The latest results of Mississippi’s third grade reading test show no dramatic declines in student performance. But they show no significant gains, either.
Since 2021-22, the first year of student data after the pandemic, the share of students passing the assessment — including the initial test and any retest — has hovered around 85%.
The Mississippi Department of Education announced Thursday that data point holds true for the 2024-25 school year, with 85% of the state’s third graders ultimately passing the reading assessment required to graduate to the next grade, just barely higher than last year’s rate of 84%.
The new pass rate remains lower than in 2018-19, when it was 85.6%.
It’s the latest chapter in Mississippi’s national reading success story, called a “miracle” by some but, more recently, a “marathon” by state education leaders. Over the past decade, the percentage of the state’s fourth graders scoring advanced or proficient on the National Assessment of Educational Progress — or The Nation’s Report Card — has skyrocketed, with Mississippi going from last in the nation to ninth. NAEP is separate from the state assessment.
Researchers, educators and lawmakers largely attribute that progress to the Literacy-Based Promotion Act of 2013. The law funneled money and targeted curriculum toward improving literacy outcomes, and famously established a third-grade reading test.
Students have three tries to score at least a 3 or higher on the reading portion of the state’s English Language Arts assessment to move to fourth grade. Students can score up to 5, which is considered advanced.
The latest results show 13.9% of Mississippi third graders scored a 5, while 35.5% scored a 4 and 26.3% scored a 3. About a quarter of students did not pass the assessment.
The initial administration of the test in the spring resulted in a record pass rate of 77.3%. Students who don’t pass get another try in May, and a final attempt in June. If they’re still unsuccessful after the third attempt, they’re held back in third grade, unless they have a district-determined exemption — they have certain learning disabilities, they are learning English or they were previously retained.
Students with disabilities who were previously retained or received two years of intensive remediation accounted for about a half of the “good cause” exemptions for 2024-25. Another third were promoted because they were tested using an alternative assessment.
Over 2,132 third-graders, or 6%, were held back.
“Educators and teachers across Mississippi understand the importance of ensuring young students have a solid literacy foundation,” State Superintendent of Education Lance Evans said in a statement. “We also applaud every teacher, administrator, literacy coach, parent and student for their hard work in achieving literacy success.”
The state education agency said in a press release that over the past year, in an attempt to raise literacy outcomes, it provided training from literacy coaches to certain schools, expanded professional development opportunities, encouraged the usage of “high-quality instructional materials” and helped integrate Science of Reading teaching for educators-in-training.
The department said at a Senate hearing this fall that it hopes to expand the reading act into grades 4 through 8. Data show that despite the major reading gains among younger students, that success hasn’t translated into higher grades.
Mississippi will resume normal issuance of food stamps immediately, the Mississippi Department of Human Services announced Thursday.
This development happened after the longest federal government shutdown in U.S. history ended Wednesday after the House approved the Senate-passed funding package, which President Donald Trump signed into law.
Mississippians who receive their Supplemental Nutrition Assistance Program (SNAP) benefits between the 14th and the 21st of each month can expect to receive their full benefits as usual, the agency said in a press release.
Those who receive their benefits between the 4th and the 13th will receive the remainder of November’s benefits “as soon as possible,” after having received partial benefits this week, according to the press release.
December benefits will be rolled out as usual, the department said.
“We are grateful to see MDHS working quickly to restore full benefits to all SNAP recipients for the month of November,” said Sarah Stripp, director of socioeconomic wellbeing at Springboard to Opportunities, a Jackson-based cash assistance program. “We also hope this crisis will help us all recognize how vital SNAP benefits are to the families and individuals who rely on them each month and our local economies.”
Confusion over the nation’s largest food assistance program ensued in recent weeks after more than a dozen states sued the Trump administration for its refusal to issue benefits. In past shutdowns, food assistance has continued to flow to states, but the federal government said Oct. 24 that it would not use emergency funds to pay for the program.
About 1 in 8 Mississippians — over 350,000 people — receive food assistance through SNAP. More than 67% of participants are in households with children, and about 41% are in households with older adults or adults with a disability. In four Mississippi counties, over a third of residents rely on the program to purchase food, according to a report from WLBT.
“It was cruel and demoralizing to watch our leaders use families’ lives and wellbeing as a bargaining chip for political gain, and we must all commit to holding our leaders accountable to not act in this way again,” Stripp said.
