Tag Archive for: Medicaid


Over half of Mississippians struggling to pay household bills, the most in the nation.

FAA seeks to address string of near-collisions at US airports.

Poland, Slovakia to send Soviet-era jets to Ukraine.



Over half of Mississippians struggling to pay household bills, the most in the nation

A recent Household Pulse Survey by the Census Bureau found that more than half of Mississippians (52.9%) are struggling to pay typical household bills. This is the highest percentage in the nation and the only one over 50%. Mississippi narrowly edges out neighboring Alabama which came in second at 49.7% and far exceeds the national average of 39.7%. 

Over that same period (the week of Feb. 4-13), Mississippi was 5th in the nation at 48.6% among states whose residents fear eviction or foreclosure in the next two months. Mississippians also led in the category of householders that were unable to pay an energy bill in full in the last 12 months with 30.5%.

Median household income is the lowest in the nation at $46,637, far below the national average of $70,784. Recent data shows that Mississippi has the highest poverty rate in the nation with 19.07%.

State Republicans suddenly remember this is an election year

During the pandemic, states received millions in federal dollars to help people get through the economic downturn. Despite the great need, average Mississippians received far less help than people in other states. Instead, the state government decided to use this windfall to push for income tax cuts.

While income tax reduction is popular in the state (62%), the suspension of the state’s 7% grocery tax is far more popular (74%). Mississippi is one of the few states to tax groceries and has the highest rate of any of them. Grocery taxes disproportionately burden the poor while income tax cuts disproportionately benefit the wealthy. But the state’s Republican leadership hasn’t considered using the state’s surplus to cut grocery taxes, despite rising food costs. 

State legislators recently narrowly rejected proposals that would have eliminated income taxes in the state. This means the stalled bills likely won’t move forward in this year’s legislative session. However, House Ways and Means Chairman Trey Lamar said the bills’ failure was “more of a timing issue with some of these representatives as opposed to any real opposition to income tax elimination. Coming off the heels of last year’s income tax bill, and this being an election year, there are a few that would just prefer to wait a little longer before making further cuts”.

Reeves believes life begins at conception, but when does it end?

In a rare win for public welfare in the state, Gov. Reeves has just signed a bill to extend Medicaid coverage to new mothers and babies from 60 days after birth to 12 months.

Mississippi has some of the worst rates of infant mortality and maternal mortality in the country. Until Reeves signed this latest bill, Mississippi was the only state in the nation that had neither extended Medicaid coverage for new mothers nor expanded Medicaid eligibility overall. 

Reeves touted expanding Medicaid coverage for new moms and babies to 12 months as being in line with the state’s pro-life stance. However, Reeves was quick to remind us he still opposes expanding eligibility for Medicaid for low-income families under Obamacare. Maybe Reeves thinks life ends at 12 months?


FAA seeks to address string of near-collisions at US airports

So far in 2023, there have been at least nine near-collisions of commercial airplanes at eight US airports. That number may seems small in light of the fact that there are about 45,000 flights taking off each day. But when you consider the hundreds of lives put at risk each time, even one near-miss is unacceptable.

The circumstances vary in each case, but in some instances, the near-miss was the result of air traffic control clearing two planes to use the same runway. This was the case in the most dramatic near-collision in Austin, TX, in which a FedEx cargo plane came within 100 feet of a Southwest Airlines passenger plane. Controllers had cleared the FedEx plane to land on the same runway where the Southwest Airlines flight was taking off. In this case, it was the quick thinking of the FedEx pilot that averted disaster, rather than any action by air traffic control.  

On Wednesday, FAA held an emergency summit this week, its first in 14 years, to discuss the issue. The panel of aviation experts cited low staffing numbers at the FAA and a lack of experience among new hires as a major factor. The staffing issues come at the same time that US demand for air travel is surging, making accidents and near-accidents more likely.

It may also be significant that 8 of the 9 incidents took place after an outage of the FAA’s automated NOTAM (Notice to Air Missions) system which notifies pilots of potential hazards they may encounter during their flights. The NOTAM system went dark late in the night of Jan. 10 and grounded all flights in the US for two hours the following morning. An investigation found that the outage was the result of FAA contractors deleting files.

