering the opportunity for additional debate on the bill.

The Midsouth Association of Independent Schools, which includes most of the private schools in the state, said in a paper titled “The ABCs of school choice” that tax credits with revenue going to private schools was more advantageous than vouchers.

“Freedom advocates, instead, look for policies like tuition tax credits and tax credits for donations to scholarship funds, to free up resources so that parents and donors can fund their own choices. Such policies expand choice for parents without shifting the burden for their children onto others.”

The House might reconsider the legislation in the coming days. It still must be approved by the Senate before being sent to Gov. Tate Reeves, who has been a school choice advocate, for his approval.

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No one more deeply understands the fraught politics of pushing Medicaid expansion in a red state than North Carolina Gov. Roy Cooper.

When the Democrat moved to expand Medicaid in 2017, the state’s legislative Republicans sued him in federal court to block him. Their years-long opposition to expansion, much like the sustained GOP blockade here in Mississippi, was rooted in little more than blind politics.

The expansion program, of course, runs through the Affordable Care Act, perhaps the biggest legacy of President Barack Obama. The all-too-familiar logic of North Carolina’s Republicans in opposing Cooper’s expansion effort: Obamacare is bad, Republican power is good.

Unsuccessful at first, Cooper got to work. He traveled his state to listen to constituents, and for years he led a coordinated pro-expansion effort. He pieced together a bipartisan coalition that became too powerful for the GOP lawmakers to ignore. Business leaders lobbied, health professionals pleaded, religious leaders prayed.

At long last, in 2023, North Carolina became the 40th and most recent state to expand Medicaid. An overwhelming majority of legislative Republicans — yes, even most of the loudest earlier opponents — ultimately voted yea.

“That was one of the greatest days of my life,” Cooper told me in an interview on Tuesday. “It was a day that changed so many lives, and the people of North Carolina are better off today for it in every way.”

Cooper has been following the high-profile debate of Medicaid expansion in the Mississippi Capitol this year. Here in Jackson, House Republicans overwhelmingly passed an expansion proposal on Feb. 29. But Senate Republicans are stalling and proposing their own plan — one that is so watered down and ineffectual that Mississippi wouldn’t be considered an expansion state if it passes.

As major deadlines approach and the politics heat up, expansion in Mississippi is still far from reality.

The North Carolina governor said he noticed a recent tweet from Republican Gov. Tate Reeves using yet another one of those tired “Obama is bad” lines.

“It’s really quite sad, isn’t it?” Cooper asked me rhetorically.

READ MORE: Hospitals, business leaders suffering FOT — Fear of Tate — on Medicaid expansion

Truthfully, Mississippi Republicans have little reason to care what Cooper has to say. But before you write off his words, know this: Two different times, North Carolinians elected Cooper on the same ballot that Republican Donald Trump won. Let that sink in: A majority of North Carolina voters elected a Democratic governor while casting votes for Trump on the same ballot. He’s clearly trusted and respected by many Republican voters in his state. Few politicians in America could claim that level of crossover support these days.

His popularity, many in the Tar Heel State believe, got Medicaid expanded and will provide health care coverage to an estimated 600,000 North Carolinians.

So when I got a few minutes with the political savant this week, I couldn’t help but ask: What would he say to Mississippi lawmakers as they’re considering expansion?

“Listen to your constituents instead of the partisan rhetoric,” Cooper responded. “You’ll hear from small business owners that they’re having a hard time affording health insurance for their employees. You’ll hear from rural county commissioners and local government officials that their rural hospitals are in danger of closing. You’ll hear from local law enforcement officers that they’re spending a lot of time dealing with people who are mentally ill or have substance use disorder. If you listen to doctors and health care providers, they’ll tell you they’re having a difficult time treating indigent patients. And if you talk to people who are working hard, making a living and just can’t afford health insurance, they’ll tell you this is a great deal for Mississippi.”

Did you catch that? Cooper doesn’t care if Mississippi lawmakers listen to him; he just wants them to listen to their constituents. Considering the vast support for expansion among Mississippi health care leaders, business leaders and voters of all party affiliations, that fundamental political concept has clearly been shelved here in recent weeks.

READ MORE: Senate Medicaid expansion plan shows generosity to the poor — but mostly in other states

North Carolina expansion went into effect in December 2023, so it’s still early days. But what are the effects so far?

“Already we’re seeing thousands of prescriptions being filled, so obviously there were a lot of people who were not getting the regular preventative drugs that they should have,” Cooper said, which one could easily take as a nod toward Mississippians being consistently ranked the unhealthiest populous in the nation.

He continued: “And look, this will help the private sector. It’s one of the reasons we had a number of local chambers of commerce endorse Medicaid expansion. When you have indigent patients who get treated and providers can’t recover the money, they go to the private sector. Studies have been overwhelming in showing that Medicaid expansion can help control private health care costs.”

