Gov. Tate Reeves renewed his call to eliminate the personal income tax, a major source of state revenue, in the first budget proposal of his second term.
The Republican governor’s proposal would phase out the income tax, which currently accounts for about 30% of the state general fund, by 2029. An earlier $525 million cut in the income tax, passed during Reeves’ first term, is currently being phased in.
“My objective this year is to keep our state’s momentum going — for all Mississippi,” Reeves said in a statement.
Overall, Reeves is proposing a state-support budget of $7.96 billion — an increase of $120 million or 1.5% over the budget passed by the Legislature and signed into law by Reeves for the current year. The new budget year begins July 1. Legislators are scheduled to finalize a budget for the upcoming fiscal year in April or May.
Reeves is proposing $100 million for development “in every region of our state” of potential sites for major economic development projects. In 2023, the Legislature approved $20 million for site development.
“Project-ready sites are the lifeblood of economic development, and Mississippi will continue winning new business as long as they are available,” Reeves said in his budget narrative.
Additional funds are being proposed in the governor’s budget for workforce training and to improve ports and airports. Reeves also is calling for “adding capacity” to I-55 in DeSoto and state Highway 7 in Lafayette County “to entice additional companies to Mississippi.”
In the budget narrative, Reeves committed to increasing the rate paid to hospitals through Medicaid managed care, resulting, he said, in an additional $70 million for Mississippi hospitals — most of which are financially stressed and many of which are in danger of closing or reducing services.
Legislative leaders are considering other options for the state’s stressed health care system, such as expanding Medicaid to provide coverage for primarily the state’s working poor and providing an additional stream of revenue for hospitals. Reeves has consistently opposed Medicaid expansion and did not address the issue in his budget narrative. Medicaid expansion would garner more than $1 billion annually in federal funds.
Reeves is proposing $10.4 million to increase the state police force patrolling in portions of Jackson to 235 officers. Some have criticized efforts by the state to expand its police presence in Jackson, saying instead the state could provide funds to supplement the Jackson Police Department.
In the area of education, Reeves renewed his call for legislators to pass his Patriotic Education Fund.
“No American child should be taught that the United States is an inherently evil nation that solely acts in its own self-interest,” Reeves wrote in the budget proposal. “Unfortunately, that worldview is being taught by radical activists in too many schools across the country, and that’s why Mississippi must take proactive steps to ensure this warped ideology does not infiltrate our state’s schools.”
The governor is proposing $5 million for grants to schools that choose to teach positive American history.
He also is proposing an additional $1.8 million for special needs children to attend private schools.
The governor does not provide any additional funds for the chronically underfunded formula that provides the state’s share of the basics to operate local school districts. The Mississippi Adequate Education Program was underfunded $176 million for the current school year and $3.5 billion since 2008.
Reeves’ budget narrative also calls for legislators to pass a “parents bill of rights” that would ensure “that parents represent the sole decision-making authority for their children.”
He’s also proposing a women’s bill of rights, which “would unequivocally recognize the distinct biological differences between men and women and would place this language clearly and concisely into law.”
Twelve Senate Democrats did not vote for a resolution Thursday honoring U.S. Sen. Cindy Hyde-Smith as being the first woman elected to represent Mississippi in Washington because she is blocking a vote on the nomination of Scott Colom to a federal judgeship.
“As Democrats we support women being elected to political office,” said Sen. Derrick Simmons, D-Greenville, who is the chamber’s minority leader. But Simmons said the decision not to vote on Hyde-Smith’s resolution was to bring attention to her refusal to allow the U.S. Senate to vote on Colom’s nomination by President Joe Biden to serve as a federal judge in the Northern District of Mississippi.
Because of a sometimes-honored U.S. Senate tradition, senators from the home state of a nominee for the U.S. district court can block a vote on the nominee by refusing to return a so-called “blue slip.” Colom’s nomination has bipartisan support from Roger Wicker, Mississippi’s senior U.S. senator, and also from former Republican governors Haley Barbour and Phil Bryant.
“Democrats are concerned with Cindy Hyde-Smith holding up the nomination of Scott Colom,” Simmons said. “No Democrat opposes the worth of the resolution honoring her. But we do feel that it is important that the federal posts in Mississippi that deal with law and order be filled. We support Scott Colom’s nomination just like a broad range of people.”
No member of the state Senate voted against the resolution that now goes to the House. But 11 of the 16 Senate Democrats did not vote. A 12th, Brandon Blackmon of Canton, voted present. The resolution actually was voted on twice due to procedural issues. The first time Blackmon voted for it. Four other Democrats voted for the resolution both times it was offered.
In the past, Hyde-Smith has said she is blocking the nomination of Colom, the first African American elected as district attorney for the 16th District in north Mississippi, because he opposed legislation banning trans women from competing in women’s sports.
While Colom has voiced general support for trans rights, he has never publicly commented on the issue of trans women competing in women sports.
Hyde-Smith also said she opposed Colom because a political action committee funded at least in part by billionaire George Soros spent funds on his first election to the office of district attorney in 2015. Soros, a New York billionaire, has supported criminal justice reform and other issues such as governmental transparency. Colom has said he did not know the PAC had received campaign contributions from Soros until it was reported in the media.
The blue slip process that Hyde-Smith is using to block a vote on Colom’s nomination began as a method to preserve segregation and racial discrimination in the South.
Starting in the 1950s, U.S. Sen. James Eastland of Mississippi was the first Senate Judiciary Committee chair to use the process to allow a single home-state senator to block a presidential nominee to the federal bench. Eastland used the process to block federal judges from being appointed in Southern states sympathetic to school desegregation, according to multiple accounts detailed in news stories and scholarly research articles.
