A focus of JXN Water’s new water bill rate structure, which went into effect on Feb. 1, was to reduce costs for low-income customers. But government concerns over violating Jacksonians’ privacy are holding up those discounts.
The new structure raises rates for most Jackson water customers, something city officials and water experts knew would have to happen in order to fund future maintenance and repairs. Even with $800 million in federal dollars coming to assist the water system, the city needs a stable stream of revenue to eventually move it from under the federal government’s control, as well as to pay for much-needed fixes to the also-failing sewer system.
For the 12,500 Jackson residents signed up for the Supplemental Nutrition Assistance Program, or SNAP, the new structure is designed to lower what they pay for water. But JXN Water hasn’t been able to give those customers the discount because it doesn’t know who is eligible. In the federal lawsuit overseeing the water system takeover, JXN Water filed a motion requesting the Mississippi Department of Human Services, which oversees the state’s SNAP program, to identify which water customers receive the benefit.
MDHS responded in a Feb. 22 letter that not only would doing so violate federal privacy rules, but also that the agency doesn’t have the capacity to take on an “unfunded mandate to assist in running (Jackson’s) water system.” As an alternative, the agency wrote, customers could instead volunteer their information to show they receive SNAP and get the water discount.
Attorney for JXN Water Paul Calamita responded during a status conference last month that going that route would dramatically decrease the number of people receiving the discount.
“When the customer has to do something to get a benefit, typically we would see like a 30-percent participation rate … there’s all sorts of reasons: People don’t trust the government, they are embarrassed, they don’t have time, they just don’t understand,” Calamita told Judge Henry Wingate.
JXN Water then filed a new motion asking the federal government to release the SNAP data, and on Tuesday the U.S. Department of Justice responded in opposition. The federal government does not have the SNAP data nor the authority to require MDHS to release the data, the DOJ wrote. Moreover, as MDHS argued, doing so would break laws protecting the privacy of SNAP recipients.
On Wednesday, JXN Water spokesperson Ameerah Palacios said that, for the time-being, customers looking for the SNAP discount will have to reach out to JXN Water and provide proof of their SNAP status.
When it presented the new structure in November, JXN Water estimated that most SNAP customers in Jackson would see a 31% decrease on their water bills under the new system.
Third-party manager for JXN Water Ted Henifin is also at odds with the Environmental Protection Agency. At Monday’s status conference, he criticized EPA for changing the way the agency is paying for federal funds for the city’s water repairs.
Initially, the EPA had sent large chunks of money to JXN Water for Henifin to draw down on and pay contractors doing work such as managing the treatment plants and fixing broken lines. But in the last couple months, the EPA chose to change the policy, and is now asking Henifin to first submit invoices for the work and get reimbursed afterwards.
In the last two status conferences, Henifin pushed back, arguing that the new system is extending how long it takes him to pay the contractors, and that his reputation is at risk as far as being able to pay them. Jackson he said, had already built a reputation in previous years of not being able to pay contractors on time. Henifin on Monday added that there are $10 million in current unpaid invoices.
The DOJ’s Karl Fingerhood, representing the federal government, said that while Henifin may want to pay contractors quicker, the invoices are still being fulfilled within the legally-required 30-day window. The DOJ added that the change came because the EPA had issues with how Henifin was submitting invoices, such as not tying them to specific deposits.
Wingate then sided with Henifin, calling the EPA policy change “unfortunate” and that there was no notice to the court before the switch happened. He also went after the agency for its delay in handling the Jackson sewer case, saying he was “amazed” by how little the EPA did between the 2013 consent decree and last year, when the case merged with the lawsuit over the city’s water system.
Later in Monday’s status conference, Wingate approved unopposed motions to allow groups representing Jackson community members — the People’s Advocacy Institute and the Mississippi Poor People’s Campaign — to be an official party in the water case. Last year, those groups were critical of JXN Water’s transparency, and asked Wingate for more involvement in Henifin’s decision-making, which the judge denied.
Brian Howey and Nate Rosenfield are examining the power of sheriffs’ offices in Mississippi as part of The Times’s Local Investigations Fellowship.
Sentencing hearings this week for six law enforcement officers, some of whom were members of the Goon Squad, revealed a disturbing portrait of a Mississippi sheriff’s department that encouraged deputies to use extreme violence as a policing tool.
Prosecutors, along with several of the deputies who were sentenced, described a toxic culture in which senior officers directed the men they oversaw to humiliate and torture people suspected of crimes.
Young deputies said they saw violence as a way to earn promotions and to live up to the expectations of their supervisors, who were considered heroes of the Rankin County Sheriff’s Department.
In court this week, Christian Dedmon, a former narcotics detective, said that a culture of misconduct reigned at the sheriff’s office and that he rose through the ranks at the department because of his willingness “to do bad things.”
Mr. Dedmon and five other former law enforcement officers from Rankin County were sentenced this week to prison terms for federal civil rights violations stemming from the torture and sexual assault of two Black men, Michael Jenkins and Eddie Parker, in January 2023.
The officers, who pleaded guilty last summer, shocked both men with Tasers and abused them with a sex toy. During what was described as a mock execution, one of the officers shot Mr. Jenkins in the mouth, nearly killing him.
Three of the deputies were also sentenced for their roles in the beating of Alan Schmidt in December 2022, when Mr. Dedmon shocked Mr. Schmidt with a Taser, and then pressed his genitals against the man’s face and bare buttocks while he was handcuffed.