There’s logic in that answer that mirrors the numerous studies showing expansion in Mississippi would have similar effects. But in this Mississippi debate, logic has too often taken a backseat to pure, unadulterated politics. This is, perhaps, where we could use Cooper’s unique perspective most.

So I ask: Many so-called conservatives in Mississippi are making this exclusively about politics, arguing simply that expansion is not conservative enough. Knowing what you know on the other side of this fight, what would you say to them?

“It saves people money, so it’s conservative. It saves businesses money, so it’s conservative. It saves lives, so it’s conservative,” he said. “… It’s been hard to find people in North Carolina who are against it after we passed it. And it was an overwhelming majority of legislators from both parties who supported this at the end of the day.”

Mississippi lawmakers can listen to Cooper or not. But the guy has been down the very road they find themselves on right now. And the stakes for so many Mississippians couldn’t be higher.

READ MORE: Senate Republicans should know: This is literally life-or-death.

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After swift backlash from existing casinos and some Republican lawmakers, a state House leader says he will let his bill to give special treatment to an unnamed developer to build one in downtown Jackson die in his committee.

In a move that caught gaming regulators and the Mississippi casino industry by surprise, a bill being fast-tracked in the House on Tuesday would have allowed — and provided state support — for a casino on the Pearl River in Jackson.

“As encouragement to the people who had requested this bill and been willing to put their money where their mouth is, so to speak, and offered to invest literally somewhere pushing $1 billion in the city of Jackson — don’t give up hope,” House Ways and Means Chairman Trey Lamar said in a Tuesday committee meeting.

It appears the as yet unnamed developer of this casino would have received unprecedented special treatment never shown another casino in Mississippi, including state financial backing and opening one specific site in a county that otherwise does not allow legalized gambling. The measure would appear to have gone against three decades of state casino policies including a “level playing field” free-market system for potential developers.

The Mississippi Gaming and Hospitality Association, which represents 26 member casinos across the state, also quickly sent a letter in opposition of the move to Gov. Tate Reeves and legislative leaders on Tuesday.

“This legislation will authorize an expansion of gaming that is unprecedented in the 34 years since legal gaming was authorized,” the letter said. “From the inception, legal gaming has been strictly limited to certain statutorily described areas of the state … the three most southern counties … or on the Mississippi River …”

The letter says many casinos have already been hard-hit by legalized gambling in neighboring states and allowing special treatment for one developer to open in Jackson would “divert the single largest source of customers” in state from there and would hurt the river casinos and devastate Vicksburg.

The letter also noted that lawmakers, when they allowed Coast casinos to rebuild onshore after they were destroyed by Hurricane Katrina, made clear gambling would not be expanded beyond the areas already being allowed in 2005. In the past, religious leaders have fought expansion of casino boundaries.

Donn Mitchell, a principal with Mississippi-based Foundation Gaming Group, which owns Waterview Casino in Vicksburg and Fitz Casino and Hotel in Tunica, said the state backing and carveout for an individual developer in Jackson would be unfair to those who have invested millions under current rules. He said the move could have a chilling effect on capital investment in current developments or legal gambling areas statewide — with companies fearing shifting sands of state casino regulations and jurisdictions.

“We are not opposed to competition, and have nothing against Jackson, but changing the rules midstream after we’ve invested tens of millions of dollars — with no state loans — to restore a troubled casino is not fair,” Mitchell said. “We know Jackson needs development, but so does Vicksburg. The two industries in Vicksburg are gaming and the Corps of Engineers and you’re talking about gutting one of them.”

Democratic Rep. Oscar Denton and Republican Rep. Kevin Ford, both from Vicksburg, said they oppose the legislation because it would likely cause residents in the Jackson metro area to stop visiting Vicksburg casinos, a crucial anchor of the Warren County economy.

“Anything this close would affect us greatly with employees, economically,” Denton said. “It would affect us greatly. There’s no question about that. We both want Jackson to thrive. But we want to try and help it another way.”

The House GOP caucus met behind closed doors at noon for its usual weekly meeting, and enough of its members were opposed to ensure the measure didn’t have enough votes to pass the full chamber, according to Ford.

Lamar, a Republican from Senatobia, late Monday filed House Bill 1989, for the state to provide loans and borrow money to help a casino development in the Jackson Capitol Complex Improvement District.

The bill would sidestep the normal processes for a casino, and is aimed at helping only the one developer, unnamed in the bill. It would create a special fund for the project, and provide loans and issue bonds.

Lamar told Mississippi Today on Tuesday morning that the state-sponsored loan spelled out in the legislation would be used to develop infrastructure around the proposed casino site.