In 2017, during his time as Senate Judiciary chair, conservative Sen. Chuck Grassley, a Republican from Iowa, wrote: “For the vast majority of the blue slip’s history, a negative or unreturned blue slip did not stop the Senate Judiciary Committee from holding a hearing and vote on a nominee. In fact, of my 18 predecessors as chairman of the committee, only two allowed home-state senators unilateral veto power through the blue slip. The first to do so, Sen. James Eastland (D-Miss.), reportedly adopted this policy to thwart school integration after the Supreme Court’s decision in Brown v. Board of Education.”
Hyde-Smith previously served in the Mississippi Senate before being elected to the statewide post of commissioner of agriculture and commerce. In 2018, Bryant appointed her to the U.S. Senate to replace Thad Cochran, who opted to retire. She has since been elected to the U.S. Senate twice.
Underneath the skin, tendons such as the Achilles and muscles such as the tibialis posterior run from the lower leg toward the heel and toe, complicating any attempt at a simple definition.
Mississippi podiatrists are fighting for a new law that they claim would reflect that anatomical reality by expanding their scope of practice to include the ankle. They say the proposal would allow them to offer more comprehensive care for diabetes complications, preventing amputations, and to treat conditions such as Achilles tendonitis and ankle fractures, expanding patients’ access to care.
The ankle itself is comprised of one foot bone – the talus – and two leg bones, the tibia and the fibula. And Mississippi is now just one of two states where podiatrists lack “ankle privileges,” as the American Podiatric Medical Association puts it.
“That’s the whole thing—they think you’re a foot specialist so you’re just supposed to stop at the talus?” said Dr. Charles Caplis, the owner of Foot Specialists of South Mississippi and vice president of the Mississippi Podiatric Medical Association, who came to the Capitol Tuesday morning to talk with lawmakers about the proposal.
But they are facing opposition from the Mississippi Orthopaedic Society, whose members currently have an effective monopoly on ankle surgeries in the state.
“The Mississippi Orthopaedic Society believes all practitioners who provide surgical care should meet the uniform educational and training standards established by the [American College of Graduate Medical Education],” wrote Dr. Bryan Fagan, the society’s president, in an email to Mississippi Today. “The safest option for citizens of Mississippi is to ensure their foot and ankle surgeons are educated, trained, and credentialed by the same standards as every other medical and surgical specialty.”
Podiatrists in Mississippi and beyond say they’re not surprised by that position, which claims they lack the right training and experience to perform ankle surgeries. The American Medical Association generally opposes scope of practice expansions that allow professionals other than doctors of medicine and osteopathic medicine to perform more services.
In Massachusetts, the only other state with similar restrictions on podiatrists’ scope still in place, the big hurdle has also been opposition from the orthopedists who perform foot and ankle surgery, said Dr. James Christina, executive director of the American Podiatric Medical Association.
“It is about competition for the same patients essentially,” he said.
On Tuesday, Caplis and Dr. Steven Georgian, a podiatrist in Lucedale, stood in the Capitol rotunda to make the argument that the status quo for lower leg care in Mississippi isn’t working. Georgian, who completed his training in Ohio and Pennsylvania, moved back to Mississippi because he wanted to fight for ankle privileges.
Nearly 15% of Mississippi adults have diabetes, the second-highest rate in the country. The disease can damage blood vessels, increasing the risk of wounds that won’t heal, and nerves, creating numbness in the feet that makes it harder for people to realize they have a cut or blister– all putting people at risk of amputation. Mississippians have high amputation rates, and nationally Black patients are three times likelier to lose a limb than others. Within five years of an amputation, patients are likely to die.
With an expanded scope of practice, podiatrists say they could treat those issues more comprehensively and reduce amputations.
Bringing Mississippi’s laws in line with other states would also help bring more podiatrists to the state, they argue, which would improve access for people with diabetes. In 2020, there were only 67 licensed podiatrists in the entire state, according to the Mississippi State Board of Medical Licensure, and not all of them practice.
Christina, of the national association, shared data showing that Mississippi has one podiatrist for every 32,500, while Florida, “which has a very good ankle law,” has one for every 10,300. (Neighboring Alabama, which just changed its law last year to include the ankle, has one for every 30,000.)
State code currently limits the practice of podiatric medicine to “conditions of the human foot.” The proposal would add the words “and ankle, and their governing and related structures, including the muscles or tendons of the lower leg governing the functions of the foot and ankle.” It would also label podiatrists as physicians.
And it would require any podiatrist performing “conservative and surgical treatments” to have received training at an accredited program.
Christina said that when podiatrists first began performing surgeries, they stuck to the foot. But their training has evolved to include ankle surgery, which also makes sense anatomically.
“The foot and ankle become a little bit tough to distinguish,” he said.
Caplis offered a rebuttal to the idea that podiatrists aren’t equipped to perform ankle surgery: Maybe that was true in the past, but it no longer is. Podiatrists get four years of graduate medical education and spend three years in a hospital-based residency that includes training in surgery.
“Medicine advances,” he said. “It’s called society, and civilization. We’re not asking for more than what we’re trained to do.”
This isn’t the first time Mississippi podiatrists have sought to expand the legal limits of their work.
Angela Weathersby, executive director of the state podiatry association, said they began the push in around 2017, and a similar proposal was nearly over the finish line before the pandemic. Now, they’re trying to rebuild momentum.
Sen. Hillman Frazier, D-Jackson, has supported it in the past because he thinks it could help reduce amputations.
“Save a limb, save a life,” he said.
John Higgins traveled to the Capitol from Biloxi on Tuesday to stand with Caplis and Georgian. As a diabetic, he saw doctor after doctor to treat wounds on his legs. They sent him to the podiatrist for what they thought was a callus. But there turned out to be an ulcer underneath. Higgins also had Charcot foot, a type of nerve damage that can cause joint bones in the foot to collapse and increase the risk of infection.