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Poland, Slovakia send Soviet-era jets to Ukraine

After nearly a year of requests from Kiev, Poland yesterday agreed to send about a dozen Soviet-era MiG-29 fighter jets to Ukraine. Today, Slovakia followed suit, promising 13 MiG-29s. At the time of Russia’s invasion last year, Ukraine had several dozen MiG-29s that it had retained following the collapse of the Soviet Union. It’s not clear how many of these remain in service over a year later.

According to Slovakia’s Defense Minister, the European Union is offering Slovakia 200 million euros ($213 million) in compensation for giving the jets to Ukraine. Slovakia will also receive $745 million in unspecified arms from the US, the minister said. There’s no reporting on whether Poland is receiving similar compensation for its pledge. However, Poland’s Defense Minister did mention that they would be replacing their MiGs with South Korean and American-made fighter jets.

The White House says it was informed of Poland’s decision before it was announced. Biden has long been under pressure to give Ukraine F-16s, a request the US has so far steadfastly refused. National Security advisor John Kirby neither endorsed nor condemned Poland and Slovakia’s decision, but said it would have no bearing on the US position on sending F-16s. 

Unlike F-16s, Ukraine’s fighter pilots require no additional training to fly MiG-29s. But maintaining them may pose a problem. Slovakia had previously grounded its MiG-29 fleet due to difficulties obtaining spare parts and the departure of Russian maintenance workers.

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Virginia: 6-year-old who shot teacher won’t be charged.

Biden releases ambitious budget proposal, challenges GOP to show their hand in debt ceiling fight.



Virginia: 6-year-old who shot teacher won’t be charged

A little over two months ago, a 6-year-old boy in Newport News, VA, brought a 9mm pistol to school and shot his 1st grade teacher in the chest. The teacher, 25-year-old Abby Zwerner, spent two weeks in hospital and is still recovering. Now, the local prosecutor says that the boy won’t be charged with any crime, despite the fact that police described the shooting as intentional.

Commonwealth’s Attorney Howard Gwynn said the “prospect that a six-year-old can stand trial is problematic,” since the boy is too young to understand the legal system and assist in his own defense. However, Gwynn said his office may yet seek charges for adults connected with the case. Gwynn didn’t offer any specifics, but some have wondered whether the boy’s parents could be charged for not having their weapon properly secured. The family claims the weapon was properly secured and that they don’t know how the boy could have accessed it.

More disturbing details emerge

When the case first made headlines, it quickly became apparent that the shooting was the result of a series of failures by school administrators. On the day of the shooting, no less than three teachers attempted to raise the alarm about the boy’s behavior. Two of them even advised administrators they believed the boy had a gun and was threatening to use it. Administrators’ response was to “ride it out” since the school day was almost over. By Feb. 1, the school’s assistant principal had resigned and the superintendent of schools had been relieved of his position.

Since that time, more information has come to light about the boy’s disturbing behavior and missed opportunities for intervention. Several of these came from a letter from Ms. Zwerner’s attorney Diane Toscano, informing the school district of Zwerner’s intent to sue. According this letter, the boy had “choked his teacher until she couldn’t breathe” in one incident a year prior to the shooting. The boy had also taken off his belt at recess and attempted to whip other children with it, the letter said. The day before the shooting, the boy had received a 1-day suspension after he  “slammed Ms. Zwerner’s phone, breaking it”. 

About an hour before the shooting, Zwerner had texted a loved one, expressing her frustration with the situation. The recipient said Zwerner “was trying to get help with this child, for this child. And then when she needed help, no one was coming”.

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Biden tries to force GOP to show their hand in budget fight

President Biden released annual budget proposal today which contained an ambitious set of objectives. The budget aims to reduce the federal deficit by $3 trillion over 10 years while expanding services to Americans.

Biden’s proposal reduces the deficit and increases revenue for benefits programs by raising taxes on the wealthy. Among the tax proposals are:

  • A 25% minimum tax on billionaires.
  • Increased taxes on corporations.
  • Repeal some of Trump’s tax cuts that benefit individuals making more than $400,000 a year.

The budget also seeks to improve the financial sustainability of Medicare and Medicaid:

  • Improve Medicare’s finances: 1) by negotiating prices and raising taxes on those making $400k+; 2) negotiating lower prescription prices for Medicare recipients.
  • Lower Medicaid costs: 1) by requiring private insurers providing Medicaid coverage to reimburse the program when they overcharge; 2) by empowering the Department of Health and Human Services to negotiate additional drug rebates on behalf of states.

