The Senate after much debate — and efforts to make the measure stronger — passed a House bill to prohibit private companies and Mississippi governments from requiring COVID-19 vaccination of employees over their “sincerely held religious objections.”
But the Senate added a change to the bill to ensure more debate and scrutiny before it could be sent to the governor and signed into law. This was out of fear that the measure could jeopardize federal funding for state universities.
The Senate passed House Bill 1509 on a 36-15, party line vote with Republicans voting in favor. The bill, authored by Republican Speaker of the House Philip Gunn, passed the House in a mostly party line vote in January.
“The Senate passed a strong, conservative bill which protects employees and children attending school in Mississippi from a COVID-19 vaccine mandate,” said Lt. Gov. Delbert Hosemann. “I personally support a broader bill providing a religious exemption for vaccine requirements for schools and will support that provision when it is properly before the Senate.”
Sen. Chris McDaniel, R-Ellisville, offered an amendment to provide such a broad exemption from any vaccine requirements, not just COVID-19. But a point of order was raised that the original bill applied only to COVID-19 and his amendment was too expansive. Hosemann ruled it was too expansive an amendment. McDaniel took the unusual step of appealing Hosemann’s ruling to the full Senate, which voted 34-16 to uphold Hosemann’s ruling.
“This may not seem like a civil rights issue, but it is a civil rights issue — the right of people to control what goes into their body,” McDaniel said.
A group of supporters of the vaccine mandate ban packed the Senate gallery, and had to be warned twice by Hosemann to stop cheering when lawmakers made anti-vaccine mandate statements.
Sen. Chad McMahan, R-Tupelo, offered an unsuccessful amendment to allow a medical-condition exemption to any vaccine mandate. Although his amendment failed, he was assured that is already in state law.
“We’re here today because the federal government overstepped its authority to tell people they have to take an experimental vaccine,” McMahan said.
Sen. Brice Wiggins, R-Pascagoula, told his colleagues he represents “ground zero” for vaccine mandates, with Ingalls Shipbuilding in his district. The shipyard enacted a vaccine mandate, but later suspended it as 20% of its 11,500 employees faced termination for not being vaccinated.
“Those employees shouldn’t be put in the position at all,” Wiggins said.
But Sen. John Horhn, D-Jackson, questioned whether the bill could jeopardize community health.
“So the rights of the individual trump the rights of society?” Horhn said, drawing a loud cheer from supporters of the bill in the gallery. “Their rights are going to trump the safety of a whole city, whole community or the whole state? By pushing individual rights, we could be putting a lot of people at risk.”
“That’s a risk we’re willing to take for protecting individual rights,” said Sen. Dennis DeBar, R-Leakesville.
But DeBar successfully added a “reverse repealer” amendment to the measure to provide more time to scrutinize the bill and make sure it doesn’t “jeopardize federal funds for IHL.” This means the House and Senate would have to vote on the measure again before it could be signed into law.
The bill is a response to a battle raging since last year between those opposed to various COVID-19 vaccine mandates issued by President Joe Biden. Some of those mandates have been upheld by the federal courts while others have not.
Besides exempting employees of private businesses from the vaccine mandate, it also would prohibit state and local governmental entities from forcing a vaccine mandate on their employees and would prohibit those entities from withholding services from people who have chosen not to be vaccinated.
The bill would also apply to the National Guard. The U.S. Department of Defense has mandated a vaccine mandate for members of the National Guard. That issue is in the federal courts.
Mississippi moms could soon lose access to healthcare at a critical period after giving birth after a measure that would extend their Medicaid coverage died in the state House of Representatives.
The Republican-led effort to prolong new mothers’ Medicaid coverage for a year passed overwhelmingly in the state Senate last month. Lawmakers who supported the bill and health advocates noted the state’s high rate of maternal and infant mortality as one reason the extension is needed.
The House let the measure die without a vote on Wednesday, likely meaning that the 60% of pregnant women in Mississippi who are on Medicaid will lose their health insurance just two months after giving birth—a period when they are still at substantial risk of fatal complications from pregnancy.
House Speaker Philip Gunn, a staunch opponent of Medicaid expansion, told Mississippi Today that he viewed the bill in that light.
“I think there were different views on whether this expands Medicaid,” Gunn said. “I have been very clear that I oppose Medicaid expansion, and that I believe we should be working to get people off Medicaid as opposed to adding more people to it.”
But the measure would not have added anyone to Medicaid in Mississippi. It would simply have allowed pregnant women, who already qualify for Medicaid, to get healthcare for 10 additional months.
Requests for comment from Rep. Joey Hood, chairman of the House Medicaid Committee, were not returned. He told the Associated Press legislators would revisit the issue next session.
Sponsor Sen. Kevin Blackwell, R-Southaven, framed the legislation as a way of protecting children in the state with the country’s highest infant mortality rate.
“All I’m saying is we’re protecting (children) in the womb,” Blackwell said during debate over the bill earlier this year. “Let’s protect them out of the womb for up to a year.”
Blackwell also noted that Mississippi is asking the U.S. Supreme Court to overturn Roe v. Wade and uphold its law prohibiting abortions after 15 weeks. He described his legislation as pro-life. On Wednesday afternoon, he told Mississippi Today he was disappointed that the measure had died for the second year in a row.
“While infants are still covered under Medicaid, mothers lose coverage after 60 days,” he wrote in a statement. “All this bill would’ve done was continue that coverage for a total of 12 months.”
Gunn, who is also adamantly anti-abortion, when asked about Senate Republicans pitching the measure as pro-life, deflected and referred again to Medicaid expansion.
“Our position on expansion is clear,” Gunn said.
Maternal and children’s health advocates and physicians in Mississippi had been optimistic that the bill would pass, ensuring moms covered by Medicaid would be able to access vital health care during the first year of their baby’s life.
On Wednesday, they were frustrated and angry.
