Mississippi
Can a Mississippi governor expand Medicaid on his own? Depends on who you ask.
Editor’s note: Mississippi Today interviewed two Deep South governors about why they chose to champion and pass Medicaid expansion in their states and what the outcomes have been. Those articles will publish on August 24.
Brandon Presley, the Democratic nominee for governor, has at times spoken of expanding Medicaid through executive action without approval of the Republican-controlled Mississippi Legislature should he win the November general election.
“Day 1, I’m going to expand Medicaid so that 220,000 working Mississippians can get access to affordable healthcare,” Presley wrote on social media in July.
At other times, perhaps recognizing the obstacles such a solo effort to expand Medicaid might face, Presley has indicated he would work with the Legislature, which he has said he believes would be amenable to Medicaid expansion.
As nearly half of the state’s rural hospitals are at risk of closing and hospitals across the state are laying off staff or cutting services because of budget problems, Medicaid expansion has become a key campaign issue in 2023.
Forty states and the District of Columbia have expanded Medicaid, a federal opt-in program that provides health care coverage to poor Americans who can’t otherwise afford it themselves. Two of Mississippi’s neighbors, Arkansas and Louisiana, have expanded Medicaid with great success and improved outcomes.
But leaders in Mississippi, the poorest state in America with one of the nation’s highest percentages of uninsured residents, have resisted expansion for more than 10 years — despite the fact that it would bring more than $1 billion per year in new funds to the state and directly help hospitals.
READ MORE: FAQ: What is Medicaid expansion, really?
In some states, such as Louisiana, expansion was done through executive orders instead of by approval of the Legislature. But there are questions about whether a governor in Mississippi could expand Medicaid without legislative approval.
Republican Gov. Tate Reeves, who is seeking reelection and faces Presley in the November general election, has long opposed expanding Medicaid.
The Division of Medicaid, which is under the statutory direction and purview of the governor, takes the position that Medicaid expansion requires legislative approval.
“State law defines who can be eligible for Medicaid in Mississippi. Our understanding is that a governor is not authorized to unilaterally establish a new Medicaid coverage group through an executive order or a federal demonstration waiver,” said Matt Westerfield, a spokesperson for the state’s Division of Medicaid.
State Sen. Kevin Blackwell, R-Southaven, who chairs the Senate’s Medicaid Committee, referred questions about whether a governor could expand Medicaid on his or her own to the Division of Medicaid. His House counterpart, Joey Hood, R-Ackerman, could not be reached for comment.
Former state Rep. Steve Holland, who for years was considered one of the leading authorities in the Legislature on Medicaid issues as the longtime chair of Public Health Committee, said the governor has considerable authority over the Medicaid program. After all, Medicaid is a division within the governor’s office.
Still, Holland said, “We have the most codified Medicaid program in the country. We have put all the eligibility requirements in law … I know Brandon (Presley) as well as anyone. If he is fortunate enough to be elected governor, he is smooth enough and prepared enough to begin immediately to expand Medicaid. And I think he can work with the Legislature to do that.”
READ MORE: Nearly half of rural hospitals at risk of closure in Mississippi, new data shows
The Presley campaign has cited the ability of the Division of Medicaid — hence the governor — to seek a federal waiver to alter the state Medicaid program. A campaign spokesperson said the governor would have authority to seek the waiver under state law, though waivers are granted for only five years and they normally are granted in coordination with the Legislature, which often must provide funding to pay for the waiver.
Holland said state law provides the Division of Medicaid under the governor significant flexibility to seek waivers from the federal government to enact programs that are not codified in state law.
The bottom line is that if there was an effort to expand Medicaid through the waiver program, an appropriation by the Legislature to fund the program most likely still would be needed. But if a governor did expand Medicaid and figure out a way to pay for the program without the Legislature, it likely would result in litigation and be left to the state courts to determine whether it was legal.
Specific sections of state law define who is eligible for Medicaid based on income levels and health issues. In general terms, in Mississippi only poor pregnant women, poor children, the disabled, certain groups of the elderly and some groups who fall into extreme poverty categories and are providing care for family members on Medicaid are eligible for Medicaid coverage.
Most able-bodied people are not eligible for Medicaid in Mississippi.
With Medicaid expansion, those earning up to 138% of the federal poverty level — or about $18,750 annually — would be eligible for coverage. The intent with Medicaid expansion is to provide health care to primarily the working poor who cannot afford private insurance and who are not provided coverage by their employers.
The most clear cut way to expand Medicaid would be for the Legislature to approve a bill to incorporate the new eligibility requirements in state law.
Whether it would be feasible for the Legislature to agree to such a change in state law is the unknown question. If Presley is elected, Mississippians will find out.
At least in the current Legislature, there is a significant appetite to at least consider the merits of expansion. Last legislative session, Mississippi Today surveyed most of the 174 lawmakers and asked them directly if they supported Medicaid expansion.