Marie lies awake at night, worrying about how she will afford health insurance in January. Her monthly premium is rising from $20 to $75 — a nearly fourfold increase — and she doesn’t know what she will do.
The 48-year-old from Yazoo City, who is being identified by her middle name due to privacy concerns and fear of retaliation, has chronic kidney failure, high blood pressure and fibromyalgia, a chronic condition that causes widespread body pain and fatigue. She does not work due to her health issues and the responsibility of caring for three children under the age of four.
“I’ve got to have something, and I don’t know what I’m going to do at this moment,” Marie said. “Today, I can’t tell you what I’m going to do.”
Marie is one of hundreds of thousands of Mississippians facing increasing health insurance prices next year. Premiums for Affordable Care Act Marketplace plans are set to rise in January if Congress does not act to extend the enhanced premium tax credits that make coverage more affordable for over 22 million Americans. Consumers will pay more than double on average, according to KFF, though the rate changes will vary based on age, income and location.
About 200,000 Mississippians are expected to drop their Marketplace coverage if the increased subsidies are not extended, Mississippi Insurance Commissioner Mike Chaney told Mississippi Today. It is projected to be one of the steepest drop offs in health coverage among all states.
The Marketplace primarily insures people who do not have health coverage through their employer, Medicare or Medicaid, and about half of them are small business owners, employees, or self-employed.
For a 40-year old living alone in Jackson and making $30,000 annually, the estimated cost of monthly premiums for a silver health insurance plan would rise more than $100, from $42 to $155 per month, KFF estimates show. Such a person would still receive $483 in monthly standard federal tax credits, first made available in 2014 through the Affordable Care Act for people who make between $15,650 and $62,600.
The enhanced subsidies were an added boost authorized by Congress in 2021 that raised the income ceiling for eligibility and allowed low-income households to access insurance without paying premiums during the COVID-19 pandemic.
As a result, the number of Mississippians enrolled in Marketplace health insurance tripled, rising by over 200,000 people between 2021 and 2025, according to enrollment data from the Centers for Medicare and Medicaid Services. During the same period, the number of people without insurance – one of the highest rates in the country – dropped several percentage points.
A disagreement over extending the increased subsidies was at the heart of the 43-day federal government shutdown — the longest in U.S. history — that ended Wednesday night, with Democrats pushing for their renewal. Democratic leaders in Congress have vowed to continue fighting to extend the subsidies, and Republicans have promised to hold a vote on their extension by mid-December.
Insurance Commissioner Chaney told Mississippi Today he believes the enhanced tax credits should be phased out, but more gently than ending suddenly at the close of the year.
“We cannot continue to give people free health care, free food, free everything and have a very small number pay for it,” he said. “People have to have some skin in the game to make the system work.”
Marie was one of the Mississippians who benefited from the new, enhanced tax credits in 2021. For the last three years, she has paid a $20 monthly premium for Marketplace insurance, making it possible for her to afford regular appointments and bloodwork to monitor her kidney condition and the costs of her medications.
But Marie said she and her husband, who works, can’t afford the higher price tag, nor can they pay the out-of-pocket costs of her care if she turns down coverage.
“If I don’t have my blood pressure medicine, that’s going to be bad,” she said. “I probably won’t live long.”
Experts warn that more people going without health insurance coverage could have serious consequences not only for those individuals but also for other consumers and hospitals.
Healthy consumers who can go without coverage are the most likely to drop coverage, a shift that is likely to drive up Marketplace premiums overall, said Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University. As healthier enrollees leave, the remaining customer base, called the “risk pool,” will become sicker on average and more expensive to insure.
This is already reflected in next year’s rates. Marketplace insurers told regulators they plan to raise premiums by about 4 percentage points more on average in 2026 to offset the loss of healthier customers, KFF reported. They are also raising prices to keep pace with rising medical costs.
Corlette said she expects prices to rise further in 2027 if the subsidies are not extended.
“It takes a while for these changes to ripple through the system,” she said.
Richard Roberson, chief executive officer of the Mississippi Hospital Association, speaks to lawmakers during the Democratic Caucus meeting at the state Capitol in Jackson, Miss., on Tuesday, April 1, 2025. Credit: Eric Shelton/Mississippi Today
If tens of thousands of Mississippians drop insurance coverage, hospitals will likely shoulder the costs of caring for uninsured patients when they turn to emergency rooms as a last resort, said Richard Roberson, president and CEO of the Mississippi Hospital Association.