“I feel as if they are playing politics with women’s lives,” said Cassandra Welchlin, co-convener and state lead of Mississippi Black Women’s Roundtable. The organization had lobbied for SB 2033 and Welchlin thought it had the votes to pass.
“A failure that will deny mothers the health care they need,” one of the bill’s co-authors Sen. David Blount, D-Jackson, wrote on Twitter.
During the COVID-19 pandemic, the federal government required Medicaid coverage for pregnant women and other beneficiaries to last as long as the public health emergency. But that declaration, last extended in January, could end as early as April 16.
A 2019 health department report on maternal mortality in the state found that nearly 40% of all pregnancy-related deaths in Mississippi from 2013 to 2016 occurred more than six weeks postpartum. Heart conditions and hypertensive disorders were the two most common causes of death. Black women in Mississippi are three times likelier than white women to die of pregnancy-related complications.
Dr. Anita Henderson, President of the Mississippi Chapter of the American Academy of Pediatrics, said pediatricians, obstetricians and family practice doctors would continue advocating for postpartum Medicaid extension.
“Extending coverage to 12 months would help save lives by providing mothers access to much-needed healthcare services, including treatment of postpartum depression, asthma, diabetes and other medical conditions that put mothers and their babies at risk,” she wrote in a statement to Mississippi Today.
Some legislators also questioned Gunn’s handling of the bill.
“He’s one man,” said Rep. Omeria Scott, D-Laurel, a member of the House Medicaid Committee. “Why does he not let the process work?”
That point stood for Medicaid expansion in general, Scott added.
“He should not have one-man veto power when you’ve got poll after poll out there that 60%-plus people say they want to expand Medicaid.”
Mississippi is one of 12 states that have not expanded Medicaid eligibility under the Affordable Care Act. But many of these states, almost all in the South, have passed laws to ensure Medicaid coverage lasts for at least six months after birth. Florida, Georgia and Tennessee did so in 2021.
On Wednesday, Welchlin said she was thinking about the Black and brown Mississippians she has met in the course of advocating for women’s healthcare access. Many of them are working moms who don’t get healthcare through their jobs and can’t afford to buy it on their own. And she was thinking especially about the Black women in Mississippi who have died of pregnancy-related complications at disproportionately high rates.
“They’re gone, and then their children are left with family members,” she said.
For much of the last two decades, Von Gordon has encouraged Mississippians to talk about race. As a student at the University of Mississippi, he helped organize the first Statewide Student Summit on Race. Gordon, 42, is now the executive director of the Alluvial Collective, formerly the William Winter Institute for Racial Reconciliation. The nonprofit aims to create stronger communities in Mississippi through educational events, like hosting seminars, assisting in oral histories, and mentoring high school students.
This session, discussion of race and racism in Mississippi in K-12 school and university classrooms are coming under threat. Last week, the House passed Senate Bill 2113, which seeks to ban the teaching of critical race theory in public schools. Now, Gov. Tate Reeves is poised to sign the legislation, and educators across the state are anxiously waiting to see how it will impact their ability to teach about race and racism in Mississippi.
The day after the House passed SB 2113 last week, Mississippi Today spoke with Gordon for “Mississippi in the Know,” a series of free breakfast conversations with policy experts.In this interview, which has been edited and condensed for length, Gordon talked about school desegregation in Mississippi and how that inspired Derrick Bell’s writings on critical race theory.
Molly Minta: Derrick Bell is one of the founders of critical race theory, and he worked as a lawyer for the NAACP legal defense (fund), and he actually litigated a school desegregation case in Leake County. His experiences working on that case were really formative for the academic work he later did to develop critical race theory. I would love it if you could talk to us a little bit about his experiences.
Von Gordon: There’s a definition that I’m really fond of. Lee Anne Belldescribes it in a book about teaching for social justice, and she writes: “Critical race theory analyzes and challenges mainstream narratives in law, history, and popular culture that uphold the status quo.” And a big part of how they do that is through counter storytelling.
I think it’s really important that Dr. Bell spent a lot of time here, and it was informative in how he thought about this theory. So he is already in Mississippi doing some work in the early 1960s. There’s an opportunity to help with the desegregation of Leake County schools.
One of the interesting things is, there was a Rosenwald School already there that was of deep value to the community. It had served the community well, even in the context of gross underfunding and, frankly, gross segregation. So there was a need that the Black people in particular in that community had to have an equitable education experience. The Legislature could have fixed that, but it did not.
There were people (in Leake County) who were concerned that by desegregating the schools, they might lose this really valuable asset that they had poured themselves into and that had produced a lot of opportunity for their children — and actually (a lot of opportunity) for them.
Now, one of the things I’ve learned about these communities — Harmony is one of them — is that they are really strong and resilient communities. We know in other parts of the country, strong communities like that got destroyed, whether you’re talking about Tulsa or Rosewood or others. The context really matters in that way. (Bell) recognizes that the law is really critical to desegregation, to unleashing the potential of being a citizen in the United States.
When we think about what critical race theory seeks to do, it seeks to have a full examination of the impact of race in our society. And I think it’s been fun, and in some ways funny, to watch this conversation happen nationally, in part because in many ways it is detached both from the real impact of systemic racism, but also what it looks like in the communities where we live and work.
MM: Another tenant of critical race theory (is) this idea of “interests converging.” Could you talk to us a little bit about that, how we can understand that idea in Mississippi?
VG: Dr. Bell is one of the scholars who has written most about this. He talks specifically about some of the civil rights gains and how they were really made possible, not because there was this great awakening in the country that Black people or Native people needed their rights or they deserve their rights. That was a part of it, but it was also that it benefited white America too.
For folks who are curious about the civil rights struggle of the sixties — when the president got involved most actively (in Birmingham), it was when the State Department and diplomats started to send back how what they were seeing on TV played across the globe.As the Cold War is emerging, we cannot project out equality and the dignity and respect of every human being, and here we have German shepherds biting our community’s babies.