Brett McAlpin in Rankin County Circuit Court in Brandon, Miss., last year.Credit…Vickie D. King/Mississippi Today
Judge Tom Lee of U.S. District Court sentenced the last of the officers Thursday. Brett McAlpin, a senior detective who has been described as the Goon Squad’s ringleader, was sentenced to more than 27 years in prison. Joshua Hartfield, a narcotics detective for the Richland Police Department, received a 10-year sentence.
An investigation by Mississippi Today and The New York Times last year exposed a decades-long reign of terror by nearly two dozen Rankin County deputies, several of them high-ranking investigators who reported directly to the Rankin County Sheriff, Bryan Bailey.
In pursuit of drug arrests, the deputies shoved a stick down one man’s throat until he vomited, dripped molten metal onto another man’s skin and held people down and beat them until they were bloody and bruised, according to dozens who said they had witnessed or experienced the raids.
Residents in impoverished communities in Rankin County have complained that deputies targeted them for years, routinely barging into homes without warrants and violently shaking them down for information on drug use.
Testimony at the hearings this week shed new light on why the violence had been so widespread.
Christopher Perras, a federal prosecutor, said Thursday that Mr. McAlpin had been involved in at least nine incidents over the past five years in which the detective led deputies in “brutalizing people with impunity.”
Mr. Perras said Mr. McAlpin, the former chief investigator, had forced younger deputies “to do his dirty work for him.”
“McAlpin is the one who molded these men into what they became,” Mr. Perras said. “He modeled that behavior for young impressionable officers, and it’s no wonder that they followed his lead.”
Jeremy Travis Paige, a local resident, told reporters last year that he was one of Mr. McAlpin’s many victims. During a 2018 raid of his home in Pearl, Miss., deputies led by Mr. McAlpin waterboarded and beat Mr. Paige until his face was blackened and bloodied. Throughout the encounter, he said, Mr. McAlpin instructed deputies to carry out the attack.
“He was the captain, and they were the hit men,” he said Thursday. “He just sat in the chair and watched them do everything.”
Mr. Paige was one of many people who said they filed federal lawsuits, submitted formal complaints or tried to contact Sheriff Bailey directly to complain about Mr. McAlpin and other deputies’ behavior. He was also one of multiple people who arrived to jail with obvious injuries, according to booking photos obtained by The Times and Mississippi Today.
Jeremy Travis Paige’s booking photo, taken at the Rankin County jail in 2018, shows his battered and bruised face after an encounter with the deputies. Credit: Rankin County Sheriff’s Department
Jeffery Reynolds, a lawyer representing Daniel Opdyke, a former patrol deputy who was sentenced to almost 18 years in prison, said his client viewed Mr. McAlpin as a father figure and followed him “right or wrong, without question.” But while complaints about Mr. McAlpin continued to surface, Mr. Reynolds said, Sheriff Bailey kept promoting him.
“Where’s the true leadership? Why aren’t they in this court?” Mr. Reynolds said.
Sheriff Bailey, who did not attend the sentencing hearings, has repeatedly denied knowledge of his deputies’ actions. But policing experts said the details revealed at the hearings cast further doubt on his claims.
“There were so many red flags in this case, it seems unbelievable to think that higher-ups didn’t have some knowledge of this,” said Chuck Wexler, executive director of the Police Executive Research Forum. “Officers were held accountable for these egregious crimes, but it should not have taken 20 years.”
The governing board of Mississippi’s public universities gave Alcorn State University’s interim president the full appointment on Thursday, forgoing a national search and marking the ninth time in 10 years the board has hired an internal candidate as a top leader.
In a press release, the Institutions of Higher Learning Board of Trustees cited the campus support for Tracy Cook that was shared during listening sessions earlier this year as a reason for his appointment. The board did not hire a search firm, IHL confirmed to Mississippi Today.
Cook had been the university’s interim president since June 2023, and his full appointment will be effective April 1, according to IHL’s press release. He steps into the role at a time when some on Alcorn State’s campus feel the country’s oldest public historical Black land-grant institution has strayed from its heyday.
“There was an obvious desire and call from the Alcorn family for Dr. Cook to be named to this role, and we are putting our full faith and confidence behind this decision,” Dr. Alfred McNair, the trustee who is serving as board president, said in a press release. “He is the right person to lead Alcorn State University.”
IHL could not say what Cook’s salary will be, but his salary as interim president was set at $300,000 last year.
An Alcorn State alumnus, Cook spent most of his career in K-12 education, working in various administrative levels in Jefferson and Claiborne county schools. He came to Alcorn State in 2015 to be the chief of staff when Alfred Rankins, the current IHL commissioner, was serving as the university’s president, Mississippi Today previously reported.
Rankins’ applauded the board’s decision.
“At this juncture in Alcorn’s history, Dr. Cook is the right choice to lead the university to greater prominence,” Rankins said in a press release. “I understand and appreciate the work that lies ahead for him. Alcorn State University is fortunate to have him at the helm.”
After working for Rankins, Cook was promoted to vice president for student affairs in 2019. He also oversaw enrollment management. From fall 2019 to fall 2023, total enrollment at Alcorn State has fallen from 3,523 to 2,894, according to IHL and federal data.
“I am honored to have the trust and support of the Board of Trustees, and excited to officially lead a university that has meant so much to me personally and professionally,” Cook said in a press release. “We have a bright future ahead of us and I am committed to leading us all toward new levels of success.”