Caplis said that on two different occasions, Higgins was admitted to the ER and a surgeon wanted to amputate his leg. Instead, Higgins went to see Caplis and was able to keep the limb.
That’s a common pattern, Caplis said.
“You go get admitted and they want to cut it off,” he said. “And then I’m having to say, ‘No, no, no, okay. He just needs to be stabilized for a minute. We can work on this.’”
Caroline Criado-Perez, a feminist author and public speaker living in London, talked about her latest book, “Invisible Women,” last week at Lemuria Books in Jackson.
Her book, published in 2019, explores the gender data gap. From frustrating examples of a freezing office or a shelf out of reach, to deadly examples of an undiagnosed heart attack or crashing a car whose safety features don’t account for women’s measurements, Criado-Perez’s book is full of the real-world consequences of a world built without women in mind.
While the lack of research on the female body is an age-old problem, she argues, it becomes all the more pressing with the emergence of artificial intelligence and the increasing reliance on “Big Data.”
Criado-Perez is working on a new book about the reproductive journey of women, and how little science knows about it. She says she plans to use Mississippi as a case study. She sat down for an interview with Mississippi Today.
Editor’s note: This Q&A has been edited for length and clarity.
Mississippi Today: Tell us about the arc of your career and how you got to the point where you were writing your book “Invisible Women.”
Caroline Criado-Perez: Yeah so that’s a question with a very long answer. Really the story of me writing this book is the story of me becoming a feminist. I didn’t grow up as a feminist. I would say I was sort of anti-feminist – I was really quite misogynistic. And I think that was a very normal thing for young women in the ‘90s. I didn’t really identify with women and I just thought, you know, we’re all equal now and everyone should just stop complaining.
And it wasn’t until I went to university – I went as a mature student, I was 25 I think – and it was the first time I had to read any feminist analysis. And I had to read this book called “Feminism and Linguistic Theory,” which introduced me to the idea of the “generic masculine,” so, using “he” gender-neutrally or “man” gender-neutrally. The author of this book pointed to research that showed that when people hear these words or read these words, they think of men. And that completely blew my mind because it made me realize that I was picturing a man and I was incredibly shocked that I never noticed that, as a woman, that I’m just picturing men all the time.
That really kick-started the whole process for me because having had that realization, I started noticing it in other areas, where we act like we’re speaking gender-neutrally and we’re actually talking about men. So, after my first degree I went and studied feminist and behavioral economics and that is where I sort of discovered the whole economy is built around this mythical man – even though we speak about it being objective like a science. And there were various other bits and pieces I was doing that made me notice it in other areas and then finally I came across it in health, and that was when I was writing my first book. And that was when I started reading some research, the very early stages of my understanding of how much health and our knowledge of the human body is actually knowledge of the male body. That we’re not as good at diagnosing heart attacks in women as in men, and women are 50% more likely to be misdiagnosed if they have a heart attack. And more than anything I just couldn’t believe that this wasn’t on the front page of every newspaper, why did people not know this, why was everyone not talking about this – women are more likely to die if you have a heart attack: what?! And this is because we haven’t researched female bodies?
So that is how it ended up being a book. Essentially because I had all these things going around in my head and I felt like I was going crazy, that everyone was just blithely acting like we were speaking gender-neutrally when I knew we were talking about men. And just the fact that it was a huge, systematic issue, I knew that it wasn’t going to be an article – it had to be a book. Because it was just in everything.
MT: I’m interested in this term you use near the beginning of your book, “absent presence.” What is the experience of being defined by an absence, a negative space, a silence?
CP: I mean, I suppose for someone who recognizes the negative space, it’s intensely frustrating to know that there are all these gaps and all these silences that, as a society, we just skip over and we don’t notice that they’re there.
This is why I start the book with the Simone de Beauvoir quotation about representation being the work of men, and how they describe the world from their own point of view – which they confuse with the absolute truth. I f—–g love that quote so much. Because I feel like it sums up my book in a quotation because it’s not about these men having deliberately described the world and excluded women from it. They think that’s really what it is like. They think they’re really talking about the real world and they don’t see these absent presences, this silent figure of the woman.
But as a woman, you’re constantly knocking up against it, against the ways in which the world has not been designed for you. And having done the research I’ve done, I now experience the world in quite a different way than I did before, and it’s not a more comfortable way – it’s a much more uncomfortable way, because I’m constantly frustrated.
And of course, when it comes to health care it’s something that one thinks about a lot – you know, has this drug been tested in my body, is this the correct dosage for me, do they know how this drug interacts, and what if I’m on contraception, have they actually done any research? And nine times out of 10, no, they haven’t. Or they don’t know how the menstrual cycle might interact with it.
So it’s intensely frustrating and sometimes frightening, I think, to then just experience the world in which, for the most part, we are still speaking gender-neutrally when we’re talking about men.
MT: You talk about how this is an age-old problem – we live in a world made by men with men in mind. Can you tell us why, in a world that increasingly relies on “Big Data,” it matters so much more? How it becomes deadly, even?
CP: Yeah, so I mean, the gap in data for women is already deadly, if you’re thinking anywhere from car design to health care, but the real danger is becoming exponential, because of the introduction of AI into every single part of our world. And the problem with developing AI using bad data, biased data, is that machine learning is not like a human, in that it doesn’t simply reflect our biases back at us – it amplifies them.
I’ve read so many papers since “Invisible Women” came out where researchers will be like, “we’ve developed this AI and it performs better than a radiologist at detecting lung cancer” or “can predict heart attacks five years before they happen,” and then when you look at the paper, not only are the datasets incredibly male-biased, so you’ve got that bias already baked in, but also, they’re not even thinking about sex.