Mississippi’s rural hospitals will lose about $200 million in 2026 if the enhanced subsidies are not extended, according to projections from the Commonwealth Fund, a private foundation that studies health care access in the U.S. More than half of Mississippi’s rural hospitals are already at risk of closing, according to one recent report.
And hospitals across the state are already anticipating cuts to Medicaid payments beginning in 2029 as a result of a sweeping tax-and-spending bill signed into law by President Donald Trump this summer. Paired with rising uncompensated care costs, those reductions will strain hospitals’ bottom line, Roberson said.
“At some point, it’s not going to be sustainable for hospitals,” he said.
The new law that reduces Medicaid funding also imposes new verification requirements for people receiving standard tax credits. This creates added red tape that produces “more friction for people,” and may drive younger, healthier people to not enroll in plans to avoid the hassle, Corlette said.
Open enrollment for Marketplace health insurance plans began Nov. 1, giving Americans the first look at their premiums next year. The deadline to enroll in insurance to start in January is Dec. 15, 2025.
If you plan to purchase insurance through the Affordable Care Act Marketplace for 2026, experts recommend these tips:
Review your premiums early – Check your insurance premiums as soon as possible to allow time to make arrangements for next year. Estimated prices for 2026 plans are now available on HealthCare.gov.
Beware of misleading products – Be cautious if you’re considering buying coverage outside of HealthCare.gov. Some companies may use aggressive or deceptive marketing to sell alternatives to traditional insurance that provide customers limited protection, said Corlette. Plans such as short-term limited duration, fixed indemnity, health care sharing ministries, and Farm Bureau health plans, could expose customers to financial risks, she said, so it’s important to research carefully before purchasing.
Seek help – If you’re facing significant premium increases or need assistance navigating the Marketplace, contact Help Health Mississippi, a free service operated by the Mississippi Health Advocacy Program, said program manager Khaylah Scott. The program’s website is helphealthms.org and its toll-free number is 1-877-314-3843.
Time is running out for Congress to extend the increased subsidies, Corlette said, noting that customers could be deterred by higher prices and opt not to renew their coverage for next year, on top of the back-end system changes that would take time to implement.
“The later we get, the harder it gets,” she said.
For consumers with a month and a half left to decide what to do about their coverage, the timeline is daunting.
“It’s overwhelming,” said Marie, who said she plans to reach out to her health insurance plan for help and explore the possibility of Medicaid coverage as the end of the year nears.
She is also turning to prayer.
“I pray a lot,” Marie said. “And we are going to keep praying because that’s the way things got to be.”
Starkville-based Campusknot was co-founded by Rahul Gopal, a graduate of Mississippi State University. Its growth and evolution illustrate the possibility and support that exists in Mississippi for startups.
“Campusknot is a perfect example of what happens when the in-state ecosystem works together over time,” said Lindsey Benefield, investment director at Innovate Mississippi. “They’ve had support at every stage — from Mississippi State University and the E-Center, to Innovate Mississippi, to individual angels — all reinforcing and building momentum around a strong Mississippi founder. The progress they’re making is well-earned.”
Katherine Lin
Gopal came from India to study aerospace engineering at Mississippi State University. The initial concept for Campusknot started while he was in college, with support from the Mississippi State Center for Entrepreneurship. Over the past 10 years, Campusknot has adapted to new technologies but the core idea of enhancing student engagement in the classroom has remained.
In its current form, the platform helps professors connect better with students. It acts as an AI teaching assistant that manages assignments and student participation.
Campusknot has been supported by Innovate Mississippi and Idea Village in Louisiana. These regional startup incubators have been “instrumental” in the company’s development, according to Gopal.
Entergy Mississippi investing over $1B into grid infrastructure
One of the projects Entergy is investing in is a natural-gas power plant in Vicksburg.
At a recent event, Entergy Vice President of Business and Economic Development Ed Gardner reiterated the company’s assertion that these projects will not place too much burden on consumers thanks to larger customers, such as the state’s burgeoning data centers.
“Your bills will be 16% lower than they were going to be because of these large customers that we’re bringing in,” said Gardner.
Joint Legislative Budget Committee adopts revised revenue outlook
A panel of Mississippi lawmakers that leads the Legislature in setting a state budget last week adopted revised revenue estimates for the current fiscal year and the coming one.