IHL is constitutionally empowered to hire the university presidents, and board policies give the 12 trustees immense flexibility in making that decision. In 2022, IHL suspended its search to hire Joe Paul, then the interim president at the University of Southern Mississippi, after he received support during the listening sessions.
And just last year, the board named its deputy commissioner, Marcus Thompson, as president of Jackson State University despite conducting a full-fledged national search.
Brian Howey and Nate Rosenfield are examining the power of sheriffs’ offices in Mississippi as part of The Times’s Local Investigations Fellowship.
A federal judge handed down sentences Thursday to a high-ranking Rankin County deputy prosecutors say was the ringleader of the notorious “Goon Squad” and a local police detective associated with the crew for their roles in the torture and sexual assault of two Black men last year.
Judge Tom Leeof US District Court sentenced former Rankin County chief investigator Brett McAlpin to more than 27 years behind bars.
Former Rankin County law enforcement officer Brett McAlpin, enters Rankin County Circuit Court where he pled guilty to all charges before Judge Steve Ratcliff, Monday, Aug. 14, 2023 in Brandon. Credit: Vickie D. King/Mississippi Today
“McAlpin is the one who molded these men into what they became,” federal prosecutor Christopher Perras said during the hearing. “He modeled that behavior for young impressionable officers, and it’s no wonder that they followed his lead.”
Former Richland Police Department detective Joshua Hartfield also received a 10-year sentence Thursday. Hartfield was the only officer who participated in the violent raid who did not work for the sheriff’s department.
The sentencing is the latest chapter in a saga that has rocked the quiet suburban county near Jackson.
A Justice Department investigation found that McAlpin, Hartfield, and former deputies Jeffrey Middleton, Christian Dedmon, Hunter Elward and Daniel Opdyke handcuffed, beat and shocked Michael Jenkins and Eddie Parker with Tasers during a warrantless raid of Parker’s home in January, 2023.
In a separate incident in December 2022, Dedmon, joined by Elward and Opdyke, shocked Alan Schmidt repeatedly with Tasers before sexually assaulting the man while he was handcuffed.
These incidents were not isolated, prosecutors and the deputies revealed during the hearings this week. In at least nine incidents over the last five years, Perras said McAlpin brutalized people during arrests.
He earned a reputation for training young deputies to mimic his violent tactics, building the Goon Squad from the ground up.
“He didn’t sit at a desk, he beat people. He forced confessions,” Perras said. “If you wanted to advance at the Rankin County Sheriff’s Department, you had to be like Brett McAlpin.”
Hartfield received the shortest sentence of all the involved officers. Of the four others, Dedmon received the stiffest sentence, 40 years; Elward, 20 years; and Opdyke and Middleton, each almost 18 years.
Because he was not a known member of the Goon Squad and was less involved in the torture of Mr. Jenkins and Mr. Parker, Judge Lee said he looked at Hartfield differently and was conflicted about how to sentence him.
“You had no knowledge at the outset of what was planned or likely to occur at the home,” he said. “You were the least involved and the least culpable.”
All of the defendants were ordered to collectively pay $79,000 in restitution to the three victims.
Local activists and attorneys for Jenkins and Parker said the problem is much deeper than just these six officers, and other deputies deserve to be prosecuted for their roles in the abuse.
“This happened over and over again,” attorney Trent Walker said. “It wasn’t the first time they did it, it was the first time they got caught.”
Last year, Mississippi Today and The New York Times exposed a decades-long reign of terror by nearly two dozen Rankin County deputies.
More than 50 people say they witnessed or experienced torture and warrantless raids at the hands of deputies, most of whom have not been charged with a crime.
The Rankin County District Attorney’s Office recently confirmed it is reviewing and dismissing criminal cases involving Goon Squad members, but District Attorney Bubba Bramlett has so far declined to share which cases have been dismissed or how far back in time his review will go.
Several months after the publications released their findings, state lawmakers introduced a bill that would expand oversight over Mississippi law enforcement, allowing the state board that certifies officers to investigate and revoke the licenses of officers accused of misconduct, regardless of whether they are criminally charged.
Several dozen doctors and health care leaders gathered at the Capitol Thursday to advocate for Medicaid expansion and call on Senate leaders – who have remained quiet on the House expansion bill that sits in their chamber – to close the state’s health care coverage gap.
“I’m calling on the Senate to do right and to come up with a mechanism by which these people can have coverage,” Dr. Randy Easterling, former president of the Mississippi State Medical Association, said.
Easterling recounted the story of one working Mississippian named Jimmy who delayed seeking treatment and was diagnosed with multiple myeloma, a type of cancer. He is now on hospice and “probably has two to three weeks to live,” Easterling said.
Easterling’s relative, an insured Tennessean, was diagnosed with the same condition as Jimmy. He received state of the art care in Nashville for his condition, which is treatable in most cases.
“I wish I could tell you that my story about Jimmy was an exception, but it’s not,” Easterling said. “Everybody behind me can tell their own stories about the hundreds and hundreds of people that we’ve seen over our practice time that this has happened to … What makes my relative more deserving than Jimmy? We need to do better.”
Since the Senate let its own Medicaid bill — which was a “dummy” with no details — die, the House measure is the only expansion bill still alive this session. The House bill would increase Medicaid eligibility to Mississippians making up to 138% of the federal poverty level, about $20,000 annually for an individual. The bill, authored by Missy McGee, R-Hattiesburg, and Speaker Jason White, R-West, contains a work requirement for enrollees, but states that the expansion would go into effect even if the federal government does not approve the work requirement.