One paper I’m thinking about that came out shortly after “Invisible Women” was published was about predicting heart attacks. And there are sex-specific risk factors. So, if you’re going to be predicting heart attacks in men versus women, you don’t want to have, as this paper did, something like a 70% male dataset, but you even more don’t want to have that data all mixed up together. Because that’s not going to work for men or women. And yet, there was absolutely no mention of sex in the paper. So, that is frightening. Because the problem with that is it could make the situation worse.
When I find AI exciting is when researchers are using AI to address problems that we aren’t addressing otherwise. So, for example, one woman I spoke to was developing AI to detect victims of domestic violence via injury patterns, potentially years in advance of them ultimately having to be taken to a shelter or something. Because of course victims don’t necessarily report, and it’s not something that we’re investing a lot of money in in health care – because there’s not a lot of money in it and doctors don’t necessarily have the time to do the sort of questioning of a victim, et cetera. So there is exciting potential for AI. But if we’re just using it to do what we’re already doing but faster, that’s where the massive pitfalls are.
MT: As a health reporter, I’m interested in the subject of endocrine-disrupting chemicals you bring up in your book. We know that these chemicals are in everything, but they’re especially pervasive in feminine products, such as toiletries and makeup – and even menstrual products that women put inside their bodies. And as you know, not only are they more common in female products – they’re also worse for women, because of how they mimic and disrupt women’s hormones. How do we begin to address the issue? How can data help?
CP: The first thing that needs to change is obviously labeling – that’s a huge one, that people have the right to know what is actually in these products. That is one of the things that makes me most frustrated. I mean, as you can imagine, since writing the book I am scanning product ingredients all the time. If there’s anything that says “fragrance” I’m like “nope, that’s out, not using that.” And it’s amazing how many products just have these random ingredients in them and they don’t have to disclose what they are. Nobody knows. Nobody knows that “fragrance” means they could put anything in there. That’s deeply frustrating.
But my answer is always going to come back to: we have to collect data on this. And that is the thing that we’re not doing. And that is just incredible to me. The problem we have is not only are there endocrine-disrupting chemicals in these products, but also, how are these affecting not only the women who use them but also the women who work with them and the women who produce them.
And, as I say in my work, it’s not just that we haven’t tested them on women – for example, absorption into female skin, which can be different, or the way that it might accumulate in a female body, because of differences in fat in the body – but also the way in which women encounter them. Because it tends not to be in discrete “now I’m going to be exposed to this chemical, and tomorrow to that chemical.” We’re exposed to a cocktail of chemicals, and that’s not how they’re tested. So the way they’re tested is in itself biased against the way women are exposed to them, as well as the fact that we aren’t even testing them on women anyways.
And I feel that this really ties into this attitude that somehow the female workplace is this cozy, safe place, that women are never exposed to any form of danger. Because historically, the sort of headline-grabbing dangerous jobs have been done by men. By the way, because they were high-paying and women were barred from doing them, but let’s not let that get that in the way of the story that “women are lazy and they don’t want to do scary, difficult jobs.” But the female-dominated jobs that are low-paid, we simply have not been measuring how dangerous they are – from the perspective of exposure to chemicals.
MT: So, it seems like the call to action of this book is to begin filling in some of these gaps in data. But if we think of the modern world as being made up of data, then the idea of collecting all this new data can feel almost like building a new world – and that might be intimidating to some. What would you say to people who feel overwhelmed by this imperative?
CP: Well, there’s no getting around the fact that it is a huge job, and it is intimidating. And if you tried to do it all, you would be overwhelmed. But nobody could possibly fix this on their own. It’s like saying “you – go fix patriarchy.” It’s not how it works. Everybody has their own area that they can address. And so, people who work in research can collect sex disaggregated data. That’s a really great thing that people who work in research can do. People who work in HR, there’s a lot that they can do when it comes to looking at how their companies consider diversity, for example, in decision making.
People who have children, there’s so much that they can do to address how the future generation even notices that the “default male” operates. Like, if you look at kids’ TV, kids’ books, it’s “default male” all over the place – all the characters are male and if there’s a female character, her characteristic is that she’s female. I’m not saying that you’re going to be able to protect kids from that, but have a conversation with them. And I wish that had happened to me when I was little, that someone had taken the time to point out “isn’t it weird that in the real world, there’s all these women, and in your stories, it’s all boys?” I think that that’s a really powerful thing and I actually think that that’s something that everyone can do is have these conversations and notice when the “default male” is in operation – because I think that that really is half the battle.
If you think about the car crash stuff, that we have historically used an average male car crash test dummy, as if that’s representative of humans overall – when you say it like that, it obviously sounds ridiculous. But we’re so used to using the male body as the human body that people don’t even notice that it’s happening. As soon as you tell people “by the way, cars have not been tested to be safe for an average female body,” they understandably get really freaked out and start demanding change from car manufacturers – which is something very cool that’s happening in America at the moment. So, a really big part of it is just spreading the word and making the changes you can make.
MT: So, we’re talking about the gap in data around the female body and how that plays out in the health care system. One of the things I’ve noticed is that when people bring up this gap and try to address it – and particularly when talking about the menstrual cycle and how it interacts with medicine or what have you – that people tend to think of it as “woo-woo” or “mystical.” I think the fact that talking about something as fundamental as the menstrual cycle is met with such disbelief sheds light on just how uncommon it is to talk about the female body. Has that been your experience? Why is that?