The new taxes and savings will fund expanded benefits for individual Americans and strengthen the economy, while reducing the deficit:

  • $35 insulin for all Americans.
  • Restore the enhanced child tax credit that lifted millions of children out of poverty during its brief 7-month run in 2021.
  • Universal pre-school and affordable childcare.
  • Paid family and medical leave.
  • Increase grants for low-income college students.
  • Funding to reduce maternal mortality.
  • More funding for free school lunches.
  • Addressing climate change.

Biden stakes out his position in debt ceiling fight

With this budget proposal, Biden is showing Republicans his hand in the ongoing fight over raising the debt ceiling. Congress has to periodically raise the amount of money it can borrow to cover money it has already spent. Numerous economists, most recently the Federal Reserve chair Jerome Powell, have warned of the dire consequences of failing to raise the debt limit.

Despite this, Republicans in Congress have not committed to raising the debt limit. Instead, they are holding the good faith and credit of the country hostage to demand massive spending cuts. However, the GOP hasn’t gone on record to say what they want to cut, only what they won’t cut.

GOP leadership has said they won’t consider spending cuts to the massive Pentagon budget or to programs like Medicare and Social Security. But that really doesn’t leave much to cut, except Medicaid.  According to a recent poll, any cuts to Medicare, Medicaid or Social Security would be wildly unpopular, even with the Republican base.

Republicans also aren’t likely to entertain any tax increases for the wealthy, despite the fact that Trump’s massive tax cuts alone will add nearly $4 trillion to the deficit over the 10 years following their passage.

Rather than staking out his party’s budget position publicly, House Speaker Kevin McCarthy (R-CA) has sought to negotiate privately with Biden. By releasing this budget today, Biden is challenging the GOP to share their budget proposal. 

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Read about what’s in Biden’s budget proposal in greater detail here.



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Fears Medicaid might be cut in debt ceiling fight.

Missouri votes against banning children from carrying guns in public unsupervised.

Space-X to block Ukraine using its satellites to pilot attack drones.



Fears Medicaid might be cut in debt ceiling fight

During a testy exchange during the State of the Union, President Biden alluded to a plan published by Florida Republican Senator Rick Scott last year which, among other things, would have required reauthorization of Medicare and Social Security every five years. At the time Scott published this plan, Republican leadership largely rejected it. But as the debt ceiling debate heated up in recent weeks, other Republicans have called for plans to cut the programs as part of an agreement to raise the debt ceiling. The ideas were voiced loudly enough that Donald Trump publicly warned Republicans against it. Since then, Speaker of the House Kevin McCarthy has said that such cuts were off the table.

When Biden mentioned Scott’s plan, Republicans loudly heckled him. Biden called them on it, saying “As we all apparently agree, Social Security and Medicare is off the books now, right? They’re not to be touched? All right”. However, this has left people wondering what Republicans do want to cut. Republicans have already said that cuts to the Pentagon’s budget are off the table, so that doesn’t leave much.

One possibility is that they intend to cut Medicaid instead. As it stands now, more than 1 in 4 Americans, 91 million people depend on Medicaid, which is 26 million more than Medicare. When the COVID emergency provisions end in April, millions of people will already be losing Medicaid coverage. Most of those losing their Medicaid coverage will be in states like Mississippi which chose not to expand Medicaid coverage under Obamacare. Coverage shortfalls in these states have already led to budget crunches in hospitals and forced many to close. If the federal government were to stop matching funds in states that did sign on to the expansion, that could cause hospitals in those states to experience budget shortfalls as well.

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Missouri votes against banning children from carrying guns in public unsupervised

Missouri’s Republican-dominated legislature has struck down a bill that would have prohibited minors from openly carrying firearms on public land without adult supervision. Democratic legislator Donna Baringer said police in her district asked for the change to stop “14-year-olds walking down the middle of the street in the city of St Louis carrying AR-15s. Now they have been emboldened, and they are walking around with them,” Baringer said. “Until they actually brandish them, and brandish them with intent, our police officers’ hands are handcuffed.”

The provision to ban children from carrying weapons unsupervised was initially part of a broader crime bill. That provision was stripped from the larger bill to secure Republican votes. Only one Republican in the body voted in favor of banning children from carrying guns with no adult supervision. 