“You’re adding a (casino) license on a river that is currently not allowed,” Lamar told Mississippi Today on Tuesday morning. “Right now, the casinos are allowed on the Coast and along the Mississippi River. This would allow the same thing for development on the Pearl River.” 

Both the director of the state Gaming Commission and the head of the Mississippi Gaming and Hospitality Association said they were caught by surprise by the proposal.

Mississippi’s casino industry has been praised for operating on a free-market system, with all developers going through the same licensing and other processes on a level field and the state has not in the past financially helped an individual project. The state has to-date avoided the scandal, corruption and organized crime that some other states have seen with legalized gambling — often centered around permitting and licensing developments.

“Most people look at that (free market system) as what has helped our system be successful,” said Jay McDaniel, director of the Mississippi Gaming Commission. “… All I can tell you is this is pretty much a surprise. The Gaming Commission has not been consulted … The question for me is, who makes the decision who gets that license?”

The bill says the site of the casino development would be within 6,000 feet of the state Capitol, owned by someone already operating a casino and would have a minimum capital investment of $500 million.

The bill would not open up other locations along the Pearl River for casino developments. Instead, Lamar said the bill only allows for developers to construct one, single casino in downtown Jackson because “nobody else has asked.”

“If somebody wants to come in on the other side of the Pearl in Rankin County and put in a competing billion-dollar casino, I’m sure we would look at that as well,” Lamar said. “You want to talk about an economic game changer for downtown Jackson and the CCID. This is 2,000-plus jobs.” 

Larry Gregory, director of the Mississippi Gaming and Hospitality Association, as he waited outside the Ways and Means committee room Tuesday, said he and member casino operators were also caught by surprise by the measure.

A Senate leader on Tuesday said that former Gov. Haley Barbour has recently pushed the casino development with state lawmakers.

Senate leaders, including Lt. Gov. Delbert Hosemann, appeared to know little about the proposal. Hosemann said if the bill comes over from the House, “then I will look at the bill,” and that he would not comment as, “I have not read it yet.”

Senate Finance Chairman Josh Harkins, R-Flowood, Lamar’s counterpart in the Senate, said, “I don’t know really anything about it. I just heard it start being mentioned.”

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Mississippi’s business leaders and hospitals each have formidable lobbies, and neither has been shy over the years about nudging a reluctant state Legislature in one direction or another if it dawdles on an important issue.

But their relative silence (only recently) on the most profound issue before lawmakers in a generation — expanding Medicaid coverage to the working poor — has been deafening.

It could be a life-or-death issue for tens of thousands of people in the poorest of states with many Third World health metrics. It’s a monumental issue for the fiscal stability of foundering rural hospitals. It’s a crucial workforce issue for businesses and economic development. It’s a major financial issue for the state.

FAQ: What is Medicaid expansion, really?

So why are we mostly hearing crickets from two of the most powerful groups in the commonwealth, on an issue in which they’ve both got serious skin in the game?

They appear to be suffering a condition known as Fear of Tate, or FOT. It’s a condition peculiar to the Magnolia State, now into the second term of Gov. Tate Reeves. It usually presents any time there’s a partisan politically charged issue before our leaders. It manifests itself in timidity or political rhetoric replacing thoughtful approach, and bad, sometimes unworkable or downright asinine policy proposals that poorly serve the average Mississippian.

Reeves has worked hard to instill FOT. He plays partisan political hardball. His main policy is “no.” He holds political grudges until the end of time and will get even if possible. And he’s managed to tamp down business lobby influence and darned-near snuffed out the hospital association lobby.

The Mississippi Hospital Association — then including leaders from the state’s largest hospitals — had for years been a vocal advocate for accepting billions of federal dollars to expand Medicaid coverage to working poor and uninsured Mississippians, like most other states have done. Hospitals had grown weary of eating hundreds of millions of dollars a year in costs of treating uninsured Mississippians.

Hospitals did some quick math, and figured $1 billion a year in federal money was more than $0. The hospital association started a ballot-initiative drive to sidestep Reeves and the Legislature and put the issue directly to voters. When the state Supreme Court derailed that drive, the hospital association’s PAC plunked down $250,000 on the campaign of Reeves’ opponent last year, Democrat Brandon Presley, a vocal supporter of Medicaid expansion.

Well, Reeves understandably didn’t like that. It’s unclear what cajoling he did, but the next thing you know, the state’s largest hospitals appeared to catch a case of FOT. They left the Mississippi Hospital Association like it was on fire, and soon thereafter, its longtime director was fired. Just like that, a major political lobby and its efforts at Medicaid expansion were defanged.

But Reeves, steadfast in his opposition to Medicaid expansion, still faced the problem that the proposal was gaining popularity with the public and among some GOP legislative leaders. And despite two terms at lieutenant governor and one as governor, he still had squat for an alternative plan to help poor working Mississippians and struggling hospitals.