It would expand Medicaid only to working Mississippians making up to 99% of the federal poverty level, about $15,000 annually for an individual. The plan, which Medicaid Chair Kevin Blackwell, R-Southaven, has referred to as “expansion light,” would be entirely contingent on a work requirement being approved by the federal Centers for Medicare and Medicaid Services.
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.
The Senate proposal has not been released to the public yet. Blackwell declined to comment on the substance of the plan, but stressed to Mississippi Today that he and Senate leaders are still tweaking parts of the legislation.
The Senate has until April 2 to pass the bill through Blackwell’s Medicaid committee and until April 10 to bring it to a floor vote.
Dr. Randy Easterling, Medical Director at Harbor House, is joined by physicians from across the state, endorsing Medicaid expansion and closing the gap in health care coverage during a press conference held at the State Capitol, Thursday, March 21, 2024 in Jackson. Credit: Vickie D. King/Mississippi Today
It’s estimated that traditional Medicaid expansion would insure roughly 123,000 uninsured Mississippians. Currently, a Mississippian must have children and be making less than 28% of the federal poverty level to qualify for Medicaid coverage. For a family of two, such as a single mother and her child, 28% of the federal poverty level would be about $5,700 a year.
Tens of thousands of working Mississippians fall into the “coverage gap,” making more than 28% of the federal poverty level, but not enough to receive subsidies that would make private health insurance affordable.
In addition to insuring more Mississippians, expansion would also reduce the risk of rural hospital closure by 62%, according to a report by The Chartis Center for Rural Health.
Right now, Mississippi hospitals lose hundreds of millions of dollars a year in uncompensated care costs, or money spent treating uninsured patients. That directly impacts the financial health of hospitals, with one report putting almost half of Mississippi’s rural hospitals at risk of closure.
“It’s a tremendous burden on the health system,” said Dr. Claude Brunson, an anesthesiologist and the association’s executive director. “The whole system depends on us being able to take care of people, and we fund that through people on insurance. And when you go out to the rural areas of our state, there are a lot of people with no insurance but they need care. And they could have insurance, and that would help stabilize those hospitals there, those practices there, so that we can keep them open. If we can keep the hospitals open, we can actually see those patients in their hometowns, in their communities, and that’ll give us the ability to improve the health of Mississippi.”
At least four people have died in suspected domestic violence crimes across the state since the Legislature has been meeting and failing to advance measures to help stem the violence and support survivors.
At the end of January, a Canton man shot and killed his wife. In February, Tupelo police responding to a domestic incident shot and killed a man who threatened another person with a gun. This month, a woman was found dead at a Stone County store, and the man suspected of killing her shot at a sheriff’s deputy before dying from a self-inflicted gunshot.
The number of domestic violence fatalities could be higher, but it’s impossible to know because of a lack of data, advocates say.
“We don’t even have accurate data in the state to show a true picture of what domestic violence looks like,” said Stacey Riley, CEO of the Gulf Coast Center for Nonviolence Inc. in Biloxi, which operates two shelters and serves six counties.
House Bill 842 would have established a multi-agency, statewide board to review suspected domestic violence fatalities and suicides, and the board would have collected that data and used it to make recommendations to the Legislature about proactive measures to decrease the deaths.
When a domestic violence fatality occurs anywhere in the state, it’s often categorized as a homicide, Riley said. Typically, it’s news stories that report whether domestic violence was involved, she said.
The Mississippi Coalition Against Domestic Violence championed the legislation and lawmakers from both parties have supported the bill, but it did not make it out of the House’s Judiciary B Committee.
“One is too many,” Rep. Fabian Nelson, D-Byram, one of the bill co-sponsors, said about domestic violence deaths.
Several other bills relating to domestic violence and abuse also did not advance this session including:
House Bill 252 by Rep. John Hines Sr., D-Greenville, would have required school districts to adopt curriculum about dating violence and healthy relationships.
House Bill 435 by Hines would have established domestic abuse courts in every county. Hines has introduced this legislation for over a decade.
House Bill 800 by Rep. Oscar Denton, D-Vicksburg, would have allowed chancery courts to issue temporary domestic abuse protection orders. Currently, these orders are issued by the justice or municipal court.
Luis Montgomery, public policy and compliance specialist for MCADV, said the organization plans to work with lawmakers next session to reintroduce the review board legislation.
He said the bill’s failure to advance was a technical issue. The original draft of the bill had the review board under the state medical examiner’s office. After learning that office couldn’t house the board, an effort was made to revise the bill to place the board under the state Department of Health, but by that time the committee deadline passed, Montgomery said.
Riley and others who work with domestic violence survivors said they are disappointed that the review board won’t become law this year, but they are hopeful it will in the future. In the meantime, they say domestic violence remains an issue in need of attention.
Rebecca Stewart, executive director of The Domestic Abuse Family Shelter Inc. based in Laurel which serves 11 counties, said data can provide valuable insight. It would allow the group to examine events that led up to a fatality and know about gaps in response, which can help with intervention efforts.
She hopes the Legislature will take a more in-depth look at domestic violence and lawmakers will ask questions to understand more about the issue and what can be done about it.
“I encourage them to really ask their constituents what do you want to see because there are a lot of people out there who are survivors of domestic violence, vicitms of sexual assault,” Stewart said. “We wouldn’t ask for something (the review board) if it wasn’t important.”