The passage of the Civil Rights Act and the Voting Rights Act — based on Dr. Bell’s work — had as much to do with what benefited the whole as it did just the need to extend these rights, basically to live out our Constitution. I think that’s an important thing for us to consider.
I’ve always been fascinated by debates about affirmative action. When I was in college and since, one of the things that I’ve always heard about affirmative action policies was that the biggest beneficiary of those policies were white women. And most of the data bears that out. But the burden of affirmative action and the stigma around it is typically born by Black people.
I think we have to ask ourselves … Are we doing things for the right reason? Or doing things in the interest of equity and justice? Or are we doing them also because it’s in our self interest?
There’s a windfall of infrastructure dollars, right, coming into the state. One of the things we know about infrastructure is, historically, where what got placed had an impact on the people living there. Most of the negative impact, particularly in our urban centers, are … born out by the black and brown people in those countries.
So are we thinking intentionally at our Department of Transportation about how this amount of infrastructure dollars are going to be spent? How are we thinking about equity, or are we only looking for where our interests converge?
MM: When I was interviewing students in Mississippi’s only law school class on critical race theory, they were talking to me about how, on the one hand, the idea of interest convergence can seem a little like Machiavellian almost. It’s not these pure ideas of equality and justice that are leading to these social changes, but the economic or material realities of, how does this change benefit people who have power in society? There’s that more cynical interpretation, but there’s also a way of thinking about it where it can actually provide a roadmap for how to create change in society.
VG: My friend and colleague now at the Alluvial Collective, Chauncey Spears, often talks about how we prepare ourselves and young people to be better citizens. One of the important things I think we have to do is let go of some fear so we can really do a deep and honest examination of who we are and how we show up in the world, and the institutions we’re part of and the systems that we encourage.
Think about where the fear is coming from, cause we’re seeing this with the whole CRT debate. It’s rooted in the fears around what young people are learning and what that might tell them about who we are — or make them question about who we are.
I’ve worked with amazing young people for a long time. I’ve been in spaces where we’ve talked about the death of Emmett Till, and the white students in the room have shared all of the emotions of guilt and shame and assume blame and a lot of other things, almost all of which are unhealthy when it comes to how we move forward. And I’ve had the experience of, Black kids, particularly Black males, 14 or 15, wondering about their own value.
Critical race theory is just one of many different ways that we need to examine the impact of oppression in our society. It is one thing to think about where we want to go and how we get there. It’s another thing to do an examination about how we have destroyed human potential for generations.
Von Gordon
A really good friend of mine said this about white kids learning about slavery and feeling some kind of way – that parents should applaud their white child who comes home and is upset about slavery as white person, because it’s evidence that their child has a moral compass. When we think about the value of a moral compass for budding citizens, that’s a really important thing. And for a black child to learn that they do have value. What happened to Emmett Till is not something anyone deserved for any reason.
The complexities of how our young people are raised to explore our history, but also kind of draw from that (history) lessons for how they need to show up as citizens should really be at the heart of this, not our fears.
MM: What you’re saying connects to what you talked about at the beginning of our conversation about an important aspect of critical race theory being counter-storytelling. … I’m wondering if you could maybe talk a little bit more about other examples of counter storytelling in Mississippi?
VG: I’ll tell you, I remember talking to … my middle daughter. She was talking about Lewis and Clark and the expedition. She was so proud of what she learned. Her older sister asked her, ‘so tell me about the other people in that story? What do you know about them?’
There were Native people there, right? They’re just the backdrop. Not only is that disrespectful, it’s a really bad way for us to learn our history. If we polled our middle school students and asked them if the original people in Mississippi, if any of them are still in Mississippi? They would probably say no, they died a long, long time ago. But Chief (Cyrus) Ben is a steward of an incredible history and community that most of our young people don’t even know exists.
In our work, first of all, we don’t go anywhere we’re not invited. When we get there, one of the first things we do is put people in circles, because circles are one of the oldest forms of community.
We recognize that at the fundamental level, where people are living their lives, they need to have a couple of things happen. They need to be able to see each other fully. They need to be able to hear each other fully. And the one thing everybody in the circle is an expert in, is their stories.
It’s intimidating when you show up in a space, and you know there are people in there with expertise, and you don’t feel you have an expertise. But when you show up and all you have to do is tell your authentic stories, who you are and where you come from and what shaped you? And that’s all everybody else has a license to do? Then you get to know each other in a unique and different way.
MM: When people are sharing their personal stories, what kind of questions do their community members tend to ask them?
VG: One of the first things I always hear is shock. Like, ‘oh my god, I didn’t know that about you.’ Or, ‘I had the same experience.’
Let me come back to the desegregation of schools in Mississippi. … When the schools in Mississippi were desegregated, that was an incredibly traumatic experience for everybody. Now, critical race theory will challenge you to examine who got the jobs at the newly integrated schools and who had to go find another line of work. But it was a deeply traumatic experience for everyone. And not many people have had the opportunity to tell those stories or share them with folks who might’ve been on the other side of that trauma.
The assumption might be if you’re a white kid at Murrah that it was hard on you, cause you went home for Christmas and you come back and bam, bam, bam. Your world is turned upside down. You might think the brown kids who were going to your school benefited. All you can think about is the benefit that they were supposed to get from it — not recognizing that, perhaps for the first time in their lives, they’re looking at a teacher wondering if that teacher has their best interest at heart, wondering if that teacher sees their humanity?
Imagine the position at that point in time that a Black family who was already living on the margins, imagine how the power they felt — or did not feel — sending their kid into a newly integrated school, where they didn’t feel like anybody in that administration answered to them?