In response, voting majority in the House said they either supported Medicaid expansion or remained undecided. One vote shy of a voting majority in the Senate said the same.
Just 21 of the House members surveyed, or 18% of the House, said they outright opposed Medicaid expansion. And just 18 of the Senate members surveyed, or 38% of the Senate, said they outright opposed it.
READ MORE: Few Mississippi lawmakers outright oppose Medicaid expansion
Holland, who served in the Legislature until 2020, says he believes Presley could get Medicaid expansion through the Legislature even with a Republican supermajority.
“Tate Reeves and (House Speaker) Philip Gunn were the two blocking it. Period.” said Holland. Gunn is not seeking re-election this year.
“In my final years in the House I had so many Republicans come to me and say expanding Medicaid is the right thing to do,” Holland said.
Another option would be for the Legislature to reauthorize the ballot initiative program that was ruled unconstitutional in 2021 by the state Supreme Court. Through the initiative process, people can gather signatures to bypass the Legislature and place issues directly on the ballot.
When the initiative process was ruled invalid, there was an effort underway to gather the required number of signatures to place Medicaid expansion on the ballot. The Mississippi Hospital Association was one of the sponsors of the Medicaid expansion initiative proposal and had hoped to have enough signatures to place the proposal on the 2022 ballot.
Multiple polls have indicated strong support among Mississippi voters for Medicaid expansion.
So far, legislative efforts to revive the initiative have been unsuccessful.
READ MORE: Mississippi leaving more than $1 billion per year on table by rejecting Medicaid expansion
Mississippi
Why Mississippi State football loss to Arizona State revealed a strong Jeff Lebby culture
It was 11:10 p.m. Saturday in Starkville when Arizona State quarterback Sam Leavitt barreled into the end zone for his second touchdown of the game.
At that point, it would’ve been fair for Mississippi State football fans to call it a night. The Bulldogs (1-1) trailed 27-3 at ASU in the final minute of the second quarter. They were dominated in just about every statistical category. New coach Jeff Lebby looked like he was headed toward his first loss, and an embarrassing one.
And even if you gave the second half a chance, eyes just a crack open, that wasn’t encouraging either. Arizona State (2-0) took the opening drive of the third quarter for a field goal while eating 8 minutes, 27 seconds of game time. That just about decided the game before Mississippi State touched the ball in the second half.
Wrong.
Instead, MSU scored touchdowns on three of its next four drives and cut the score to 30-23 with 5:27 to play. The defense, which was torched for 346 rushing yards, needed one more stop to let the offense try to tie it. It would’ve been the largest comeback in program history.
Mississippi State’s path to a bowl game seems murkier than it was a week ago. But in the long-term, there’s still encouragement after the 30-23 loss.
“Our guys battled in an incredible way in the second half, and we’re going to hold on to that,” Lebby said in his postgame radio interview. “We’re going to find ways to get back in the building, get back to work and be able to walk into Davis Wade (Stadium) with a ton of confidence and ready to go win a football game.”
The encouragement from Mississippi State’s comeback effort
Lebby said after beating Eastern Kentucky 56-7 in Week 1 that there is an abundance of teachable moments in wins, just like losses.
There is plenty to point to after losing to Arizona State.
Mississippi State came out incredibly flat. The Sun Devils scored on their first five possessions. The MSU offense had one field goal, two punts, a fumble returned for a touchdown and a turnover-on-downs in the first half. MSU had -13 rushing yards in the first half.
There were concerns entering the game about the travel distance, late kickoff and high temperature. But let’s be real, Mississippi State was playing so poorly at the start that it was hard to judge if those were factors.
“I got to do a better job getting these guys ready to go play out of the gate,” Lebby said. “I thought our energy, our effort and our emotion was really good, but then we did not play clean there in the first quarter, so that part was frustrating.”
The Bulldogs outscored the Sun Devils 20-0 in the final quarter and a half. It was a surprise. Arizona State was rolling. Mississippi State was not.
MORE: Introducing Sam Sklar, the Clarion Ledger’s new Mississippi State beat reporter
For Lebby, a first-time head coach at any level, let it be a learning moment for him. It was his first time getting pinned in a corner. The Bulldogs adjusted correctly in the second half like good coaches do.
The rushing offense and defense both need to improve. Badly. Quarterback Blake Shapen has been impressive in his first two Mississippi State games and the wide receiver room is deep and talented as ever, but they can’t be the only answer.
That’s just for this season.
Mississippi State has its first tally in the loss column. But it isn’t a strike against Lebby leading the future of the program.
Sam Sklar is the Mississippi State beat reporter for the Clarion Ledger. Email him at ssklar@gannett.com and follow him on X @sklarsam_.
Sam Leavitt leads ASU to convincing victory in 1st career start
Leavitt and the Sun Devils cruised past visiting Wyoming 48-7 on Saturday night at Mountain America Stadium.
