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Nearly five months after a new law to make prenatal care more accessible to low-income women was supposed to go into effect, its fate remains unclear. 

The state is still in negotiations with the Centers for Medicare and Medicaid Services – the federal agency responsible for approving the state plan – according to Matt Westerfield, spokesperson for the Mississippi Division of Medicaid. CMS is supposed to take no more than 90 days to approve or reject a plan, but that 90-day clock has been suspended indefinitely since issues have been raised with legislation Mississippi lawmakers wrote last session. 

Presumptive eligibility for pregnant women allows temporary and immediate Medicaid coverage for low-income expectant mothers while they wait for their official Medicaid application to be approved – a process that can take months. 

Strict Medicaid eligibility requirements in Mississippi mean that a majority of low-income women are only eligible for Medicaid once they become pregnant. If a woman applies when she finds out she’s pregnant, that means a lengthy application process could cut well into her pregnancy and delay her seeking prenatal care, which is proven to lead to poor outcomes such as preterm birth – in which Mississippi leads the nation. 

Nicole Boyd, R-Oxford, who leads the Senate Study Group for Women, Children and Families, has been checking in weekly with Medicaid about the status of the policy. In a committee hearing Monday, Boyd followed up twice with newly appointed Medicaid Executive Director Cindy Bradshaw at the beginning and end of the meeting to try to gain clarity on the status of the policy. 

Boyd asked Bradshaw whether the 2024 legislation could be salvaged or whether lawmakers would need to redo legislation to enact the policy in 2025. Bradshaw said both that she hopes the state and federal agencies can come to an agreement, and also that she’d feel better with new legislation. 

“Well, I think we can come to a reasonable place that we will be able to get it,” Bradshaw said. “Am I 100% comfortable with that? No. I would prefer that we have legislation to shore up the concessions that we’ve had to make.”

It’s not clear what concessions the Mississippi Division of Medicaid has had to make, but it’s likely that CMS is requiring Medicaid to take out a proof of income and proof of pregnancy requirement lawmakers included in the original bill. 

Federal guidelines state that while the agency may require proof of citizenship or residency, it should not “require verification of the conditions for presumptive eligibility.”

CMS will not comment on ongoing negotiations with individual states.

If 2024 legislation can’t be salvaged, lawmakers would have two options for rewriting the law next session. They could take out the requirements with which CMS has an issue, or they could take their chances hoping a Trump administration would grant a waiver allowing them to keep requirements at odds with federal guidelines – something lawmakers will likely bank on with a Medicaid expansion bill next session, as well. 

Insisting on the proof of pregnancy requirement doesn’t serve much of a purpose, since it wouldn’t be possible for a woman to fake a pregnancy and receive prenatal care, such as ultrasounds. As for the proof of income requirement, it can be cumbersome on low-income women already facing socioeconomic hurdles, explained Tricia Brooks, a research professor at the Center for Children and Families at Georgetown University and the lead author on the KFF Annual Survey on Medicaid and CHIP Eligibility, Enrollment and Renewal Policies.

“I remember when I first got pregnant, I thought I had the flu because I was nauseous for days on end,” Brooks said. “If I go to the doctor and find out that lo and behold maybe I am pregnant, and you want me to get enrolled, but now you’re asking me for paystubs … So now I have to come back in or somehow communicate or transmit proof of income to the provider. That just gives everybody pause of, ‘Oh my god, is this even worth it?’”

In the meantime, the Division of Medicaid is continuing to accept providers who wish to participate in the program and conduct eligibility determination trainings, according to Westerfield. Until CMS approves the state plan, none of the providers that have been approved will be able to provide care under the policy to eligible women.