Like that happened all over our state. Several people have said this to me over the years, particularly in Tupelo. They have this thing they call the Tupelo way. And one of the things they pride themselves in is the approach they took to desegregating their schools. Some real-meaning people brought the community together and said. ‘we’re going to make sure our public schools are our institutions.’
There can be a healthy debate about how they actually did that, or whether that’s really, really true. But you look at how those communities sit in Mississippi now, how they are thriving? There’s a direct correlation between the sense of leadership around doing as little harm as possible compared to other communities which embraced a different way of educating their young people.
MM: I have just one last question … is there an aspect of the whole discourse and dialogue around critical race theory … that I haven’t asked or something you want to point out that you feel like people miss?
VG: Critical race theory is just one of many different ways that we need to examine the impact of oppression in our society. It is one thing to think about where we want to go and how we get there. It’s another thing to do an examination about how we have destroyed human potential for generations.
I can’t think of anybody I know who would read a book from beginning to end, from cover to cover, about critical race theory that would not come away with a sense of conviction about being better, about our need as society to be better.
We often say that previous generations did not know. One of the things that Dr. Kendi lays out really well in (Stamped from the Beginning) is, people knew, and we got the history that we have. People knew. We’re going to have to do better ourselves.
In really personal ways, this exploration of who we are matters, and CRT is one among many, many others that we absolutely need to employ. Don’t be intimidated by the jargon. Don’t be intimidated by what the talking head on TV said about it. Get in there for yourself. That’s my story, I’m sticking to it.
Briana Wright has worked all her adult life. The 27-year-old Kosciusko resident has been a crew member at McDonald’s for three years. Before that, she worked for Tyson Foods, where she mostly hung chickens for processing.
Wright is stuck in what is commonly referred to as the healthcare coverage gap. She is one of the 300,000 or so Mississippians with no health insurance because she can’t afford private health insurance but doesn’t qualify for Medicaid.
States have had the option to expand Medicaid eligibility to most people with incomes under a certain level — about $30,300 annually for a family of three — since 2014. Mississippi remains one of 12 states not to expand despite profound financial benefits and an increased federal matching rate under the American Rescue Plan Act of 2021.
As Wright and other Mississippians in similar positions continue to struggle, state lawmakers once again have decided not to consider expansion and do not seem poised to do so anytime soon.
The current program covers the disabled, poor pregnant women, children and some elderly people. Generally speaking, able-bodied adults are not eligible for Medicaid in Mississippi.
If state leaders were to expand Medicaid, at least 225,000 Mississippians would qualify for healthcare coverage — including Wright.
As a result of being uninsured, Wright doesn’t see any doctors annually for checkups or preventative care.
Briana Wright
But in May of last year, she started vomiting and experiencing severe pain in her abdomen. The intensity of the pain led her to the local emergency room. The doctors suspected pancreatitis, but at a follow-up appointment the next month with a surgeon at Jackson-based Central Surgical Associates, she was told she needed her gallbladder removed.
She let her doctor know she had no health insurance, and he suggested reaching out to the Mississippi Department of Rehabilitative Services to see if she qualified for its vocational rehabilitation program. The program offers resources to people with disabilities that impede their ability to work.
The program agreed to cover the costs of her surgery so she could continue working. Last fiscal year, the department spent over $10 million on “physical restoration,” or medical services for Mississippians with disabilities, according to the department spokeswoman. “Disabilities” are defined as any condition that is an impediment to someone gaining or maintaining employment.Despite the absence of Medicaid expansion, the state is still footing the bill to cover some working Mississippians’ medical care.
Wright was approved for the program, and she thought she had found the solution to her problem — until the $245 bill for the Central Surgical Associates consultation appointment came in the mail. She had thought the appointment cost would be applied to her surgery bill, but she soon learned she was responsible. She couldn’t afford to pay it, and the vocational rehabilitation program doesn’t pay for past bills, she said.
According to Wright, she tried to set up a $25 a month payment plan with Central Surgical Associates, but they told her she had to pay in full in order to have the surgery.
Judy Skinner and Laura Yarbrough, employees at Central Surgical Associates, told Mississippi Today they did offer Wright a payment plan. They said they tried calling her numerous times from June to November but couldn’t get through.
Wright’s bill was turned over to collections Oct. 31, though Wright maintains she wasn’t offered a payment plan. She said she only remembers one phone call from the doctor’s office, which she answered while at work but didn’t hear anyone on the line.
“I’m trying my best, but it doesn’t seem like it’s good enough,” said Wright.
Today, even if she could come up with the $245, she would have to reapply for the vocational rehabilitation program and have yet another $245 consultation with the doctor because of the amount of time that has passed since her initial appointment.
In the meantime, her symptoms have gotten worse. She regularly has sharp pains, nausea and indigestion. She often has to sit down during her shifts and has been sent home early from work several times.
“It makes it hard to work,” she said. “I wish there was a way … I could be eligible to be on some type of affordable medical insurance to help me out some.”
Lt. Gov. Tate Reeves and Speaker Philip Gunn, R-Clinton, in December 2014. Credit: Rogelio V. Solis, Associated Press
Health advocates and other Mississippi health groups have long championed Medicaid expansion. But two key state leaders, Gov. Tate Reeves and Speaker of the House Philip Gunn, have repeatedly expressed their staunch opposition.
“Briana’s experience is a poignant and far too common illustration of both the human and fiscal benefits that Medicaid expansion could bring to Mississippi,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program. “Expansion would help over 200,000 Mississippi residents get health coverage and simultaneously bring billions of our tax dollars home from Washington, D.C. Hardworking families in our state need to be able to see the doctor and get access to life-saving medicine.”
The federal government covers 90% of the costs of expanding Medicaid, leaving 10% up to states (and even less for two years under the American Rescue Plan Act.)
A recent study estimated if Mississippi were to expand the program, the state would save an estimated $212 million by 2027. That money could be appropriated on anything lawmakers wanted — not just healthcare.