Former Noxubee County Sheriff Terry Grassaree plans to plead guilty in the federal case where a woman alleges he demanded she take sexually explicit photographs and videos of herself in jail — and then share them with him.
The Mississippi Center for Investigative Reporting at Mississippi Today and The New York Times highlighted Grassaree in its series, “Unfettered Power: Mississippi Sheriffs,” which showed how sheriffs can rule like kings in rural counties. They answer to no one and typically face little press or prosecutorial scrutiny.
In a 2020 lawsuit, Elizabeth Layne Reed accused two deputies, Vance Phillips and Damon Clark, of coercing her into having sex. She said the men gave her a cellphone and other perks in exchange for sexual encounters inside and outside the jail. Deputies even put a sofa in her cell.
According to her lawsuit, Grassaree knew all about his deputies’ “sexual contacts and shenanigans,” but the sheriff did nothing to “stop the coerced sexual relationships.”
In response, Grassaree has previously denied any knowledge of what his deputies were doing. “Are you a boss?” he asked. “Do your employees tell you everything they do?”
Instead of intervening, the lawsuit alleged, the sheriff “sexted” her and demanded that she use the phone the deputies had given her to send him “a continuous stream of explicit videos, photographs and texts” while she was in jail. She also alleged in the lawsuit that Grassaree touched her in a “sexual manner.”
The lawsuit was settled for an undisclosed amount.
The original federal indictment accused Grassaree of using his cellphone to facilitate a bribe, which experts say could have been the perks the woman says she received.
One of those deputies, Phillips, pleaded guilty last year to bribery. Prosecutors asked for his sentencing to be postponed “pending a resolution of another criminal matter,” an obvious reference to Grassaree’s case.
The judge granted the request, and no date has been set yet for Phillips’ sentencing.
The other deputy, Vance, wasn’t charged. “I never coerced Reed into sex,” he wrote in his response to the lawsuit, but he never answered whether he had sex with her.
Under Mississippi law, it is a crime for officers to have sex with those behind bars, and the felony carries up to five years in prison.
The superseding indictment accuses Grassaree of lying to the FBI, destroying evidence and wire fraud.
In this 2000 photo, Noxubee County Deputy Terry Grassaree kneels on the neck of Teronto Calhoun, a 20-year-old he arrested for resisting arrest. Credit: Scott Boyd/The Macon Beacon
According to a document filed by his attorney in U.S. District Court, Grassaree plans to plead guilty to charges, but does not specify which ones. If he pleaded guilty to all of them, he could face up to 90 years in prison.
Nearly two decades ago, Grassaree faced allegations of rape inside the jail that he supervised and lawsuits claiming that he covered up the episodes. At least five people, including one of his fellow deputies, accused him of beating others or choking them with a police baton.
In 2006, after Grassaree and his staff left jail cell keys hanging on a wall, male inmates opened the doors to the cell of two women inmates and raped them, according to statements the women gave to state investigators. One of the women said Grassaree pressured her to sign a false statement to cover up the crimes, according to the state police report.
About a year later, in a lawsuit, four people who had been arrested gave sworn statements accusing Grassaree of violence. Two of the people said he choked or beat them while they were in his custody. A third said he pinned her against a wall and threatened to let a male inmate rape her.
All told, at least eight men — including four deputies and Grassaree himself — have been accused of sex abuse by women inmates who were being held in the Noxubee County jail while Grassaree was in charge.
Now, 18 years after a woman first said that he pressured her to lie about being raped, the former sheriff faces possible prison time.
In an interview from 2023, Reed said she wanted the public to know what happened to her in the hope that others would come forward. “Women in jail and prison need to be protected, she said.
In 2018, when Mike DeWine was Ohio’s attorney general, he began investigating an obscure corner of the health care industry.
He believed that insurers were inflating prescription drug prices through management companies that operated as middlemen in the drug supply chain. There were concerns that these companies, known as pharmacy benefit managers, or P.B.M.s, were fleecing agencies like Medicaid, the government-run health insurance program for the poor.
Three years later, after Mr. DeWine became governor of Ohio, the state announced an $88 million settlement with one of the nation’s largest insurance companies, Centene.
The case led to a nationwide reckoning for the company, as attorneys general in one state after another followed Ohio’s lead, announcing multimillion-dollar settlements and claiming credit for forcing Centene to reform its billing practices.
On the surface, it appeared that these settlements, which now total nearly $1 billion, were driven by state governments cracking down on a company that had ripped off taxpayers.
But a New York Times investigation, drawing on thousands of pages of court documents, emails and other public records in multiple states, reveals that the case against Centene was conceived and executed by a group of powerful private lawyers who used their political connections to go after millions of dollars in contingency fees.
The Centene case was organized by at least four law firms, several with close ties to former Gov. Haley Barbour of Mississippi. Credit: Rogelio V. Solis/Associated Press
The lawyers were first hired in Ohio, without competitive bidding. Then, they gathered evidence against Centene of questionable billing practices across the country.
Using information they acquired from Centene and other sources, they negotiated with the company to set the basic framework of an agreement that could be applied in other states. With that in hand, they approached attorneys general in multiple states and made a compelling offer: hire them, at no direct cost to taxpayers, and recoup millions of dollars Centene had already set aside.
So far, the lawyers have been awarded at least $108 million in fees.