Republicans characterized the ban as an unnecessary infringement on gun rights. Republican legislator Tony Lovato, who hails from a St. Louis suburb, said that “While it may be intuitive that a 14-year-old has no legitimate purpose, it doesn’t actually mean that they’re going to harm someone. We don’t know that yet”. 

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Space-X will no longer allow Ukraine to use its satellites to pilot attack drones

Gwynne Shotwell, the president of Elon Musk’s company Space-X, says the company will no longer allow Ukraine’s military to use its Starlink service in drone attacks against Russian invaders. Starlink is an internet service that runs on low-orbit satellites. Shortly after Russia invaded Ukraine on Feb. 24 last year, they set about sabotaging Ukrainian communications, including the internet. Musk stepped in to offer several thousand Starlink terminals for free so that Ukrainians could continue using the internet. Space-X and others have since donated a total of 24,000 terminals. 

Shotwell’s statement indicated that while Space-X agreed that Ukraine’s military could use Starlink for comms, the use of the service for attack drones had weaponized the service in a way that violated the agreement. She went on to say that Space-X had put measures in place to limit how the service could be used.

The announcement drew ire and some confusion from Ukrainian officials. Starlink has been crucial to Ukraine’s success in identifying and locating Russian targets and targeting long-range artillery. There’s currently no viable alternative to ensuring the accuracy of these strikes. I

t’s a bit unclear where exactly Space-X is drawing the line as far as Ukraine’s military use of Starlink. It’s possible that Space-X doesn’t object to Ukraine locating the enemy with Starlink but does object to them using the service to actually pilot the drones. As of yet, Ukrainian forces haven’t reported any interruptions in Starlink service or function.

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15 million may lose Medicaid in April. EpiPen maker settles suit over price-gouging scandal. Missile strikes in Ukraine; Russia under economic siege.




At least 15 million may be kicked off Medicaid in April

As of July 2021, Medicaid enrollment was at an all-time high of 76.7 million people. That’s a 19% increase over 2019. Pre-pandemic, Medicaid enrollment had been slowly dropping. But that changed as millions of Americans lost their jobs and insurance coverage due to the pandemic. In response, Congress enacted the Families First Coronavirus Response Act (FFCRA). Among other things, FFCRA increased Medicaid funding to states in exchange for continuous enrollment during the public health emergency. This meant that for the duration of the pandemic, Medicaid recipients could not have their coverage revoked even if their economic circumstances changed.

But that protection may come to an end as early as April. This means that many states are going to have to re-evaluate the eligibility of a huge number of recipients in a very short space of time. Potentially, even people who are eligible for the coverage may find themselves unenrolled. To avoid this, eligible recipients must provide up-to-date income verification to continue their enrolment. This can be a very time-consuming process for recipients, as many states already have huge backlogs and have cut their Medicaid administration staff.

How to apply for Medicaid in Mississippi (opens in new tab).

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EpiPen maker to settle lawsuit over price-gouging scandal

In 2016, EpiPen manufacturer Mylan increased the price of a pair of EpiPens by 500%, from $100 a pair to $600. EpiPens are an emergency life-saving treatment for sufferers of life threatening allergic reactions. The price hike sparked outrage and a still ongoing public conversation about the power of Big Pharma companies to fix prices.

Mylan, which has since changed its name to Viatris, agreed to settle a federal lawsuit stemming from this controversy for $264 million. The settlement will head off a trial that was to begin this month. Had the plaintiffs prevailed at trial, Mylan/Viatrix might have had to pay upwards of $1 billion in damages. Some states’ antitrust laws might have forced them to pay multiples of that.

Mylan/Viatris admits no wrongdoing in the settlement. This lawsuit did not pertain to the price hike itself, because a federal judge threw out that part of the case last year. The still-intact portion of the case accused Mylan/Viatris’ of conspiring with generic brand Teva Pharmaceuticals to delay the release of Teva’s generic version of EpiPen. This agreement ensured Mylan/Viatris could maximize its profit from the price hike.

Meanwhile, Mylan/Viatris as has sold its biosimilars business (which makes products like EpiPens) to an Indian pharmaceutical company for $3.34 billion.

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What role did Sen. Joe Manchin’s daughter play in the price-gouging scandal? (opens in new tab).