The only major political player in Mississippi to signal support for Medicaid expansion is Lt. Gov. Delbert Hosemann, who often decries the working poor’s lack of healthcare access. He recently recounted the story of an uninsured mother of two in Greenwood who developed breast cancer but delayed seeing a doctor. She died soon after.
“The lieutenant governor has visited with many Mississippians who are working every day without healthcare coverage for themselves and their families. When people are healthy, they are in a better position to be employed, contribute to their communities and take care of their families,” Leah Smith, Hosemann’s chief of staff, said in a statement to Mississippi Today. “The lieutenant governor continues to be interested in finding solutions which increase healthcare access for working Mississippians.”
But in the final four weeks of the 2022 legislative session, there are no bills to expand Medicaid or healthcare coverage to any working Mississippians. At least eight expansion bills were filed this session, but none were ever debated or considered before dying in committee.
Dozens of similar bills have been filed in past years but have never made it far. The Republican-controlled legislature, coupled with the opposition from Reeves and Gunn, means there is very little appetite for even exploring expansion.
Sen. Chad McMahan, a Republican from Guntown, is a rare outlier — though he says he is “not necessarily for expanding Medicaid.”
“I’m interested in holding hearings on Medicaid for the purposes of reform,” McMahan told Mississippi Today. “… I do not want to expand Medicaid to anyone who is not working, but for those Mississippians who are and do not have basic minimum coverage, (I support creating) a category for them to have basic emergency health care services.”
McMahan’s father was a small business owner, and their family did not have health insurance. He remembers the $20,000 medical bill they incurred after he had an injury in the 1980s.
“I am very sympathetic to working people that don’t have healthcare,” McMahan said.
In the meantime, Wright and 300,000 other uninsured Mississippians remain without access to any healthcare — and Wright fears losing her job, or worse.
“I’m afraid my gallbladder will worsen and make me even more sick,” she said.
The MHSAA Basketball Tournament wrapped up Saturday in the most dramatic sense possible, with the Clinton boys overcoming a huge deficit late to beat Olive Branch in the 6A Championship. Clinton coach Leonard Taylor joins the Cleveland boys to talk about the win. Plus, Rick and Tyler discuss the college baseball landscape in the Magnolia State.
Tens of thousands of patients at Mississippi’s largest hospital and its clinics will be on the hook for higher out-of-pocket costs if an agreement with the state’s largest private insurer isn’t soon reached.
As a March 31 deadline for the University of Mississippi Medical Center and Blue Cross & Blue Shield of Mississippi to sign a new contract approaches, the two parties are meeting weekly but are nowhere near a resolution to the dispute.
Though UMMC leadership maintains that reaching an agreement is their top goal, they also have another message: They’re not backing down.
“If they will not agree to pay us fairly, we will go out of network with Blue Cross and it will negatively impact some patients,” Dr. LouAnn Woodward, UMMC vice chancellor for health affairs, said in an interview with Mississippi Today on Thursday. “That is not the desired outcome. That is not what we want. But it is important to the future of the medical center that we are paid fairly. And we are going to hold that line.”
But Blue Cross also appears poised to hold its line. Blue Cross officials say they also hope an agreement can be reached, but they’ve already begun preparing to direct their customers to get care at other in-network hospitals.
“If we need to, we have the ability through a clinical team to make sure that we get them somewhere if for some reason, (UMMC) will not see them,” Bryan Lagg, senior vice president of consumer marketing and sales at Blue Cross & Blue Shield of Mississippi, told Mississippi Today on Friday.
With about three weeks before the current contract expires, here’s what you need to know about the dispute.
What the sides disagree on
There are two major points of contention in the contract negotiations:
Reimbursement rates, which determines the amount a hospital receives to provide care to Blue Cross patients.
Blue Cross’ quality care plan, which measures hospital performance and whether services provided to patients are adequate.
UMMC is asking Blue Cross for substantial increases to inpatient, outpatient and professional reimbursement rates, some as large as 50%. Overall reimbursement from Blue Cross would increase by around 30% in the first year of the new contract. UMMC asked for the same rate increases during the last contract dispute with the health insurer in 2018, but the two parties settled on a deal that didn’t raise rates. Instead, Blue Cross removed language that made the contract evergreen, meaning the insurance company could no longer change the contract terms at any time.
Blue Cross officials say that UMMC asking for this level of reimbursement is unreasonable and would necessitate a substantial increase in customer premiums.
“We have to look at this from a sustainability standpoint, particularly with the economy and what’s happened with the pandemic,” Lagg said. “We’ve got to make sure that health insurance and health care, especially focusing on prevention, is affordable.”
Woodward said that when compared to other academic medical centers in the region — such as University Medical Center New Orleans or Regional One Health in Memphis — UMMC is underpaid by Blue Cross.
“It does sound like a large ask,” Woodward said. “It is a large ask, but it is because they have underpaid us by a large amount for a long time.”
LouAnn Woodward, vice chancellor for health affairs and dean of the UMMC’s School of Medicine discusses the additional coronavirus testing sites in Clarksdale and Olive Branch during a press conference at UMMC, Thursday, March 26, 2020. Credit: Eric J. Shelton/Mississippi Today, Report For America
The other major point of contention in the contract negotiations is the Blue Cross quality care program. The program, first rolled out last year, measures hospital performance across 15 different categories that include topics like blood clots after surgeries and the rate of readmissions.
Woodward said that improving patient outcomes has been the top strategic priority at UMMC since 2015, but that the current Blue Cross “one size fits all” quality care program doesn’t take into account the complexity involved in the care the medical center provides or their status as an academic medical center and the state’s only safety net hospital.
“We’re not getting any signals that they really want to meet us in the middle. We’re getting signals that they’re still showing up — I think just to say they’re showing up, but it’s not a real, robust conversation.”