For FY 2026, which ends in June, the lawmakers revised their final estimate of state revenue downward by about 1%, or $75 million, to $7.55 billion. For fiscal year 2027, which starts in July, lawmakers on the JLBC also used a cautious estimate, banking on revenue being down to $7.532 billion.
State Economist Corey Miller gave lawmakers an update on tax revenue. He said corporate income tax collections are down slightly, sales tax revenue is up and individual income tax collections are up despite the state phasing out the tax.
The JLBC agreeing on how much money the state has to work with is an initial step for setting a state budget. The full Legislature convenes in January and will set a budget for the coming fiscal year.
Rick calls in from New York to discuss all the latest in Mississippi football, including the sixth-ranked Rebels claiming their latest victim, the Golden Eagles’ improbable run and Delta State’s opponents simply chickening out. Also, the Cleveland boys run down the 2025 Mr. Football winners and the first round of the high school playoffs.
Editor’s note: This essay is part of Mississippi Today Ideas, a platform for thoughtful Mississippians to share fact-based ideas about our state’s past, present and future. You can read more about the section here.
There’s a tone many of us recognize in our bones. Not outrage. Not apathy. It’s that faded, sepia-toned feeling – the sense of standing just offstage while the rest of the country barrels past in red or blue. You care, but you don’t quite belong.
That’s where millions of Americans live. Nearly 80 million eligible adults didn’t vote in the last presidential election. These aren’t people who don’t care. Many simply don’t feel spoken for by either party or the culture at large.
What we hear again and again, here in Mississippi and beyond, is this: Most people genuinely want what’s best. They just disagree – sometimes fiercely – on what that looks like.
Philosopher Alasdair MacIntyre warned decades ago that our moral arguments have grown hollow because we’ve lost the shared frameworks that once gave them meaning. Words like freedom and justice still circulate, but we no longer agree on what they mean.
Lora Delhom Credit: Courtesy photo
Psychologist Jonathan Haidt explains why: People weigh values differently. One person hears “choice” and thinks freedom. Another hears “choice” and worries about fairness. Both are moral positions — just spoken in different languages.
You see it on the ground here. At a recent Leland City Council meeting, one group argued that a family shouldn’t live in a collapsing house without running water. Safety and liability demanded action. Another group insisted removing the family would cause deeper harm, because even a dangerous house was still shelter. Both sides were trying to do the right thing. They just couldn’t agree on what “right” looked like.
You see it at the Capitol in Jackson. The school-choice debate pits parents’ desire for options against public schools’ plea for resources. Both sides want opportunity for children. But one defines it as freedom to choose, the other as fairness in access.
And you see it in Washington, where Congress once again failed its central duty of passing a budget. For nearly half a century, lawmakers have rarely met that deadline. The American people are rightly frustrated. But underneath the dysfunction is the same issue – a translation failure between competing visions of “best.”
Have we built our fences so high – political, cultural, even literal – that we can no longer see the beauty on the other side?
Here in Mississippi, that question matters. We know how high the stakes are. One in four of our children grows up in poverty. Our ACT averages lag the nation. Yet we also know what’s possible. The “Mississippi Miracle” in early literacy showed the nation that bold investment, bipartisan policy and shared commitment can move the needle for kids.
We don’t need perfect agreement to do it again. But we do need recognition that our neighbors, even the ones we spar with, are usually trying to do the right thing. Moral humility – not certainty – may be the only way forward.
Mississippi has a chance to lead by example. That means demanding transparency and results in every school, whether public, private or charter. It means protecting both individual rights and community responsibilities. And it means refusing to let ideological corners dictate the fate of children who need every adult at the table.
We’re not enemies. We’re just holding different maps. And maybe, if we stop mistaking translation failure for moral failure, we’ll realize we’re all still steering toward what’s best.
Bio: From Chicago to New Orleans and back to the alluvial Delta soil, Lora Delhom writes, teaches and creates art shaped by the river’s flow and guided by a commitment to people and animals. She is an educator and community storyteller based in Leland. Her work reflects both a love of place and a belief in the power of words to build bridges across divides.
A North Carolina senator is holding up Mississippi’s nominations for federal judgeships and U.S. attorneys because he wants Sen. Roger Wicker to help an indigenous group in his state gain federal recognition as a tribe.