CP: Right. That’s just sexism. It’s like, “oh, that has to do with ladies.” So, you’re reminding me of this report that came out, and again it was after “Invisible Women” was published, and it was about women and asthma. And there were all these testimonials from women who said “I went to the doctor and told them I feel like I get asthma flare-ups in relation to my menstrual cycle, I can tell where in my menstrual cycle I am, based on my flare-ups.” And the doctors were like “that’s just nonsense, you’re making it up” – because women can’t possibly know what’s going on with our bodies. Anyways, it transpires that actually, yes it is. It is hormonally-linked.
So that is something that, hashtag-not-all-doctors, but that they will say because there is this idea that lingers on somehow, in these people who are trained in science, that women are somehow just hysterical and should be less believed than men. But, I mean, that’s just misogyny.
MT: So you’re writing a new book. Tell us about how it relates to health care and how you’re using Mississippi as a case study.
CP: Yeah, so the book is about a woman’s reproductive journey from the beginning of whether or not she’s going to have children and going through things like pregnancy and how little we know about, firstly, how to treat a pregnant woman for anything, because we don’t do any research on women, let alone pregnant women. And then, how little we know about reproduction, so things like miscarriage and the disorders of pregnancy we know very little about, and of course that ties into abortion.
So that’s the area I’m wanting to focus on while I’m in Mississippi – for the obvious reason of Dobbs, and also my husband is from Mississippi, and also I had a miscarriage in January last year when we were last here, which was briefly scary, particularly as a British person, being here and thinking “if this goes wrong, am I going to be able to get the care I need?”
So I’m just really interested in understanding what it is actually like for a woman whose pregnancy goes wrong in Mississippi right now. Because I know there are these exceptions, but also, they’re never used. So, the focus for that chapter is I want to look at what happens to women who need an abortion and legally, supposedly, can get one, but actually, can’t get one. And then the rest of the book is looking at fertility and infertility through to the menopause.
House Bill 539, introducing presumptive eligibility for pregnant women, passed the full House 117-5 on Wednesday and now advances to the Senate.
The bill, authored by House Medicaid Committee Chairwoman Missy McGee, R-Hattiesburg, allows pregnant women whose net family income is 194% or less of the federal poverty level to be presumed eligible for Medicaid. They could receive medical services before their Medicaid application is officially approved by the Mississippi division of Medicaid.
For an individual, an income up to 194% of the federal poverty level would be an income up to about $29,000 a year.
The bill does not introduce an additional eligibility category or expand coverage, McGee explained. Rather, it simply allows pregnant women eligible for Medicaid to get into a doctor’s office earlier.
“So, what the bill proposes,” McGee said, “is that a qualified provider – whether that be (from) the health department, (a Federally Qualified Health Center) or a doctor’s office, who has been trained and approved through Medicaid – would have the ability to presumptively designate a woman eligible for Medicaid when she presents pregnant and presents proof of income … and therefore allow her to get into the doctor’s office early while the division of Medicaid is making that final and official determination that she is eligible.”
Presumptive eligibility would cost the state roughly $560,000, McGee said, compared to the $1 million it can cost the state to care for just one extremely premature baby receiving care in a neonatal intensive care unit – “a minimal investment for a tremendous benefit to women in our state,” McGee said.
The bill allows pregnant women to receive care under presumed Medicaid eligibility for 60 days after their first doctor’s visit. The hope is that by the end of the 60-day window, they will have submitted their paperwork and been fully determined as eligible for Medicaid – since a regular Medicaid application only takes 45 days to process.
Medicaid application processing times have increased over the last few months due to people being kicked off coverage after the pandemic – the percentage of applications taking longer than 45 days to process was 10.79% last July. By the time this bill would go into effect next July, “unwinding” from the pandemic is expected to be over.
One of the five representatives who voted no on the bill, Dan Eubanks, R-DeSoto, raised a question on the floor about women who are deemed ineligible during that 60-day period.
“If Medicaid pays a doctor bill, and then a woman is found to be ineligible in the end, then that is a part of the cost to the state estimated to be, in total, about $567,000 a year,” McGee replied.
The bill still needs to be passed on the Senate side before it is signed into law, but its rapid passage this early in the legislative session shows promise that it will advance.
Though it’s only a piece of the puzzle, the bill would go a long way in addressing pregnancy outcomes in Mississippi, said Dr. Anita Henderson, pediatrician and former president of the state pediatric association.
“We are thrilled that the House Medicaid Committee and then the full House passed presumptive eligibility for pregnant women,” Henderson said. “It will really help moms get that first OB visit sooner to start working on their high blood pressure, diabetes, or any chronic medical conditions, infections. The more we can get our moms seen, the more we can help, the more likely we’re going to reduce our premature birth rates, our fetal mortality rates, our infant mortality rates and our maternal mortality rates.”
Starting next year, the number of high school graduates will begin to fall in Mississippi. That’s the looming reality a joint hearing of the House and Senate Colleges and Universities committees zeroed in on Wednesday.
In Mississippi, this trend, called the “enrollment cliff,” will force the largely tuition-dependent colleges and universities to compete for a shrinking pool of students. Regional institutions like Delta State University, Mississippi University for Women and Mississippi Valley State University, all of which are already struggling with enrollment, will be especially hurt.
The state is poised to see the second-worst decline of high school graduation rates in the Southern U.S. by 2027 after Virginia, according to data presented by Noel Wilkin, the University of Mississippi’s provost and executive vice chancellor for academic affairs.
The committee wanted to know: What is the Institutions of Higher Learning Board of Trustees, the governing body for Mississippi’s eight public universities, doing about this?
“When can we expect a report to detail those recommendations and strategies for the future,” Sen. Scott DeLano, R-Biloxi vice chair of the Senate committee,asked Al Rankins, the IHL commissioner.