Below is a list of the 13 providers that have been approved to participate as of Nov. 18: 

• Physicians & Surgeons Clinic – Amory
• Mississippi Department of Health, Dr. Renia Dotson – County Health Department (Family Planning Clinic)
• Family Health Center – Laurel
• Delta Health Center Inc (Dr. H. Jack Geiger Medical Center) – Mound Bayou
• G.A. Carmichael Family Health Center Providers – Belzoni, Canton, Yazoo City
• Coastal Family Health Center Inc. – Biloxi 
• Delta Health System – Greenville
• Delta Medical Group – Women’s Specialty Clinic – Greenville
• Southeast MS Rural Health Initiative Inc. – Women’s Health Center – Hattiesburg
• University of Mississippi Medical Center – Jackson
• Jackson Hinds Comprehensive Health Center – Jackson
• Central MS Health Service – Jackson
• Northwest MS Regional Medical Center – Clarksdale

An expectant mother would need to fall under the following income levels to qualify for presumptive eligibility:

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The National Folk Festival kicked off in downtown Jackson on Saturday. The festival is the longest running arts event comprised of a free, outdoor, three-day celebration of music, art and dance. 

The National Council for the Traditional Arts chose Jackson out of 42 cities from across the country.

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Mississippi College will change its name and drop its football program after the current season, the board of the private institution announced Monday.

The college, in the Jackson suburb of Clinton, will become Mississippi Christian University beginning with its bicentennial in 2026. It said in an announcement that the new name emphasizes the school’s status as a comprehensive university while keeping the MC logo and identity.

“These transformational and necessary changes are extremely important to the future of this institution,” Mississippi College President Blake Thompson said. “As we look ahead to the institution’s bicentennial in 2026, we want to ensure that MC will be a university recognized for academic excellence and commitment to the cause of Christ for another 200 years.”

Mississippi College sports teams compete in NCAA Division II. The college will have 17 sports after football is discontinued.

“As we consider the changing landscape of college football, the increasing influence of the NIL and transfer portal, as well as increasing costs to operate and travel, we felt it was necessary to focus our efforts on building first-class programs that can compete for championships,” MC Athletic Director Kenny Bizot said.

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A group of anti-abortion doctors is asking the state Supreme Court to reverse its earlier ruling stating that the right to an abortion is guaranteed by the Mississippi Constitution.

The original 1998 Supreme Court ruling that provides the right to an abortion for Mississippians conflicts with state law that bans most abortions in Mississippi.

The appeal to the Supreme Court comes after an earlier ruling by Hinds County Chancellor Crystal Wise Martin, who found the group of conservative physicians did not have standing to bring the lawsuit.

Mississippi members of the American Association of Pro-Life Obstetricians and Gynecologists argued that they could be punished for not helping a patient find access to an abortion since the earlier state Supreme Court ruling said Mississippians had a right to abortion under the state Constitution. But the Hinds County chancellor said they did not have standing because they could not prove any harm to them because of their anti abortion stance.

Attorney Aaron Rice, representing the doctors, said after the October ruling by Wise Martin that he intended to ask the state Supreme Court to rule on the case.

It was a Mississippi case that led to the controversial U.S. Supreme Court decision in 2022 to overturn Roe v. Wade, which had guaranteed since the early 1970s a national right to an abortion.

Mississippi had laws in place to ban most abortions once Roe v. Wade was overturned, But there also was the 1998 state Supreme Court ruling that provided the right to an abortion.

Despite that ruling, there are currently no abortion clinics in Mississippi. But in the lawsuit, the conservative physicians group pointed out the ambiguity of the issue since in normal legal proceedings a Supreme Court ruling on the constitutionality of an issue would trump state law.

But in her ruling, Wise Martin pointed out that the state Supreme Court in multiple recent high-profile rulings has limited standing or who has the ability to file a lawsuit. Wise Martin said testimony on the issue revealed that physicians had not been punished in Mississippi for refusing to perform abortions.

Both the state and a pro abortion rights group argued that the physicians did not have standing to pursue the lawsuit. The state also contends that existing law makes it clear that most abortions are banned in Mississippi.

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GLOSTER — Drax, the United Kingdom-based wood pellet producer that’s violated air pollution limits in Mississippi multiple times, is asking the state to raise the amount of emissions it’s allowed to release from its facility in Gloster.

In September, the state fined Drax $225,000 for releasing 50% over the permitted limit of HAPs, or Hazardous Air Pollutants, from its facility Amite BioEnergy. In a pending permit application that it submitted to the Mississippi Department of Environmental Quality in 2022, the company is seeking to transition from a “minor source” of HAPs to a “major source.”