The Arizona State football team elevated its play on the field in its 48-7 win over Wyoming in Week 1.
It is elevating its uniform game for Week 2 against Mississippi State.
ASU football is wearing a gold alternate jersey against the Bulldogs at Mountain America Stadium in Tempe on Saturday night.
The jersey includes maroon “Arizona State” lettering and maroon numbering, along with a noticeable Big 12 logo.
The Sun Devil football team unveiled the uniform last month, with Athletic Director Graham Rossini posting that “you’ll see this on the field early this season.”
On Thursday, ASU football announced that it would be wearing the uniform against Mississippi State with a video that said “Modern shine, with a classic design.”
On Friday, it posted another look at the uniform.
More: Arizona State vs Mississippi State live score updates, analysis for college football game
ASU vs Mississippi State schedule, TV: How to watch college football game
Promising look: Arizona State football’s 2024 win prediction doubles after Week 1 victory over Wyoming
Social media reacted favorably overall to ASU football’s uniform vs Mississippi State:
Do you like the look for ASU football?
ASU vs. Mississippi State picks: Who wins Week 2 college football game?
Looking promising: Arizona State football makes huge leap in college football ranking, Big 12 power rankings
Reach Jeremy Cluff at jeremy.cluff@arizonarepublic.com. Follow him on X, formerly Twitter @Jeremy_Cluff.
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WARREN COUNTY, Miss. (WJTV) – There are questions about a bus company’s track record after a fatal bus crash in Mississippi on Saturday, August 31.
Seven people died when a passenger bus traveling on Interstate 20 left the roadway and overturned. The Mississippi Highway Patrol (MHP) said that 41 passengers and two drivers were enroute to Dallas from Atlanta.
Autobuses Regiomontanos owned the bus in the crash. The company, which is registered with the U.S. Department of Transportation (DOT), has had a troubled record in recent memory. It consists of lawsuits, driver fitness violations and even another fatal crash in 2023.
According to the DOT, the company, based in Laredo, Texas, operates 17 vehicles and employs 39 drivers. The company currently has a ‘conditional‘ safety rating. It is given to companies with ‘inadequate‘ safety controls. Still, companies with this rating may continue to operate.
Its most recent compliance review occurred in July 2023. Using data available from the DOT’s Safety Management System, it has had 155 inspections. Of those inspections, 58 had violations. Nearly all were vehicle maintenance violations.
Three infractions between October and December of 2023 involved issues with vehicle tires. Other infractions included 16 brake or air brake violations and citations for having two buses with no or defective emergency exits.
Seven victims killed in Mississippi bus crash identified
Other inspection violations related to the bus company’s drivers. All violations occurred this year. They include the following:
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(1) Operating a commercial vehicle without corrective lenses or hearing aids as indicated on the driver’s medical certificate (2) Operating a commercial motor vehicle (CMV) while not possessing a valid commercial driver’s license (CDL).
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05/13/2024
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05/14/2024
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05/14/2024
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05/28/2024
-
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Operate a CMV while not in possession of a CDL on person.
DOT data indicates that company buses have been in four separate accidents over the last two years. A November 2022 crash required a bus to be towed away and another in April 2023 resulted in someone dying. Below is the record.
|
Date |
Location |
Deaths |
Injuries |
|
10/16/2023 |
Louisiana |
0 |
1 |
|
4/15/2023 |
Texas |
1 |
2 |
|
11/23/2022 |
Tennessee |
0 |
0 |
|
9/24/2022 |
Arkansas |
0 |
1 |
The NTSB is investigating the crash in conjunction with MHP. NTSB officials said they will look at the carrier’s safety record and protections for bus occupants.
Community comes together to help Mississippi bus crash victims
Autobuses Regiomontanos violated several provisions of the Americans with Disabilities Act (ADA). According to the U.S. Department of Justice (DOJ), it failed to have an ADA training program in place for its employees and contractors, failed to file required ADA compliance reports and failed to ensure that all lifts on its buses were properly maintained.
In 2015, the company entered into a settlement agreement with the U.S. Attorney’s Office for the Southern District of Texas.
The company was also named as a defendant in a $708 million lawsuit filed by New York City City in January. The city accused Autobuses Regiomontanos and other charter bus and transportation companies of taking migrants to the Big Apple on behalf of the State of Texas.
The DOT advises travelers to do the following before they book their next bus trip.
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Search for bus companies
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Verify that a company is authorized to operate
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Review the company’s safety records
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Make sure the company is licensed and insured
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If appropriate, report a company
DOT agencies advise consumers that unless a motor carrier has received an unsatisfactory rating or has been ordered to discontinue its operations, it is authorized to operate on the nation’s roadways. Additionally, readers should not conclude that a carrier is safe or unsafe by only using data from DOT agencies. For more information, click here.
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