“Whenever you’d like to see a report,” Rankins responded. IHL has been talking about the enrollment cliff for years, he added, and has a working group focused on the regional college’s unique needs.
Kell Smith, the director of the Mississippi Community College Board, which operates differently from IHL, attended the hearing but did not present. He said MCCB doesn’t have a strategic plan for the enrollment cliff but some of the individual community colleges might.
“Very simply — how can we fix the problem to prepare for 15 years from now?” Rep. Donnie Scoggin, R-Ellisville the House chair, asked Wilkin.
There are few simple answers. The enrollment cliff is unavoidable, the product of declining birth rates that will be exacerbated by out-migration from Mississippi and deaths due to the COVID-19 pandemic, John Green, a Mississippi State University professor, told the committee.
But the changing economics of higher education is largely the result of funding choices by the Legislature years ago. In Mississippi, the four-year public universities are all more dependent on tuition than they are state appropriations.
Rankins presented a chart showing that in 2000, state appropriations supported nearly 60% of the universities operating budgets, while tuition was 26%. In fiscal year 2023, that ratio had basically flipped, with tuition supporting 64% of operating budgets.
This raises the question: If Mississippi’s colleges and universities are increasingly reliant on student tuition, not taxpayer dollars, are they still a public service?
It’s complicated, said Rep. Lance Varner, a member of the House committee, whose 16-year-old daughter has started getting recruitment letters from out-of-state colleges hoping to attract her away from Mississippi.
“If you own a business, your goal is to try to get people to come to your business,” he said.
At the same time that he thinks higher education is a public good, Varner, R-Florence, said he bets the universities wish they could be even less dependent on state appropriations.
“Every one of those colleges is working hard to make sure they’re self-sufficient,” he said. “They don’t want to depend on the Legislature.”
At the University of Mississippi, tuition and fees now represent 78% of its total operating budget, according to IHL’s presentation, the highest of any public university.
A huge driver of that is the number of out-of-state students, who pay nearly three times more for tuition than Mississippi residents, now make up half the university’s total population of more than $21,000, Wilkin told the committee. This is one way Ole Miss is responding to the enrollment cliff, which it started preparing for in 2017.
“We have become a destination state for higher education,” Wilkin said.
University of Mississippi netted $62 million in tuition from in-state students in fiscal year 2023 — but brought in $188 million from non-resident students. It’s a crucial revenue source that, Wilkin said, allows Ole Miss to keep its costs down for in-state students.
“If I were to take all the revenue that comes from in-state students and all the state appropriations we get and compare that to what it costs us to educate those students, we’re still left with a multimillion-dollar hole,” Wilkin said.
Wilkin also discussed the “intangible” aspect of higher education that shapes if, why and where students attend college, especially in light of the fact high school graduates are becoming more diverse.
“All of us see there have been questions raised about the value of a higher education degree today,” he said.
By 2036, white students are projected to comprise 43% of high school graduates compared to 51% today. Black students will increase from 25% to 28%.
Smith, the MCCB director, said after the meeting that community colleges need to be focusing more on students who don’t have a high school diploma.
“We need to go after those students irregardless of what the enrollment cliff looks like,” he said.
A proposal to manage hospitals and clinics in the Delta under a new authority — and give political power over it to the governor — was met with distrust from the area’s lawmakers this week.
Representatives from the Delta Council, an economic development organization that was one of the first non-health care groups to endorse Medicaid expansion, presented a plan Tuesday at a joint meeting between the House and Senate Public Health Committees intended to help preserve health care in the Delta, one of the state’s sickest regions.
But the proposal was received poorly by Delta lawmakers, who said this was the first time they were hearing of it.
“I’m just so sick and tired,” said Rep. Otis Anthony, D-Indianola, as murmurs of support echoed around the table. “This is my sixth session, and I’m just sick and tired of people outside of the Delta telling us what we need, and we’re not at the table.”
The plan presented by the Delta Council centers on creating a Delta Rural Health Authority, which would manage a consortium of hospitals and health care facilities in the region, including rural medical clinics and federal qualified health centers.
The health care facilities would “collaborate” and share resources in order to expand physician coverage and services in the Delta.
The authority would also have the power to consolidate health care services in the Delta, if it deems appropriate.
Some of the objectives of the authority, the plan says, include maintaining essential health care services and workers in the Delta, maximizing financial outcomes and reimbursement opportunities for the region’s health care facilities and, subsequently, improving health outcomes.
The plan would not create new facilities or hospitals, and communities would not be forced to participate.
The Delta Council’s Wade Litton started the presentation Tuesday by emphasizing that the proposal is not a result of a few weeks of work — it’s been in the works for over 16 months, he said.
The council is asking for $5 million to $10 million from the Legislature to establish the authority.
Baker Donelson lawyer Richard Cowart told legislators that three to five hospitals in the Delta are already interested in being part of the authority, mentioning towns such as Greenville, Greenwood and Clarksdale. The presentation showed three hospitals under the authority — one a critical access hospital, one a rural emergency hospital and the last an acute care hospital.
“Until they know what it is, they’re not going to commit to it,” he said. “You have the Delta leadership, health care leaders saying we would like … to take a different approach and we would like your permission to do it.”
Gary Marchand, interim chief executive officer of Greenwood Leflore Hospital, confirmed that the facility is involved with the plan and said hospital leaders have discussed the proposal since late summer last year.
He wouldn’t comment on the proposal’s promise, aside from saying that the hospital’s leaders “agree with efforts to evaluate healthcare service delivery in the Delta.”
Cowart said the authority board would be composed of nine to 12 people. He said the governor would appoint three members, the Legislature would appoint two and then each community, as they joined, would appoint members.