Dr. LouAnn Woodward, UMMC vice chancellor for health affairs
There are certain services and facilities UMMC has that cannot be found anywhere else in the state. These include Mississippi’s only Level 1 trauma center, Level IV neonatal intensive care unit and children’s hospital, among other critical care services.
“Blue Cross says, ‘You’re just like every other hospital. Your doctors are just like all the other doctors,’” Woodward said. “But clearly the other hospitals and other doctors in the state of Mississippi do not feel that way. Because when they have patients that are too sick for them to take care of, they send them to us.”
Woodward said that between 30-40 patients are transferred to UMMC every day from other hospitals in Mississippi. This is because those hospitals don’t have the intensive care capabilities or specialists that UMMC has. UMMC rarely transfers patients to other hospitals.
UMMC has quality care programs with other insurers, like Medicaid, but the difference is that program was negotiated between the two parties.
“We sat down, we said what will be beneficial to Medicaid, what will be beneficial to UMC. We came up with the targets together,” Dr. Alan Jones, UMMC associate vice chancellor for clinical affairs, told Mississippi Today.
Another difference is that the Blue Cross quality care program is directly tied to reimbursement rates. There are penalties for not meeting certain targets, and reimbursement levels are increased if others are met. No other quality program UMMC has with commercial insurance providers is tied to reimbursement rates, UMMC officials said.
“We’re not saying we just want to pick these measures that we already do good with,” Jones said. “We want to try to work on things that would help their members and our patients, but they only want us to do what they say every other hospital in the state has signed.”
Dr. Lee Greer, corporate medical director at Blue Cross & Blue Shield of Mississippi, told Mississippi Today that the Blue Cross quality care plan centers around things that most hospitals do, and that they’re best practices that all hospitals should follow.
“Whether your ambulance drops you off at Greenwood, or it drops you off here at a hospital in Jackson or it drops you off at the hospital on the coast, those process measures should be adhered to each time, regardless of the complexity,” Greer said.
What happens if the sides can’t agree
Most Blue Cross patients with commercial plans who use UMMC’s healthcare services will be out of network, meaning they would be billed the full out-of-pocket costs to continue receiving care at UMMC.
Officials from both sides believe that if a contract cannot be negotiated, many current UMMC patients would have to find health care at a different hospital system — a looming headache for many Mississippians who need specialized care that only UMMC provides in the state.
All affected patients — at least 50,000 across the state, UMMC officials estimated — will be notified of this up front, and they will be charged at a discounted rate instead of the hospital’s inflated “chargemaster” prices, Jones told Mississippi Today.
However, there are three groups of people the out-of-network status would not apply to:
Those enrolled in the Mississippi State and School Employees’ Health Insurance Plan would not be affected. Though that plan is administered through BCBS, the current negotiations only affect the insurer’s commercial insurance plans.
Patients who come into UMMC’s emergency room or are transferred from another hospital will still have their current reimbursement rates honored.
Patients for which UMMC has a continuity of care obligation. UMMC can’t stop caring for, say, a pregnant woman in her last trimester of pregnancy or a cancer patient who is in round two of 12 rounds of chemotherapy. In those cases, their Blue Cross reimbursement will be accepted.
Dr. Thomas Fenter, chief medical officer at Blue Cross & Blue Shield of Mississippi, wrote in a March 2 letter to Blue Cross patients that the insurer will continue to provide network benefits to UMMC patients even if they go out of network. He also instructed Blue Cross customers to provide Blue Cross or UMMC with written directions for the insurer to make their benefit payments to UMMC.
This direction from Fenter stems from a Mississippi law passed in 2013 that banned balance billing. The law states that if a health care provider accepts payment from a health insurance company on behalf of a patient, the provider is prohibited from collecting any amount from the patient above their deductible, co-pay, or co-insurance amount.
For example, if a patient is billed $10,000 by their hospital, but their health insurance company pays the hospital $5,000 per their reimbursement agreement with the hospital, the hospital cannot turn around and try to collect the remaining $5,000 from the patient. Though balance billing is illegal in Mississippi, it still happens.
However, the law doesn’t apply if the provider refuses to accept the payment from a patient’s health insurance provider. In that case, the patient would then have to file a claim directly with their insurance provider.
Jones told Mississippi Today that Fenter’s instructions are misleading and are written to make customers believe that UMMC has no choice but to accept the payment from Blue Cross. That’s not the case, and Jones said that if a contract agreement isn’t reached, UMMC will not be accepting those payments from Blue Cross.
“If we were to do that, then they would be able to pay us whatever they wanted in perpetuity, and we wouldn’t be able to do anything about it,” Jones said.
The ongoing negotiations
Though negotiations were first conducted over email starting last fall, representatives for both sides have been meeting in-person weekly since January. And as the March 31 contract end date inches closer, the sides are meeting more regularly.
Woodward and Jones both told Mississippi Today that Blue Cross is not negotiating in good faith. Each time their team has received a counterproposal from Blue Cross, it includes reimbursement increases in some areas, but when they calculate the overall reimbursement amount, it stays the same or actually decreases from current levels.
“We’re not getting any signals that they really want to meet us in the middle,” Woodward said. “We’re getting signals that they’re still showing up — I think just to say they’re showing up, but it’s not a real, robust conversation.”
Blue Cross maintains that the rates they’re offering are fair and protect their bottom line.
“At each point, we have offered increased reimbursement,” Lagg said. “They continue to come back with the same net increase in overall costs … At some point, we have to look out for our members and manage cost and quality in a more holistic view.”
UMMC is the only hospital among Mississippi’s 33 largest that hasn’t agreed to the Blue Cross quality care plan, Greer said. He also claimed that over the first year of its implementation, member hospitals have become safer, seeing their rates of readmission decrease. He also said that measures that are outcomes-driven — such as readmission rates — are risk-adjusted to account for the complexity of an individual patient’s situation.