The Centene case is just one example in a thriving industry that allows private lawyers to partner with elected attorneys general and temporarily gain powers usually reserved for the government. Under the banner of their state partners, these lawyers sue corporations and help set public policy while collecting millions of dollars in fees, usually based on a percentage of whatever money they recoup. The practice has become standard fare in the oversight of major industries, shifting the work of accountability away from legislators and regulators to the opaque world of private litigation.
Private lawyers do not have to publicly defend the deals they make or prove how aggressively they went after a company accused of wrongdoing. Nearly all their work happens in secret, especially if companies settle before the stage of a lawsuit when evidence is filed with the court.
The lawyers do not even have to disclose who worked on a case or who was paid, so the public may be left unable to monitor potential conflicts of interest even as the lawyers pursue litigation on behalf of the people.
The Centene case was organized by the Mississippi-based law firm Liston & Deas along with at least three other firms, several with close ties to former Gov. Haley Barbour of Mississippi, who was once considered one of the most influential Republican power brokers in the nation.
The Mississippi Division of Medicaid office in Jackson. Credit: .Rory Doyle for The New York Times
The lawyers included Paul Hurst, who served as Mr. Barbour’s chief of staff when he was governor and who married into Mr. Barbour’s family, and David H. Nutt, one of the richest men in Mississippi, who amassed a fortune funding state lawsuits against tobacco companies. Cohen Milstein, a huge national law firm with deep experience in contingency work for state attorneys general, was also part of the venture.
Though he is not listed in any government contracts as a lawyer of record, Mr. Barbour himself was a member of the legal team when Liston & Deas vied for the contract in Ohio.
At the time, Mr. Barbour also worked for Centene as a federal lobbyist.
Even now, close to three years after Centene signed its first settlements, no one has fully explained Mr. Barbour’s role in the case for the company. There is no way for the public to know whether he influenced the outcome or to measure whether Centene paid its full share, because the data used to calculate what Centene overcharged remains hidden from the public under provisions designed to protect attorney work product.
Mr. Barbour and other lawyers said that the former governor worked on the case for less than a year when the group was examining several insurance companies, and that he cut ties when Centene emerged as the primary target. Mr. Barbour said he informed Centene and his colleagues about the development and was never involved in negotiations or legal matters. He continued representing Centene as a lobbyist, he said, but his role in the case on behalf of the company was as “more of an observer.”
The lawyers said that Mr. Barbour was never paid for his work and that the settlement was not influenced by Mr. Barbour’s connections to Centene or to the lawyers who remained. They said each state attorney general reviewed Centene’s billing practices when deciding whether to enter a settlement agreement.
In recent years, P.B.M.s have been widely criticized, including by members of Congress, who have held multiple hearings and proposed legislation. The Centene settlements stand as the most successful attempt to hold a company operating in the industry accountable.
Liston & Deas and its partner law firms uncovered that Centene had arranged discounts with CVS Caremark on certain drugs and then pocketed the savings instead of passing them on to Medicaid. In some states, they revealed that Centene layered on unnecessary management fees that it had not disclosed. Although Centene settled without admitting guilt, the company agreed to be more transparent in how it sets reimbursement rates.
The lawyers noted that they spent several years investigating Centene and negotiating with the company at their own risk, saving states the cost of building a case.
Mr. Nutt, one of the lawyers who pursued the case, said states were happy with the terms of the settlements.
“Almost every one of those states audited to determine if our damage model was fair,” Mr. Nutt said.
“The formula was based on a triple damages model that we developed. And everybody was quite satisfied with it, because it was three times what anybody could have proven in court.”
Hiring Outside Counsel
For most of their history, state attorneys general were largely focused on advising state officials on legal matters and representing local agencies in court.
That changed drastically almost 30 years ago, when states came together to sue tobacco companies and won a $206 billion settlement to cover the cost of medical care related to smoking. The lawsuit helped redefine the role of the attorney general as one of the most powerful positions in state government and a natural place to start a political career.
Through high-profile lawsuits against corporations, an attorney general could directly affect policy and build a reputation as a champion of the people.
But complex litigation against large companies can require years of investigation and legal work, with no guarantee of success. Increasingly, states have turned to private lawyers willing to work on contingency as a way to stretch limited resources.
The rise of contingency fee cases kicked off a new wave of lobbying across the nation. Law firms looking for contracts have poured money into attorney general election campaigns and sponsored conferences at high-priced resorts, where private lawyers mingle with attorneys general and pitch their latest ideas for lawsuits.
Many states have capped how much lawyers can be paid in contingency fees and have increased oversight of private firms working for the government. But there remains concern about undue political influence and potential conflicts of interest.
The heads of the nation’s largest tobacco companies at a 1994 congressional hearing about the contents of cigarettes. The success of state litigation against the tobacco industry helped transform the role of attorneys general. Credit: John Duricka/Associated Press
“In theory, there’s an incentive to have the settlement be as big as possible, and of course that’s great for the state,” said Paul Nolette, a professor at Marquette University who has studied how the role of attorneys general has changed over time.
But in reality, lawyers have an incentive to recover the largest amount of money in the shortest amount of time, which could pressure them to water down settlements and compromise on punitive measures, Dr. Nolette said.
“I think that does raise some questions about how forcefully A.G.s and private attorneys are prosecuting a particular case,” he said.
Several experts said that contingency cases had recouped billions of dollars on behalf of the public and had become a critical way to regulate the behavior of powerful industries and large corporations.
But inviting private lawyers to help set public policy has inherent risks, they said.