But a draft of a Senate bill establishing the regional authority provided to Mississippi Today showsthat the governor would appoint five members to the board. Though a majority would have to be Delta residents, the rest would just have to live in Mississippi.
That clause is the heart of the Democratic lawmakers’ concern regarding the health authority — the power that Gov. Tate Reeves would have over it.
More regional health authorities may be established under the draft bill with the governor’s approval, and the governor would appoint five members of those authority boards, too. And while the bill says board appointments will “seek to create a competencies-based board that also reflects the racial and ethnic diversity of the region,” Delta lawmakers say that language means that’s not guaranteed.
A senator has not formally introduced a bill in the Legislature. The lawmakers’ criticism of the proposal also largely stems from what they believe is a lack of community input.
“How do you have a solution when you haven’t had community meetings or a broad approach that includes legislators, boards of supervisors, hospital workers and administrators?” Rep. John Hines, D-Greenville, said in an interview. “They haven’t been that inclusive. It’s old men getting in a room doing what they want to do to keep the money for themselves.”
Hines made note of the Delta’s racial composition and the history of decisions made by white people in the South negatively affecting Black people.
“When you live as a Black person in a part of the state where Black people are the majority, they are most in danger when the state has more power over your life than people at the local level,” he said. “Whenever you take the voice of people away from them … you always end up making a community weaker.”
Though the Delta is a historically Black region, the council’s 2023-2024 officers appear to be eight white men.
The council’s representatives admitted at the meeting that though they had engaged with community members, county supervisors and hospital officials in the Delta, none of the area’s legislators had been contacted about the plan.
“Don’t you think it would have made sense to have involved people who were investing in these communities to come to the table rather than coming and saying, ‘This is what y’all need to do to survive,’” Hines said at the hearing. “I have some concerns about this. I’m not against a regional approach, but the proposal you presented I do not agree with.”
State Health Officer Dr. Daniel Edney, a Delta native, wouldn’t comment on the Delta representatives’ opposition to the plan but said the region is running out of health care options.
“This regionalization has proven itself, and the Delta doesn’t have many other options to look at,” he said, in an interview following the hearing. “Everybody knows that health care in the Delta needs help. If this isn’t it, what is it?”
Anthony, along with other representatives, said Medicaid expansion is a solution to the Delta’s dwindling health care infrastructure.
Despite support from the majority of Mississippians and extensive research underlining the policy’s financial and health benefits, Reeves and other Republican leaders have vehemently opposed expansion. Reeves has instead pitched other ideas as alternatives. Rep. Darryl Porter, D-Summit, told Mississippi Today that he believes this authority is the governor’s latest attempt to “sidestep Medicaid expansion.”
Forty other states have adopted Medicaid expansion, and researchers say it would generate billions of dollars and thousands of jobs by insuring 200,000 to 300,000 Mississippians.
“These are conversations the governor has refused to have,” Anthony said at the hearing. “We can tell you from the Delta what the problem is.”
Nearly half of the state’s rural hospitals are at risk of closure, largely due to uncompensated care costs, or money hospitals spend taking care of uninsured patients.
“The governor wants local hospitals to fail,” said Rep. Jeffrey Harness, D-Fayette, in an interview with Mississippi Today.
The council’s plan does not take into account the impact of Medicaid expansion but Cowart noted that the policy would be “very beneficial” to the region, in addition to the proposal.
Anthony said he was “appalled” to hear recommendations from various organizations about the region’s health care crisis when stakeholders have been clear about the problem “for the past 30 years.”
“We’ve been telling this state what we need, and the state has consistently robbed and taken economic opportunity from the Delta,” he said. “It’s very disrespectful, when we starve the region economically by not making major economic investments in that area and then coming back and saying, ‘I know what’s wrong.’”
Reeves called two special legislative sessions in the past two weeks for lawmakers to spend hundreds of millions of tax dollars to lure businesses to areas outside of the Delta.
While almost the entire Capitol approved the economic deals, several Delta lawmakers previously told Mississippi Today they believe Reeves is using the power of his office to choose which areas of the state thrive and which starve from a lack of economic investment. The governor’s office has denied these allegations.
It’s not clear who would formally introduce the bill yet, or what its final iteration would be. But as it stands, Hines said he and his colleagues do not support the authority’s establishment.
“We are sick and tired of people telling us what to do rather than asking us what we need help with,” he said.
Ferlando Esco hasn’t been home in nearly 20 years.
The former Canton resident is serving a life sentence in Mississippi’s prisons not because he was convicted of killing or seriously hurting anyone. The 50-year-old received that sentence under the state’s habitual offender law.
That law states that two prior, separate felony convictions that resulted in a prison sentence of at least one year in state or federal prison can result in a life conviction without the possibility of parole. Only one of the felonies has to be a violent crime.
His daughter, Ferlandria Porter, 30, has been fighting for his release and is calling on the state Legislature to pass laws that give people like her father a chance at parole – a chance to come home.
“I’m still fighting and praying that the laws change, that the habitual offender law changes,”Esco said in a phone interview from a Colorado prison, where he was transferred last year and remains in the custody of the Mississippi Department of Corrections.
Porter is collecting signatures for a petition asking for changes to the habitual offender law. In the petition, she writes the state’s habitual offender law significantly affects those like Esco who committed a felony in adolescence and leaves them without hope.
Esco, who is 50, said the laws don’t recognize how he and others have matured and changed while incarcerated. He tries to help younger men when they come to prison because he sees himself in them. Esco has also taken classes that are available to him and he prays.
A 2019 report by FWD.us found that more than 2,600 people are serving prison time under Mississippi’s habitual offender laws, and nearly half have been sentenced to life or a virtual life sentence of 50 years or more. Black men are disproportionately sentenced under these laws.