A “major source” permit would remove the limit over the facility’s total HAP emissions, but it would apply a new limit over the rate at which Drax could release the pollutants.

This year’s fine was its second penalty for violating Mississippi law around air pollution limits. In 2020, the state fined the company $2.5 million for releasing over three times the legal threshold of Volatile Organic Compounds, or VOCs, one of the largest such fines in state history. Drax underestimated its VOC releases since the facility opened in 2016, but didn’t realize it until 2018. The facility didn’t come into compliance until 2021.

The Environmental Protection Agency lists a variety of potential health impacts from exposure to HAPs, including damage to the immune system and respiratory issues. VOCs can also cause breathing problems, as well as eye, nose and throat irritation, according to the American Lung Association.

For years since Drax’s violations became public, nearby residents have attributed health issues to living near the facility. During a public hearing on Drax’s permit request Thursday in Gloster, attendees reiterated those concerns.

“We all experience headaches every day,” resident Christie Harvey said about her and her grandchildren. Harvey said she has asthma too, and her doctor was “baffled” by her symptoms. “Each week I have to take (my grandchildren) to the clinic for upper respiratory issues … It’s not fair that we have to go through this. Drax needs to lower the pollution as much as possible.”

Part of the public outcry is the proximity of people’s homes to the plant, which is within a mile of Gloster’s downtown.

“The wood pellet plant in Lucedale is situated in an industrial park outside of town,” Andrew Whitehurst of Healthy Gulf, an environmental group dedicated to protecting the Gulf of Mexico’s natural resources, said at the meeting. “The wood pellet plant that (Enviva is) trying to put in Bond will be situated north and west of the downtown area. Not like this when it’s right smack in the middle (of the city). It’s totally inappropriate. People can’t take it, they don’t deserve it.”

In a statement to Mississippi Today, Drax said it prioritizes the public health and environment in Gloster, adding that the permit modification is a part of standard business practice.

“When we first began operations, some of our original permits were not fit for purpose,” spokesperson Michelli Martin said via e-mail. “We are now working to acquire the appropriate permits for our operating output and to improve our compliance. Within these permits the requirements may change based on engineering data and industry standards. This permit modification is part of our ongoing plan to provide MDEQ with the most accurate data. Drax fully supports the resolution of our permitting request and looks forward to working with MDEQ to finalize the details.”

While researchers, including from Brown University, are studying the health symptoms of residents near the wood pellet plant, there is no proven connection between the facility’s emissions and those symptoms.

Erica Walker, a Jackson native who teaches epidemiology at Brown and who’s leading the study, spoke to Mississippi Today earlier this year. Regardless of the cause and effect, she said, the decision to put the plant near disadvantaged communities with poor health outcomes is concerning.

“We want to make sure we aren’t additionally burdening already burdened communities,” Walker said.

About 1,300 people live in the city, according to Census data, and 39% live below the poverty line.

Moreover, Gloster residents often have to travel hours, to cities such as McComb and Baton Rouge, to find the nearest medical specialist. Amite County, where Gloster is, has a higher rate of uninsured residents than the rest of the state, according to County Health Rankings, and the ratio of residents to primary care physicians is over three times greater in the county than Mississippi as a whole.

As part of its application, Drax is seeking a Title V permit under the Clean Air Act, which the EPA requires for major sources of air pollutants. This gives the EPA the opportunity to review Drax’s application and public comments submitted with it. The public can submit comments on the application until Nov. 26, and can do so through MDEQ’s website.

The Mississippi Environmental Quality Permit Board, which is made up of officials from several state agencies, will then decide whether or not to grant the new permits. A full overview of the process and Drax’s application is available online.

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Republican Gov. Tate Reeves on Wednesday announced that state agencies are disbursing over $110 million toward economic development, infrastructure upgrades and workforce development around the state. 

The funding for the projects is coming from the state Legislature, the Appalachian Regional Commission, the Delta Regional Authority, the Southeast Crescent Regional Commission and the federal government. 