Missile strikes in Ukraine; Russia under economic siege

Shelling by Russian forces continued and intensified in the eastern Ukrainian city of Kharkhiv today. This morning, missiles struck Independence Square, the second largest city square in Europe. A government building and the city’s iconic opera house were destroyed. At least 10 civilian fatalities have been confirmed, and at least 70 Ukrainian soldiers were killed in the shelling. Ukrainian President Volodymyr Zelensky proclaimed the missile strikes an act of state terrorism by Russia.

Meanwhile, an ever-growing convoy of Russian military vehicles continues its advance towards the Ukrainian capital of Kiev. Resistance by Ukrainian forces as well as sabotage of roads and bridges have slowed the convoy’s advance somewhat. Breakdowns of some of the vehicles have delayed the convoy further. Analysts say that while the convoy includes some artillery platforms and tanks, most are logistical support vehicles. This implies that the convoy’s mission is to either occupy or lay siege to Kiev.

Talks between Russian and Ukrainian delegations on the Belarussian border yesterday ended with no conclusive agreement. However, the two sides agreed at least to keep talking, saying they would reconvene in the next few days.

Economic pain in Russia

Ordinary Russians are feeling the bite of Western sanctions on Russian banks and some business entities. Many ATMs have run out of currency (both rubles and dollars), though analysts say this is likely just a tactic to prevent people from withdrawing their savings. The value of the ruble vs. the dollar fell by 40% yesterday. The Russian central bank responded by more than doubling interest rates from 9.5% to 20% in an effort to stabilize the currency. Any Russian citizens who are paying mortgages or other loans will soon be faced with skyrocketing fees.

The sanctions have also disrupted mundane everyday activities for Russians. Because of sanctions on the bank that coordinates Mastercard and Visa payments, Russians are now unable to use credit cards and apps like Apple Pay. Many have reported being unable to by food in grocery stores or tickets in metro stations as a result.

It’s debatable who average Russian blames for their predicament. Most Russians consume only Russian state media and are likely to view the sanctions as an act of Western hostility towards the Russian people themselves. A minority of Russians who have access to Western news sources may see the sanctions as a rebuke of the aggression of their leader, Vladimir Putin. But even in those cases, they are likely to see the sanctions as punishing ordinary Russians rather than those in power.

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Mississippi asks Supreme Court to overturn Roe v. Wade. Missouri court rules state must expand Medicaid. EU states put restrictions on unvaccinated.



Mississippi asks Supreme Court to overturn Roe v. Wade

On Thursday, Mississippi Attorney General Lynn Fitch filed a brief to the US Supreme Court, calling the 1973 Roe v. Wade decision “egregiously wrong” and appealing to the nation’s highest court to overturn it. Fitch’s brief is part of the state’s efforts to appeal a lower court ruling that struck down Mississippi’s Gestational Age Act (GAA), which would ban most abortions after 15 weeks.

The state’s brief argues that “the conclusion that abortion is a constitutional right has no basis in text, structure, history, or tradition”. Furthermore, the brief states that by preventing states from imposing undue burdens on the right to abortion, the Supreme Court placed itself “at the center of a controversy that it can never resolve”.

By calling on the court to strike down the universal right to abortion nationwide, Mississippi’s AG has adopted a much more aggressive stance than was the case when the state first asked the court to hear the case a year ago. The change in strategy may indicates that the state feels emboldened by recent changes to the court, which now has a 6-3 conservative majority.

“Extreme and regressive strategy”

Nancy Northup, CEO of the Center for Reproductive Rights, is representing “The Pink House”, Mississippi’s only remaining abortion clinic. Northup first filed the challenge to the GAA on behalf of the Pink House, which resulted in the law being overturned.

In response to AG Fitch’s brief, Northup stated that “Today’s brief reveals the extreme and regressive strategy, not just of this law, but of the avalanche of abortion bans and restrictions that are being passed across the country”. She continued, “Their goal is for the Supreme Court to take away our right to control our own bodies and our own futures — not just in Mississippi, but everywhere”.

The court agreed to hear the case in May, and will likely do so in November or December of this year. A decision will follow in the first half of 2022.

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Missouri court rules state must expand Medicaid

The Missouri State Supreme Court has ruled that the state’s government must expand Medicaid coverage to an additional 275,000 low-income recipients. The ruling upheld the will of the state’s voters who supported an amendment to the state’s constitution on the ballot last August.