Republican Sen. Thom Tillis told a reporter from NOTUS that his block on four Mississippi nominees is due to negotiations with Wicker, Mississippi’s senior senator, over federal recognition of the Lumbee and other issues unrelated to the nominees themselves. Wicker serves as chairman of the Senate Armed Services Committee, which has enormous sway over the legislation in which the Lumbee tribe would be recognized.
“Roger’s one of my favorite people here, and, you know, it’s just a matter of using the leverage people use every day here,” Tillis said.
Wicker’s office did not respond to a request for comment.
The Lumbee is a group of indigenous people in North Carolina that has been seeking federal recognition as a tribe for over a century. But other federally recognized tribes have opposed the effort.
Tillis has been a vocal supporter of federal recognition for the Lumbee. He is not running for reelection in 2026, so next year will be his final opportunity to secure a bipartisan bill for the indigenous people.
President Donald Trump has also supported federal recognition for the Lumbee.
Most of North Carolina’s congressional delegation supports federal recognition of the Lumbee. Language granting them federal recognition was added to the House version of the Pentagon’s annual spending blueprint.
But language about the Lumbee was not included in the Senate’s version of the blueprint.
Tillis also said he is negotiating with Wicker over other issues, but he declined to say what the issues were.
In August, Trump nominated Robert Chamberlin and James Maxwell, both justices on the Mississippi Supreme Court, to vacant federal judgeships in northern Mississippi. Trump in July nominated Scott Leary and Baxter Kruger, his choices for U.S. attorney for the Northern and Southern districts of Mississippi, respectively.
None of the four nominees responded to requests for comment. Both Wicker and Mississippi’s other U.S. senator, Cindy Hyde-Smith, support the nominees, though neither is a member of the Judiciary Committee.
This story is provided by a partnership between Mississippi Today and the NOTUS Washington Bureau Initiative, which seeks to help readers in local communities understand what their elected representatives are doing in Congress.
Monday’s Supreme Court decision to deny a request to overturn its ruling that legalized same-sex marriage drew sighs of relief from same-sex couples in Mississippi.
“I’m relieved the Supreme Court let this one go,” said Kyle Harshey, who is married to the Rev. Christopher McAbee, associate rector at St. Andrew’s Episcopal Church in Jackson. “I don’t believe the person you love is up for debate.”
More than two-thirds of Americans say that same-sex couples deserve the same rights and protections as people in traditional marriages, according to Gallup polling. Among Democrats, that support has risen this year to its highest level, 88%, while the support among Republicans has fallen from 55% in 2021 to 41% this year.
In Mississippi, support for same-sex marriage is 54%, according to a 2024 report by the Public Religion Research Institute, but the state is also home to nearly 6,000 same-sex marriages, according to 2020 U.S. Census data.
In June, the Mississippi Baptist Convention passed a resolution calling for the Supreme Court to reverse its decision on same-sex marriage, just as justices did in reversing its historic ruling on abortion.
The Rev. Shawn Parker, executive director of the Mississippi Baptist Convention Board, said they are disappointed the Supreme Court didn’t take up the issue.
“Our convictions are that everybody should be treated with kindness, but we believe that God designed marriage for a man and a woman for life,” he said. “That serves as the context for raising children. That serves as the fabric of society.”
While there is a legal aspect to marriage, the convention’s concerns center on the sanctity of marriage, he said. “It was ordained by God in the beginning.”
These days, society disregards “God, the creator, more and more,” he said. “We’re becoming more self-focused, which is detrimental to society and ultimately detrimental to each of us. We should be God-focused and other-focused.”
Everyone looks to an authority, he said. “That authority might be my own opinions, popular culture or science or some other source, but we choose to start with the authority of God as the creator and his word and his revelation.”
The Catholic Church remains opposed to same-sex marriage, but the late Pope Francis in 2023 allowed priests to bless same-sex couples in a pastoral capacity for individuals who love one another.
The United Methodist Church in 2024 repealed its prohibitions on its ministers officiating at same-sex weddings, a factor that has led to more than 6,000 congregations leaving the denomination.
The Episcopal Church has been performing same-sex marriages since 2015. Harshey and McAbee married three years later.
McAbee said he and many others are elated over the Supreme Court decision. “I’m also feeling that it’s very important for us in the LGBTQ community to not gloat in our victory, but to remember there are so many other Americans facing injustices,” he said.
Many are being hurt by health care cuts, and “undocumented people are being terrorized by ICE,” he said.
It is a time to pause for thanksgiving, “but also a moment to remind myself that this is part of an effort to create justice for all people,” he said.