Private lawyers may be more likely to have conflicts of interest because they generally represent many businesses and individuals, not just the citizens of a state.
And unlike most attorneys general, private lawyers are not elected officials. They are not generally governed by open records laws or subject to public pressure, as from legislators setting their budgets.
In the Centene case, Mr. Barbour’s associations with both Centene and the private lawyers raise “important questions” about who controlled the case to make sure it was pursued in the best interests of states that settled, said Kathleen Clark, a professor of legal ethics at Washington University in St. Louis.
“Did state A.G.s proactively pursue these cases, or did they passively accept the ‘free money’ or ‘easy money’ of the proposed settlements that the law firms had already negotiated with Centene?” Ms. Clark asked.
Christina Saler, a partner at Cohen Milstein, said Mr. Barbour’s early association with the legal team was not a conflict of interest because Mr. Barbour withdrew from the case before lawyers started investigating Centene.
“After Mr. Barbour’s disassociation, we had no further contact with Mr. Barbour on this matter,” she said.
A Well-Connected Team
Mr. Barbour’s involvement in the Ohio case against P.B.M.s illustrates the potential for favoritism when states hire private lawyers.
Mr. Hurst noted the involvement of Mr. Barbour when seeking the contract in Ohio, according to emails acquired from the Ohio attorney general’s office through a public records request.
In a June 22, 2018, email exchange, just a few days before the state hired Liston & Deas, Mr. Hurst recalled meeting with the attorney general’s staff in Ohio.
Mr. Hurst went on to note that members of his team had worked with Governor Barbour while he was in office and that they all “continue to work together now.”
In an email a week later, an assistant attorney general shared Mr. Barbour’s cell number with Mr. DeWine, saying that Mr. Barbour had shared it so he could “call him about this case anytime.”
Mr. Barbour, who had served two terms as governor of Mississippi, was a former chairman of the Republican Governors Association and a former chairman of the Republican National Committee. Known as a prolific fund-raiser, he was credited with bringing in hundreds of millions of dollars to support Republican candidates across the nation.
In 1991, Mr. Barbour co-founded BGR Group, a lobbying firm that quickly became one of the most influential in Washington.
A portrait of Mr. Barbour, right, at the State Capitol in Jackson. He was Mississippi’s governor from 2004 to 2012. Credit: Rory Doyle for The New York Times
Two decades later, when Mr. DeWine was in the midst of a hard-fought campaign for governor, Mr. Barbour’s close associates solicited him for the legal work on the Centene case. In October 2018, less than three months after Mr. DeWine hired Liston & Deas, he traveled to Washington to visit Mr. Barbour’s lobbying firm for several hours, according to calendar records.
At the time, Mr. Barbour and others at BGR were registered lobbyists for Centene.
Mr. Barbour has never been named in state contracts as one of the private lawyers on the case in Ohio or anywhere else. His involvement has rarely, if ever, been publicly reported.
Ms. Saler, of Cohen Milstein, said there was no need to inform state officials because Mr. Barbour had not been involved in the Centene portion of the case and had exited the venture several years before states hired the lawyers.
At least four law firms were involved in the case in two or more states, according to retainer agreements and financial records showing broadly how settlement funds were disbursed.
According to Max Littman, a former data analyst with HealthPlan Data Solutions, the analytics firm that helped identify Centene’s overcharges in Ohio, one important role for many of the lawyers was to use their connections as they presented the overcharges to various states.
Mr. Littman, who said he worked closely with the legal team, described the dynamic: Liston & Deas, with roots in a deeply red state, would approach Republican attorneys general, and Cohen Milstein, “who were our Democrats,” would focus on Democratic states.
When The Times asked for records showing Liston & Deas’s qualifications to be hired to represent the State of Ohio, the attorney general’s office said no records existed. Cohen Milstein and other law firms had submitted such documentation in the past when seeking contracts in Ohio.
Settling With States
In June 2021, nearly three years after Ohio hired its outside counsel, two states announced the first settlements with Centene on the same day: Ohio would get $88 million, Mississippi $55 million.
After that, Centene settled in one state after another, often with just months between announcements.
In fact, Centene had already set aside $1.1 billion to handle all subsequent cases. The company estimated the amount after early discussions with the private lawyers that did not involve the state attorneys general who would later work with them.
David Nutt & Associates and Liston & Deas, both based in Ridgeland, Miss., worked on Centene settlements in multiple states. Credit: Rory Doyle for The New York Times
With a settlement in hand and an estimate of how much each state could collect, the private lawyers had a powerful pitch. The team also had the option to file whistle-blower lawsuits, which can advance without a state attorney general’s having to hire outside counsel.
The team pursued whistle-blower lawsuits in Texas, California and Washington.
In Texas, the whistle-blower lawsuit came with a benefit for Attorney General Ken Paxton: Under Texas law, his office is allowed to recoup “reasonable attorney’s fees” for work associated with such cases. It collected nearly $25 million in legal fees on the Centene case while spending just 561 hours on it, financial records show. That comes out to more than $44,000 per hour of work. The Texas attorney general’s office declined to comment.
Ms. Saler said all the state attorneys general decided their own strategies in reaching settlements with Centene based on the best interest of taxpayers in their states.
In states that hired the lawyers on contingency, the attorney general closely reviewed Centene’s billing practices. But no state has revealed whether its own overcharge calculations matched those of the private lawyers.