Missouri’s Republican-controlled legislature had thus far refused to honor the result of that ballot initiative by funding the expansion. Three women who are newly eligible then sued to force the state to fund the expansion. A lower court ruled that the expansion was unconstitutional because it would force the legislature to appropriate new funding, which would violate state law. Today’s ruling from the state’s highest court overturns that ruling.

Essentially, the state must move forward with new enrolment, even without additional funding. New recipients will be admitted to the pool of existing beneficiaries. The ruling leaves it up the state’s General Assembly to determine what to do when the current appropriation runs out.

One of the attorneys who represented the three female plaintiffs says the ruling “sends an important message” that the state will eventually have to respect the voters’ will and fully fund the expansion.

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EU states put restrictions on unvaccinated

Many Europeans are still resisting vaccination, even as COVID cases from the Delta variant are on the rise. In an effort to drive up vaccination rates, several EU countries are adopting mandates for some sectors of the workforce while placing movement restrictions on the unvaccinated.

Greece recently passed a mandate requiring all public and private sector healthcare workers to get the jab by September. France is adopting a “health certificate”, which citizens will need to access certain venues and establishments.

Starting August 5, Italians will have to present a “green pass” to access stadiums, museums, theatres, cinemas, exhibition centres, swimming pools and gyms. The green pass will be available to anyone who has had at least one dose of a COVID vaccine, or has proof of a negative test within the previous 48 hours.

Italy is also considering making a green pass mandatory for anyone traveling within the country by bus, train or plane in the near future.

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Dems push “human infrastructure” in $3.5T budget. Delta variant storms Mississippi. Taliban takeover in Afghanistan marches on.



Democrats float $3.5 trillion budget proposal

Congressional Democrats have crafted a $3.5 trillion budget resolution. The details of the plan are not finalized. However, since the budget can pass through reconciliation, without Republican votes, Democrats have an opportunity to include some of President Biden’s “human infrastructure” priorities that have been excluded from the $600 billion bipartisan infrastructure proposal. So far, the proposals that have come to light include an extension of new child tax credit, new clean energy standards, universal pre-k, and an expansion of Medicare coverage to dental, hearing and vision.

Proposed pay-fors include rolling back Trump tax breaks for corporations and taxpayers making more than $400,000 a year. The plan also hopes to save money on healthcare spending by introducing bargaining for prescription drug prices for Medicaid and Medicare beneficiaries.

Since Republicans are unlikely to support these proposals, Democrats must ensure that all 50 of their senators are on board. However, some key Democrats have already voiced concerns about the budget proposal. For instance, perennial question mark Sen. Joe Manchin (WV), who hails from coal country, is not happy about the proposal’s emphasis on renewable energy. He also has concerns about how the plan will be paid for.

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Delta variant takes Mississippi by storm

Mississippi State Health Officer Dr. Thomas Dobbs is sounding the alarm once again about rising COVID numbers in the state. This time it is about the growing prevalence of delta strain cases. The strain has taken firm hold in areas throughout the country, especially in places with a large percentage of still-unvaccinated people.

Much of the national comment has focused on Missouri, which is also experiencing a resurgence in some areas. Steve Edwards, CEO of CoxHealth in southwest Missouri, noted earlier this week that patients there are “younger and sicker” than this time last year.

The picture is much the same in Mississippi, according to Dobbs. Dobbs tweeted this week that 7 children in the state were in ICUs due to COVID, two of them on ventilators. Their ages range from under 1 to 17. Dr. Alan Jones of the University of Mississippi Medical Center in Jackson has also seen a “significant increase” in pediatric patients in recent weeks.

Among the general population, Dobbs as said the rise in COVID infections and hospitalizations across the state is “pretty alarming”. The current cases are “pretty much all delta”.

Younger and sicker

With only one-third of the state’s total population fully vaccinated, Mississippi has the second-lowest vaccination rate of any state in the country. In Alabama, the least vaccinated state, 96% of recent COVID deaths have been among unvaccinated people.

The delta strain is more aggressive than previous strains. In the last three weeks, the number of COVID patients requiring medical care has doubled. Hospitalizations have risen 26.7% in the last week alone.

The strain is also opportunistically targeting younger and younger people, many of whom are still not vaccinated. Across the country, the average COVID patient is now in their 20s.