On Monday, the Supreme Court declined to hear the petition filed by Kim Davis, a former Kentucky county clerk who drew national attention for refusing to issue same-sex licenses because of her religious beliefs. She defied court orders to issue these licenses until a federal judge jailed her for contempt of court. In 2018, she lost a reelection bid.
She wanted justices to overturn an order that has required her to pay more than $300,000 in damages to the couple denied the marriage license. She also wanted the Supreme Court to overturn its 2015 same-sex marriage ruling in Obergefell v. Hodges.
Justice Clarence Thomas was among the four justices who dissented in that opinion. He has called for reversing that decision.
Harshey said he believes Davis’ religious beliefs present “a distorted view of Christianity,” which in reality are a “shield for discrimination,” he said.
While he is “personally thankful” for the outcome, he said Monday’s action is far from the end because some justices still want to reverse the 2015 decision.
GOODMAN — At 102 years old, James Anderson has one piece of advice.
“All I know is love one another and be good to each other,” he said.
The centenarian was born in rural Sallis, in central Mississippi’s Attala County, on Sept. 18, 1923, the seventh of eight children. His father was a sharecropper, and he spent his childhood farming with his family and went to school part-time.
Anderson now lives in Goodman in Holmes County. One of his daughters, Dorothy Falls, is retired and takes care of him. His home is right next to his two-acre garden and a restaurant owned by his son Ricky, called Rick’s Drive Inn. Anderson still spends time in his garden.
James Anderson at his Goodman home with his daughter Dorothy Falls. Anderson, who went through Army basic and combat training in 1943, said to all those who have served and those currently serving, he thanks them for their service and wishes them a blessed Veterans Day. Credit: Vickie D. King/Mississippi Today
In 1943, Anderson was sent to Fort Eustis in Virginia for training after being drafted to the Army during World War II.
He said he spent six months in basic training and combat training. However, he was discharged after training and never saw combat. To this day, he doesn’t know why.
“They shipped everybody out but me,” he said. “I never did understand it. They didn’t tell me nothing. They just gave me a discharge.”
Anderson’s experience in training does provide him with a respect of the military. He said he wanted to express his appreciation to all veterans as they are honored on the national holiday.
After training, Anderson returned to being a farmer while also taking on various jobs across the country to support his wife, Annie Lou, and their eight children. He and Annie Lou married the same year he went to training.
James Anderson, 102, at his Goodman home. Credit: Vickie D. King/Mississippi Today
Anderson’s jobs spanned from Memphis to Chicago and more. But he has always come back to his home state.
“I guess I like Mississippi better than I did anywhere else,” he said.
Anderson became a custodian and later bus driver at Goodman-Pickens Elementary School, retiring in 2005. He was ordained as a deacon in 1947. Annie Lou passed away in 1993, after 73 years of marriage.
In 2023, the year Anderson turned 100 years old, the Mississippi House of Representatives adopted a resolution to honor him for his service.
The resolution says Anderson “shot the (large) 40MM guns and remained a steadfast and brave soldier for the United States of America.”
Federal cuts to Medicaid and policy changes to Medicare signed into law by President Donald Trump in July could force Mississippi nursing homes into dire straits and leave vulnerable adults on the streets, experts say.
Costs previously covered by the federal government will shift to states and poor families under the law, and some nursing homes will be forced to close while residents are rendered unhoused, industry leaders said. The law also rolls back a Biden-era rule calling for increased staffing in nursing facilities. In conjunction with the staffing cuts most nursing homes anticipate having to implement under the new budget constraints, industry leaders expect drastic repercussions for those served by and employed in nursing homes.
“This law is really going to reshape the face of health care across the United States, including long-term care,” said Sam Brooks, director of public policy at Consumer Voice, a national nonpartisan advocacy group for long-term care. “We fought this bill tooth and nail and just really see this as an existential crisis for disabled and older folks.”
Lawmakers in favor of the law argue it doesn’t make cuts to Medicare – the federal insurance program primarily for elderly adults – but long-term care advocates argue nursing homes and residents will be harmed by these changes. Nationwide, the majority of nursing home residents use Medicaid – a fact that becomes more pronounced in Mississippi, the poorest state.
“Nursing homes rely heavily on Medicaid,” Brooks said. “You can’t cut a trillion dollars in Medicaid and not affect all Medicaid budgets … Nursing homes are not going to be over here siloed.”