“At each point, we have offered increased reimbursement. They continue to come back with the same net increase in overall costs … At some point, we have to look out for our members and manage cost and quality in a more holistic view.”
Bryan Lagg, BCBS senior vice president of consumer marketing and sales
Lagg also said that the quality care plan makes sense business wise, as it addresses the concerns of their policyholders.
“Our customers are coming to us,” Lagg said. “They want to make sure that on their deliveries, that they have fewer neonatal or newborn intensive care unit claims. They want fewer readmissions. And so the market is asking for that better quality.”
Woodward said the level and quality of care UMMC provides is exactly why they should be paid more by Blue Cross. And they’re just asking for the level of reimbursement given to other academic medical centers.
“What we’re trying to do is to catch up,” Woodward said. “Not necessarily hit the mark, and certainly not exceed it, but we’re trying to make up some ground.”
Bailey Howell Trophy winner Iverson Molinar, is joined by his coach Ben Howeland (left) and Howell (right).
Ole Miss’s Shakira Austin, a repeat winner, and Mississippi State’s Iverson Molinar accepted the Peggie Gillom and Bailey Howell trophies, respectively, during an awards luncheon Monday at the Mississippi Sports Hall of Fame Museum.
It says here media voters from across the state got it right in voting that MSHOF executive director Bill Blackwell said was the closest in recent years. Ole Miss, 23-8 overall and 10-6 in the Southeastern Conference, was the best women’s team in the state, and Austin, who averaged 15.4 points and nine rebounds a game, was the Lady Rebels’ best player. Mississippi State, 17-14 overall and 8-10 in the SEC, was the best men’s team in the state, and Molinar, who surely will be named to the All-SEC team Tuesday, was far and away the Bulldogs’ best player.
Clearly, there was a certain symmetry to both awards.
Before we get into all the particulars, one of the most interesting moments of the program came when Ben Howland was talking about Howell’s legacy. Howland mentioned that Kentucky’s Oscar Tshiebwe has averaged 15.3 rebounds per game this season and commentators are calling him the greatest college rebounder in decades.
Said Howland, “Bailey Howell averaged 17 rebounds per game for his entire career!”
How good is that?
Of course, Howland also could have mentioned that Vanderbilt’s Scottie Pippen Jr. leads SEC scorers this season with 20.5 points per game. Howell averaged 27 per game for his career. It should be stressed that Howell played during an era when there was no shot clock, and coaches, including the great Babe McCarthy at State, often held the ball (“freezes it”) for long periods of times.
No telling what Bailey Howell would have averaged at today’s much faster pace. Little wonder he was the second overall pick of the 1959 behind another fairly good player, the one named Wilt Chamberlain.
Peggie Gillom Trophy winner Shakira Austin is flanked by Gillom (left) and her Ole Miss coach, Yolett McPhee-McCuin
Austin won over fellow finalists Amyshya Williams-Holliday of Jackson State and Anastasia Hayes of Mississippi State. Williams-Holliday, who began her college career at State, led JSU to a perfect 18-0 record in the Southwestern Athletic Conference and a 20-6 mark overall. She led the Lady Tigers in scoring with 19.8 points per game and in rebounding with 11.2 per game. Hayes averaged 18.6 points per game for State.
Presumably, the close voting was between Austin and Williams-Holliday, who both had outstanding seasons for successful teams. The two did go head-to-head in November with Austin scoring 24 points and grabbing 10 rebounds to lead Ole Miss to a 79-66 victory. Williams-Holliday paced Jackson State with 16 points and 10 rebounds.
Both Austin and Williams-Holliday have more basketball to play. Ole Miss should be a 6-seed, maybe even a 5-seed, in the NCAA Tournament. Jackson State will play Arkansas-Pine Bluff in the SWAC Women’s Tournament at Birmingham Wednesday night.
Molinar, State’s point guard, averaged 17.8 points and 3.6 assists per game and saved some of his best performances for the strongest competition. For instance, he scored 30 points in an overtime loss at Kentucky. He has scored in double figures in every State game this season.
“As good a player as he is, he takes his studies just as seriously as he does his basketball,” Howland said of Molinar. “As good of a player and student as he is, he is an even better person.”
Howell, a six-time NBA All-Star who still follows State basketball closely, believes Molinar has the talent and game to make it at the NBA level.
“He doesn’t have any weakness in his game,” Howell said of Molinar. “He can handle it, pass it and he is a very good defensive player. If there’s an area where he can use some improvement its in his long-range shooting. There’s such an emphasis in the NBA on three-point shooting.”
Molinar won the Howell over finalists Jarkell Joiner of Ole Miss and Tyler Stevenson of Southern Miss. Joiner averaged 13.4 points per game despite injuries this season. Stevenson led the Golden Eagles in scoring (14.7) and rebounds (7.7).
Mississippi lawmakers are working to revise the state’s eviction law after a federal judge recently ruled it unconstitutional.
Rep. Nick Bain, R-Corinth, authored the new bill — which gives tenants a seven-day grace period after a judge orders their removal — to rectify issues with the current statute.
The bill also allows tenants who are being evicted because they are behind on rent to stay in their home if they pay all past due rent and fees by the court-ordered move out date, something that was not guaranteed in the existing law.
Currently, Mississippi’s law offers no grace period to tenants, which means that a renter may be forced out of their home on the day they lose in court, but also that a landlord may immediately seize all their belongings.
“If we don’t pass it, we will not have a constitutional eviction statute in Mississippi,” Bain said. “So it attempts to do that, puts a Band-Aid, and I think there’s going to be, maybe next session, a broader bill to address landlord-tenant altogether.”
Bain’s bill has passed the House and is awaiting full Senate approval.
U.S. District Judge Michael Mills ruled the law unconstitutional in November after a landlord in north Mississippi used it to justify taking everything Samantha Conner, a low-income single mom, owned.