State officials who hired Liston & Deas and the other firms knew that the lawyers had previously negotiated with Centene. But in a vast majority of states, officials did not explicitly address that fact when talking publicly about the settlements.
In addition, Liston & Deas and most of the states the firm worked for have not revealed exactly how much Centene overcharged for drugs or how settlement amounts were calculated. A few states have offered sparse descriptions, which vary widely.
The New Hampshire attorney general’s office wrote in its settlement announcement that Centene’s activities had a “$2.4 million negative financial impact.” Centene agreed to pay the state nearly 10 times that amount.
The attorney general’s office in Washington, one of the few states where officials agreed to discuss basic details about the settlement with The Times, said the $33 million it recovered amounted to treble damages.
A news release from the California attorney general’s office said the state recovered double its damages, for a total settlement of more than $215 million.
As of last month, Centene had settled in at least 19 states. The Liston & Deas website says Centene will ultimately pay about $1.25 billion to 22 states.
A Sweetheart Deal?
Some observers believe Centene would have faced stricter penalties if the federal government had taken up the case instead of private lawyers hopscotching from one state to the next.
Several experts in health care fraud litigation and whistle-blower cases said the best way to recoup money for taxpayers would have been to file a federal whistle-blower case, similar to what the lawyers did in state court in Texas and California.
A federal case could have triggered the involvement of the Justice Department, which might have investigated Centene more thoroughly. And a federal case probably would have gotten more attention and media coverage, required more transparency and taken longer to complete, the experts said.
Mr. Hurst and other lawyers in the case said they had not filed any type of federal action against Centene.
A spokesperson for the Justice Department confirmed that it had inquired about the P.B.M. and Centene cases in Ohio, but no further federal action was taken. The department declined further comment.
Mary Inman, a lawyer at Whistleblower Partners L.L.P. with decades of experience, said one of the reasons Liston & Deas wound up in state court might have been that its case relied on whistle-blowers the federal government was unlikely to approve.
The whistle-blower in Texas was Mr. Hurst. In California, the whistle-blower was Matthew McDonald, a lawyer at David Nutt & Associates and the son of Bryan McDonald, who worked in Mr. Barbour’s administration when he was governor.
Ms. Inman said whistle-blowers are typically insiders with firsthand knowledge of wrongdoing who share information at some risk to themselves, not lawyers who gain information while on the job.
“It’s very unusual,” Ms. Inman said. “And it’s something that I, as a longtime lawyer in this space, I would not want to do because atmospherically and reputationally it doesn’t look great.”
Mr. Barbour said he believes everyone walked away from the settlements happy — including executives at Centene. As evidence, he cited the company’s stock performance.
“I can’t speak for them, but if I had agreed to pay a big settlement and my stock went up after the first day, I would think it was a pretty good settlement,” Mr. Barbour said.
Senate leaders this week are trying to drum up votes for a Medicaid “expansion light” proposal that would cover far fewer uninsured Mississippians — about 49,000 less — than a House-passed bill and would leave hundreds of millions of federal dollars on the table.
Joan Alker, executive director of Georgetown University’s Center for Children and Families and a Medicaid expert, told Mississippi Today that the Senate’s approach would do little to address Mississippi’s need for a healthy workforce and very few people who need health insurance coverage to protect them from high medical bills would get it.
“It is also a very fiscally irresponsible approach for Mississippi’s taxpayers as the state would be turning down $690 million that the federal government has put on the table for Mississippi’s health care system,” Alker said.
A draft of the Senate proposal was provided to Mississippi Today on Wednesday. Senate leaders have said for weeks they had a Medicaid plan forthcoming, but it has yet to be made public or presented for a committee vote. The House passed its HB1725 expansion bill in February.
The Senate draft 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 FPL — 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 ACA 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 FPL, 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 6-years-old or younger.
Go into effect 30 days after CMS 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 CMS 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 Medicaid Committee Chairman Kevin Blackwell, a Republican from Southaven who authored the proposal, declined to comment on the substance of the proposal, but he stressed to Mississippi Today that he and Senate leaders are still tweaking parts of the legislation.
Since the Senate let its own Medicaid bill — which was a “dummy” with no details — die, the House measure is the only expansion still alive this session. The Senate Medicaid Committee is expected to insert the Senate proposal as a “strike-all” amendment.”
While House Bill 1725 – which overwhelmingly passed the House – also has a work requirement, it is only a “best-case scenario.” The bill has a provision that if federal authorities do not approve the waiver necessary to allow a Mississippi work requirement by Sept. 30, 2024, Medicaid would still be fully expanded to people up to 138% of the federal poverty level, starting in January 2025. That means under the House plan, Mississippi would receive the 90% federal match, as well as an additional nearly $700 million that would make expansion free to the state in the first two years of its adoption.
Since the Senate plan is drastically different than the House proposal, a final version would almost certainly be hammered out later in the session in a conference committee.
Blackwell’s proposal would insure less people, but his plan could be a way to convince more Republican senators, who have been more skeptical about expansion than their House counterparts, to vote in favor of the legislation.
The realpolitik is any final plan would have to pass the House and Senate by a two-thirds majority to show it has the potential to override a potential veto from Republican Gov. Tate Reeves.
Reeves has privately told senators that he plans to veto a Medicaid expansion bill if it reaches his desk and has been a vocal opponent of expanding Medicaid coverage.
The deadline for the bill to pass Senate committee is April 2, with an April 10 deadline to pass the Senate floor.