Among those sentenced as habitual offenders are people serving time for nonviolent offenses, like Tameka Drummer, who went to prison in 2008 for possessing less than two ounces of marijuana. She had two prior violent felonies that she already served time for.
Porter sees a life sentence without parole as essentially a death sentence. She understands that the Parole Board, especially in recent years, is tough about its decisions, but at least people would have a chance to be released.
“Give him a chance to come home to be a grandfather,” she said.
Esco has seen how his daughter is advocating for his release and reform to the state’s habitual offender law.Visits with his grandchildren have renewed his hope of returning home, even over the years as lawmakers file reform bills and they don’t become law.
In November, Esco was transferred from Walnut Grove Correctional Facility to a prison in Colorado, according to prison records. Porter said the family was not given a reason for his move, andthey hope to visit him there.
The first felony conviction on Esco’s record was a strong arm robbery from 1991 when he was 16, according to court records.
He said the habitual offender law penalized him for a mistake he made as a teenager, when his mindset made him more likely to take risks and not think about consequences.
“You don’t know that it will come back to haunt you … and that’s what happened to me,” Esco said.
The next conviction that paved the way for his sentence as a habitual offender was in 2005, when he was 30. Esco received six sentences stemming from his role in an attempted robbery in the parking lot of a McDonalds in Madison, where one man was shot. His two co-defendants pointed to Esco as the mastermind of the plot to lure the man there, according to court records.
Esco remembered being in a state of disbelief when he was sentenced to life. He said all he could think about were his young children and what would happen to them.
Porter, family members and supporters believe Esco is innocent and was wrongfully convicted in the Madison case. He maintains he was not at the McDonalds at the time of the failed robbery.
Porter has another petition laying out the details of her father’s case and calling for his release.
In his appeal and a petition for post-conviction relief, Esco argued that his co-defendants were coerced into implicating him in exchange for lesser prison sentences. He also argued that an eyewitness, a McDonald’s worker, did not identify Esco from a lineup and that evidence wasn’t presented in court, according to case records.
The Mississippi Court of Appeals rejected the arguments.
In recent years, there have been bills proposed in Mississippi to alter how people are sentenced as habitual offenders, but many of those efforts died in committee.
So far this session, Rep. Bryant Clark, D-Pickens, filed a House Bill 225 that would revise the habitual offender penalty so someone would have to have been previously convicted of two violent crimes, and they would be eligible for parole or early release consistent with the eligibility for the offenses they were sentenced to. Life sentences would be calculated at 50 years.
House Minority Leader Rep. Robert Johson III of Natchez refiled bills to make habitual offenders parole eligible (HB 572) if they serve 10 years for a sentence that is 40 years or longer and to exclude drug and nonviolent offenses when computing prior offenses (HB 570).
Rep. Jeffrey Harness, D-Fayette, refiled HB 285 to exclude nonviolent offenses from habitual offender penalties.
Last session, Senate Minority Leader Derrick Simmons of Greenville filed a series of bills, which would have changed how former convictions count toward sentencing someone as a habitual offender, including whether they were at least 18 when the crime was committed and the two prior felonies were violent crimes.
Without a law change, there aren’t many avenues for Esco to be released from prison.
He has tried to fight his case in court but that hasn’t been successful. The most recent attempt was a federal habeas petition, but it was dismissed in 2017 after going up to the 5th U.S. Circuit Court of Appeals.
Porter said the family will look into whether her father can apply for a pardon from Gov. Tate Reeves. To date, the governor has not pardoned anyone.
“We suffer,” Porter said about how her family is affected by her father’s incarceration. “I feel like we’re being chained up, too.”
The Clevelands recap the NFL conference championship games and look ahead to the Super Bowl, plus some college basketball thoughts. Father and son agree on two things: Patrick Mahomes is the best quarterback in the game and all the fuss about Taylor Swift is comical.
Online sports betting would become legal in Mississippi under a proposal that advanced Tuesday evening in a state House committee meeting.
The House Gaming Committee passed House Bill 774, which would legalize mobile sports betting but require customers to use online services from existing Mississippi casinos to place a bet.
“The number one goal is to protect our brick-and-mortar buildings,” House Gaming Committee Chairman Casey Eure said. “Every mobile sports wager will be tied to a brick-and-mortar building.”
Under the proposal, bettors would not have to physically visit a casino to register for sports betting. The entire registration process could happen remotely, as long as it was done in Mississippi.
In-person sports wagering and mobile fantasy sports have been legal in the state since 2018, but online betting has remained outlawed over worries the practice could erode the profits of casinos.
The House proposal would require online sportsbooks like DraftKings or FanDuel, called a “skin,” to partner with a physical casino in Mississippi before allowing customers to participate in mobile betting.
Democratic Rep. Robert Johnson III of Natchez, the House minority leader, voiced concerns that smaller casinos in the state would get choked out of the market because larger casinos, often owned by chains, could quickly partner with sports betting outfits.
“I wouldn’t think that any casino would have a problem partnering with someone,” responded Eure, a Republican from Harrison County.
Eure, the bill’s author, estimated that Mississippi would generate between $25 million to $35 million in revenue during the first year if the state enacted a mobile sports betting program. The revenue would come from a 12% tax on sports wagers with 4% going toward the local municipality where the sponsor casino is located and 8% going toward the state.
The entire 122-member House chamber can now consider the proposal, but it’s unclear when it will do so. House Speaker Jason White, a Republican from West, implied on Tuesday afternoon that the chamber would vote on the measure sometime this week.
If the full House passes the proposal this week, it will move to the Senate for consideration. It would have to clear Senate committee and a full vote on the Senate floor to move to the governor’s desk. If the Senate amends the original bill in any way, it would have to go back to the House for approval.