Mills put a stay on his decision to give lawmakers time to revise the law before it would be struck down altogether.
“It’s something we’ve got to do or nobody’s going to be getting evicted,” Bain said.
Mississippi has some of the highest eviction rates in the nation. In Jackson, the capital city, between seven and eight families are evicted from their homes every day, according to 2016 data, the most recent available, gathered by the Princeton University-based research group the Eviction Lab. Of all large cities in the nation, Jackson had the fifth highest eviction rate that year.
In 2019, the Legislature revised the law to give even fewer protections to tenants facing an eviction, making the Mississippi’s Landlord-Tenant Act the harshest in the nation.
The revisions came with what Judge Mills called “unpredictable and absurd results” because of some landlords’ severe interpretation of the law.
The law reads, “If the judge grants possession of this premises to the landlord and you do not remove your personal property, including any manufactured home, from the premises before the date and time ordered by the judge, then the landlord may dispose of your personal property.”
Many states Landlord-Tenant statutes across the country spell out what landlords may do with a renter’s left-behind belongings, a necessary legal guideline in the case of abandoned property. But Conner’s apartment manager, Kevin Casteel, used the law to prevent Conner from taking her belongings as she left her apartment on the day of her removal.
“That’s a common occurrence with a lot of the laws that we pass, is you have these bad actors who unfortunately sometimes cause the whole state to pay the price, or innocent people to pay the price,” Bain said.
Conner’s lawsuit, which asks the judge to award her damages considering all that she lost, including family photos and keepsakes that cannot be replaced, is still pending. But knowing that her efforts resulted in changes to state law is part of her victory, Conner said.
“I think that this is going to enable people and may give other people the courage to be able to go forward and maybe seek out some justice,” Conner told Mississippi Today in December. “… They can use this law now to say that, ‘Hey, you cannot do this to people.’ People matter. We have feelings.”
Bain said the Legislature may look at a bigger overhaul of Mississippi’s complex, hodge-podge eviction statute next year. The law is supposed to provide a consistent framework for how renter removals work across the state: How many days after a missed rent due date a landlord may file an eviction, notice requirements, and how long after a court judgement a landlord can file a warrant of removal.
But tenants, landlords and judges have faced confusion about Mississippi’s law, and differing interpretations have caused varying outcomes for renters across the state.
“It’s a cumbersome, a very clunky, for lack of a better word, clunky statute,” Bain said.
Note: This analysis first published in Mississippi Today’s weekly legislative newsletter. Subscribe to our free newsletter for exclusive early access to weekly analyses.
The two legislative Republicans who defended the anti-critical race theory bill on the Senate and House floors said it all: Out-of-state conservative media inspired the Mississippi bill, it would do little to change or limit any public school teaching, and its passing was largely a symbolic gesture to Republican voters ahead of the 2023 election year.
If you missed the eight total hours of floor debate of the bill, that’s the short of it, according to the bill’s author Sen. Mike McLendon and his House counterpart Rep. Joey Hood. Both Republicans appeared grossly unprepared to answer basic questions about what, exactly, the three-page bill would do.
Every Black lawmaker in both the Senate and House voted against the bill, which now sits on Gov. Tate Reeves’ desk for signature or veto. Black senators were so upset about the bill that they walked out in protest during the final vote — an inevitably successful one, given the Republicans’ supermajority. In Mississippi’s history, a legislative walkout like that had never been done before.
McLendon, the bill’s official “author,” struggled to answer basic questions about the bill from fellow senators on Jan. 21.
He said he heard from many of his constituents who had learned of critical race theory “on the national news” and wanted to ensure it would not be taught in Mississippi. That, he said, is the reason he “sponsored” the bill, the text of which was provided to him by the Mississippi Center for Public Policy, which often gets draft language from out-of-state interest groups.
McLendon said all his bill does is “prohibit a child or a student from being told they are inferior or superior to another.”
Likewise, Hood struggled to answer basic questions from his House colleagues during floor debate on March 3. Under constant questioning, he conceded he had not studied the origins of critical race theory.
“A lot of people have a lot of different definitions of what critical race is,” Hood said.
He repeatedly said all the bill would do is say no university, community college or public school “shall direct or compel students to affirm that any sex, race, ethnicity, religion or national origin is inherently superior or that individuals should be adversely treated based on such characteristics.”
“History in Mississippi can be taught under this legislation,” Hood repeatedly said from the well of the chamber when he couldn’t provide answers to specific questions about the bill.
When pressed by colleagues about whether the bill’s passage was more of a symbolic gesture to Republican voters than anything, neither McLendon nor Hood offered any counter to the question.
“This bill is only before us so that some of you can go back home and have something to campaign on,” Rep. Willie Bailey, D-Greenville, said during the House debate. Hood did not offer any rebuttal.
Speaker of the House Philip Gunn appeared to concede that point himself shortly after the final House vote. He led the House in prayer from the speaker’s dais, saying: “Lord, we face difficult things in this body. We all represent a constituency. We all have voters for whom issues are important. Sometimes those issues are difficult. Today is one of those days, Lord. We pray for healing, we pray that you would not allow this to create division, not only within this body but within this state.”
Critical race theory is not taught in any K-12 public school in Mississippi. The only public entity teaching a CRT course is University of Mississippi Law School, Mississippi Today found. And even a Republican in that class says that state lawmakers completely misrepresented the actual teachings of the course.
The term “critical race theory” is not mentioned once in the three-page bill, meaning it’s very unlikely that the term will make it into the state code books.
While Republicans limped through the House and Senate floor debates without real answers, some opponents said they feared that even if the language of the bill is innocuous, it will have a chilling effect on the teaching of history — particularly Mississippi’s dark, racist history — and lead to censorship in the state’s classrooms.
“The language means something to me,” Rep. Zakiya Summers said during House floor debate. “… You cannot pass a bill like this and continue the rhetoric that we can all work together.”