Vulnerable adults in Mississippi stand to lose more, with 74% of the state’s nursing home residents on Medicaid, significantly higher than the national average, said Sylvia-Nicole Cecchi, project coordinator with the Mississippi Health Advocacy Program.
“Ultimately, these cuts could disrupt care for roughly 69,000 seniors and people with disabilities in Mississippi who rely on Medicaid,” Cecchi said. “When states are forced to cut nursing home reimbursement rates, studies show that the quality of care declines — residents face fewer staff, less attention, and poorer health outcomes.”
Home- and community-based care is also likely to be affected, though the bill doesn’t make direct cuts to the service, explained Priya Chidambaram, a senior policy manager who focuses on long-term care at KFF, a health care research nonprofit.
“It’s a significant source of Medicaid spending,” Chidambaram said. “It’s also optional, so that’s a place states kind of have to look at first when federal spending is cut.”
The majority of long-term care Medicaid users receive care at home in the U.S. In Mississippi, roughly 3 in 5 Medicaid recipients access care this way, according to a KFF analysis.
Elderly adults will also be subject to subtle but significant enrollment changes to Medicaid and Medicare programs, such as an increase in paperwork.
One such example is the reversal of a Biden-era policy that made it easier for people to enroll in and remain on what’s called the Medicare Savings Program. That program allows low-income Medicare beneficiaries to supplement their plan with Medicaid to bring down out-of-pocket costs for premiums, deductibles and copayments.
As a result of increased red tape, eligible beneficiaries are expected to get kicked off, denied or scared away from the savings program. Costs will increase for 1.3 million Medicare beneficiaries who are not able to take advantage of the supplemental Medicaid coverage, the Congressional Budget Office estimates.
“A lot of what this law does is just adds paperwork for people,” said Toby Edelman, a senior policy attorney with the Center for Medicare Advocacy. “There’s no reason to have an eligibility determination every six months for people that have no change in anything. These elderly residents are not getting new income.”
The law also changes Medicaid’s policy around retroactive coverage for nursing home residents from three months to two months.
Retroactive Medicaid coverage for nursing home residents exists because going to a nursing home is not always planned. Sometimes an older adult will be discharged from a hospital to a nursing home after suffering a disabling condition, and oftentimes that person isn’t already on Medicaid.
It might not seem like much, but paying out of pocket for one month in a nursing home can wipe out a person’s savings, Edelman explained.
“The out of pocket costs for nursing homes these days are very, very high – $5,000 or $6,000 a month,” she said. “People just don’t have that kind of money – especially people who are eligible for Medicaid.”
Nursing homes are allowed to evict residents for unpaid bills, though it’s not clear how many evictions are wrongful – or how often unpaid bills are a result of a Medicaid enrollment error. The most frequent complaint against nursing homes is consistently related to evictions and transfers, according to the National Long-Term Care Ombudsman Resource Center.
An increase in enrollment errors, at a time when facilities are facing tighter budgets, could lead nursing homes to evict Medicaid-eligible seniors with unpaid bills.
“One of the biggest drivers of involuntary discharge in nursing homes is unpaid bills,” Brooks said. “And oftentimes those bills are unpaid because of some Medicaid snafu – not getting the documents in, not applying on time.”
Nursing home facilities will suffer, too. Keeping residents housed while not getting reimbursed by Medicaid could force already-struggling homes to shutter. In Mississippi, there are 11 nursing homes at risk of closure, according to the United States Senate Committee on Finance in June.
Leadership at the 11 nursing homes could not be reached by the time of publication.
The Mississippi Health Care Association, the state’s largest association of nursing homes, did not respond to a request for comment.
“The destabilizing effect (the law) will have on nursing homes and their residents will leave these seniors in peril,” said Cecchi, of the Mississippi Health Advocacy Program.
Mississippi nursing homes at risk of closure:
Glenburney Health Care and Rehabilitation Center in Adams County
West Point Community Living Center in Clay County
Leakesville Rehabilitation and Nursing Center, Inc. in Greene County
Pleasant Hills Community Living Center in Hinds County
Columbia Rehabilitation and Healthcare Center in Marion County
Diversicare in Batesville in Panola County
Pearl River County Nursing Home in Pearl River County
Longwood Community Living Center in Prentiss County
Azalea Gardens Nursing Center in Stone County
River Heights Healthcare Center in Washington County
Mississippi Care Center of Greenville in Washington County