Reeves, just 47 days before the 2023 election, came up with a plan to help the hospitals (though his message for uninsured working folks has remained to get a better job with insurance). But he apparently also came to the conclusion that Medicaid and federal help is the only realistic game in town, so he enacted his own Medicaid expansion — expansion of payments to hospitals, and levying a tax on them to cover the state’s share.

Major hospital leaders were pleased with the proposal for them to get about $700 million more in Medicaid money. They appeared to back down on the push for expanded coverage to the working poor.

READ MORE: Gov. Reeves announces 11th hour plan for hospital crisis. Opponents pan it as ‘too little, too Tate’

And since then, some legislative leaders say, hospitals are not coming out strong for the Medicaid expansion because they fear Reeves might taketh away — somehow rescind the increased payments to hospitals. But it would appear, under current state law and federal Medicaid approval for a “waiver” to allow the increased payments, the Reeves administration could not really do that without legislative approval.

Now, after Reeves’ reelection, the Republican-led state House has passed a Medicaid expansion bill. But the Senate, despite Lt. Gov. Delbert Hosemann having expressed openness to expansion for years, has hung fire. Some House and Senate leaders and others at the Capitol say the Senate is seeing an outbreak of FOT on expansion.

The Senate has let its own bill die without a vote, and despite saying it has its own plan forthcoming, it still has not been made public, despite deadlines and the end of the legislative session looming. Reeves has reportedly been threat—er—lobbying senators against expansion, and leaked details of the Senate’s draft plan show it’s pretty much a non-expansion expansion. It would leave hundreds of millions of federal dollars on the table, causing state taxpayers to pay more, and it would insure far fewer Mississippians than the House plan. If enacted, Mississippi would remain on the list of non-expansion states. Some experts and expansion advocates have said it’s likely unworkable and would not receive federal approval.

READ MORE: Senate Medicaid ‘expansion light’ would insure fewer than House plan, turn down federal money

Now for the business lobby, which itself appears to have developed FOT on Medicaid expansion.

Back in July of 2021, Scott Waller, president of the Mississippi Economic Council — the state’s chamber of commerce — said business leaders were preparing to weigh in on Medicaid expansion, and soon.

He said MEC, which has about 11,000 members from 1,100 companies, would soon begin a research drive, including measuring public opinion and polling MEC business leaders on Medicaid expansion and other health care issues. He said he expected the group would take a position and make policy recommendations on expansion before the 2022 legislative session started, because “a healthy workforce is a vital component of moving our state and economy forward.”

But that didn’t happen then, and it still hasn’t happened.

MEC last week issued a social media statement, ostensibly on Medicaid expansion, that was so milquetoast and timid that many legislative leaders questioned what it meant.

“Providing healthcare for working Mississippians is vitally important. It remains MEC’s stated position that legislative leaders ‘find workable solutions and help shape a plan to increase access to healthcare for working Mississippians that explores all available options.’”

Asked for an explanation of what exactly this statement meant and whether MEC supports the expansion plan the House passed nearly a month earlier, Waller said the statement “stands for itself.” He said, “What was stated is the stated position of our board … that the Legislature find a solution.”

If Republican House leaders were hoping for business backing and cover for the bill they had passed nearly a month earlier, that wasn’t it. Just a vague tweet.

The Mississippi Manufacturers Association showed a little more backbone, and actually appeared to endorse the House plan.

“In late Feb., (Speaker) Jason White and the House passed Healthy MS Works, expanding healthcare access to 200,000 Mississippians,” the MMA statement said. “MMA supports improved access to quality healthcare, especially in rural areas, and efforts to promote a healthier workforce.”

But this wasn’t from a Capitol rally, with MMA members front and present on the rotunda steps to get lawmakers’ attention. It was a social media post on a Friday when most lawmakers had already gone home for the weekend.

To date, the most vocal support for expanding Medicaid coverage has come from the religious community, health advocates and doctors and nurses. Groups of preachers and doctors held rallies last week calling on lawmakers to help the Magnolia State’s working poor and uninsured. Mississippi’s American Cancer Society chapter has done yeoman’s work advocating for expansion, and appears to be the only group spending major resources on a public awareness campaign on TV and radio.

Some House members — and some Senate advocates of expansion — have lamented the lack of robust support from two powerful lobbies, whose members at times past have quietly lobbied them to accept the billions of federal dollars being offered, expand Medicaid and help create a healthier workforce.

But as lawmakers attempt to gather and hold a veto-proof majority for an expansion plan under the governor’s threats, FOT appears to be making that harder.

READ MORE: Senate Medicaid expansion plan shows generosity to the poor — but mostly in other states

The post Hospitals, business leaders suffering FOT — Fear of Tate — on Medicaid expansion appeared first on Mississippi Today.