“We’ve secured billions in new private-sector investment and created thousands of jobs across the state,” Reeves said. “The funding we announced today will go a long way toward continuing Mississippi’s economic momentum and will help create more high-paying job opportunities for Mississippians across the state.” 

The bulk of the spending will go toward developing and improving industrial sites, which are often used to entice manufacturing companies to locate or expand operations in the state. If these sites have adequate infrastructure near them, companies are more likely to locate there.

Despite new investment in the state, Mississippi continues to grapple with one of the lowest rates in the nation of people who are actively seeking work or employed, at 53.9%. 

State Economist Corey Miller said at a legislative hearing last week that one of the reasons Mississippi is also experiencing a relatively low unemployment rate of 2.8% is because people have stopped looking for jobs. 

Reeves said on Wednesday that Mississippi may have a low percentage of people looking for jobs because the state has a relatively low cost of living and some families can afford to have only one income. 

“If an individual doesn’t want a job, the government ain’t going to force them to get a job,” Reeves said. “And that’s just a reality.” 

Still, the governor believes Mississippi can improve its labor force participation rate by improving education and providing people with better work skills. 

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JACKSON, Miss. (AP) — A federal appeals court panel incorrectly interpreted federal and state laws when it ruled that Mississippi cannot count mail-in ballots that are cast and postmarked by Election Day but arrive a few days later, two groups argue as they seek a new hearing.

Attorneys for Vet Voice Foundation and Mississippi Alliance for Retired Americans are asking the entire 5th U.S. Circuit Court of Appeals to reconsider the ruling that a portion of the court issued Oct. 25.

The ruling did not affect the counting of ballots for the Nov. 5 election because the three-judge panel noted that federal court precedents discourage court actions that change established procedures shortly before an election.

However, the case could affect voting across the U.S. if the Supreme Court ultimately issues a ruling.

The attorneys for Vet Voice Foundation and the Mississippi Alliance for Retired Americans argue in court papers filed Friday that the panel of judges “incorrectly suggested that post-election day ballot receipt deadlines are a recent invention.”

“In fact, the practice of counting ballots cast by election day but received afterward goes back to the Civil War, when many states permitted soldiers to vote in the field before sending their ballots to soldiers’ home precincts,” attorneys for the two groups wrote.

Many states have laws that allow counting of ballots that are cast by Election Day but received later, the attorneys wrote.

“Far from making any attempt to preempt these laws, Congress has acknowledged and approved of them for more than five decades,” they wrote.

The three-judge panel of the conservative appeals court reversed a July decision by U.S. District Judge Louis Guirola Jr., who had dismissed challenges to Mississippi’s election law by the Republican National Committee, the Libertarian Party of Mississippi and others.

Richard Hasen, a professor at the University of California, Los Angeles School of Law, wrote on his election law blog that the ruling by the appeals court panel was a “bonkers opinion” and noted that “every other court to face these cases has rejected this argument.”

Republicans filed more than 100 lawsuits challenging various aspects of vote-casting after being chastised repeatedly by judges in 2020 for bringing complaints about how the election was run only after votes were tallied.

The list of states that allow mailed ballots to be counted if they are postmarked by Election Day includes swing states such as Nevada and states such as Colorado, Oregon and Utah that rely heavily on mail voting.

In July, a federal judge dismissed a similar lawsuit over counting mailed ballots in Nevada. The Republican National Committee has asked the 9th Circuit Court of Appeals to revive that case.

Guirola wrote that Mississippi’s law does not conflict with federal election laws. The suit challenging the Mississippi law argued that the state improperly extends the federal election and that, as a result, “timely, valid ballots are diluted by untimely, invalid ballots.”

Guirola disagreed, writing that “no ‘final selection’ is made after the federal election day under Mississippi’s law. All that occurs after election day is the delivery and counting of ballots cast on or before election day.”

Although the Mississippi challenge was led by Republicans and Libertarians, there is bipartisan support for the state’s practice. Mississippi Attorney General Lynn Fitch is defending the state’s top election official, Secretary of State Michael Watson, in the lawsuit. Both are Republicans.

Associated Press reporters Kevin McGill in New Orleans and Mark Sherman in Washington contributed to this report.

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