The long-suffering Dobbs has often been at odds with Gov. Tate Reeves. When Reeves lifted the state’s mask mandate, Dobbs immediately took to Twitter to implore Mississippians to continue wearing masks, insisting the danger wasn’t over. Now, Dobbs is advising Mississippians over 65 and those with underlying conditions, vaccinated or not, to avoid even masked indoor gatherings.

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Afghan Taliban capture Pakistani border crossing

As the US continues to withdraw troops, the Taliban is rapidly capturing more and more territory across the country. Today, Taliban forces captured a busy border crossing with Pakistan. Most of the Afghan soldiers who were manning the post immediately surrendered. Four who dared to put up a fight quickly were quickly dispatched.

This entry point is important for the Taliban both monetarily and strategically. It crosses into Pakistan’s Baluchistan province, where the Taliban already has a considerable presence. Controlling this crossing would allow the Taliban’s fighters into Baluchistan to cross freely into Afghanistan and potentially bolster their numbers and eventually launch a full scale assault on Kabul.

End game

For now, the Taliban is concentrating on controlling key border crossings. This strategy allows them to both to choke off economic arteries to Kabul, and to force neighboring countries to recognize their authority.

Taliban forces are also taking over key provincial cities. These include areas dominated by ethnic Tajiks and Turkmen (most Taliban are Pashtun). But rather than an outside invasion, the Taliban has opened negotiations with local leaders in these areas and recruited them.

Officially, Taliban leadership say the goal of the military offensives is to strengthen the group’s negotiating position in peace talks with the Afghan government. But one Taliban commander, speaking anonymously, has plainly told NPR: “These military achievements are so we can rule the country”.

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This is the second in a two-part narrative about the history of hospitals in Union County. Part One was posted Monday, April 4th. See link to Part One below.

In 1946 the U.S. Congress had passed, and President Harry Truman had signed the Hill-Burton Act, a law that provided federal assistance for the construction of modern hospitals in rural communities. The Act, which financed many new hospitals, also imposed additional rules and regulations on how those hospitals were to be operated.

Working with Mrs. Shands, the local medical community, the offices of Congressman Jamie Whitten, Senator Jim Eastland, Senator John Stennis, architects and other professionals, the board, with the leadership of Supervisor Sam Tom Barkley, determined to build a brand new Hill-Burton hospital in New Albany.

This photograph shows the Union County General Hospital soon after it opened in 1966. The 65-bed hospital was built by the Union County Board of Supervisors with the help of the 1946 Hill-Burton Act Photo: Union Co. Heritage Museum

This photograph shows the Union County General Hospital soon after it opened in 1966. The 65-bed hospital was built by the Union County Board of Supervisors with the help of the 1946 Hill-Burton Act
Photo: Union Co. Heritage Museum

Union County General Hospital, a three-story, 65-bed facility, opened in March, 1966, a half-century ago, west of downtown New Albany on Highway 30 West. The first administrator was R. B. Harrington. The late Dr. James Thornton, who had moved to the new hospital from Shands Hospital, delivered the first baby in the new facility.

The early 1960s were a time of radical changes in the way health care was paid for in America. In the early 1960s President John F. Kennedy advocated what he called “Medical Care for the Aged.” As with much of Kennedy’s legislative agenda, the plan went nowhere. However, following Kennedy’s assassination, the powerful political skills of Lyndon Baines Johnson brought about the launch of both Medicare and Medicaid in 1965. With the two federal health care programs came dozens of new regulations, placing a heavy new administrative and regulatory burdens on hospitals and other health care providers

A nice new facility and strong public support aside, 1966 was a tough time to go into the fast-changing hospital business in America. In addition to the Hill-Burton rules and regulations, hospitals now struggled with the new Medicare and Medicaid requirements.

The cost of health care for the entire country increased sharply from 1960 to 1985. U.S. healthcare expenditures as a percentage of Gross Domestic Product (GDP) doubled during that 25 years, from 5.1 percent to 10.1 percent. The reasons for the huge increase are too complex to discuss here. Suffice it to say that Medicare, Medicaid and private health insurance plans all tried to put the brakes on out-of-control costs. HMOs sprung up attempting to hold down health care costs. Government and private insurance plans curtailed the kinds of services they would pay for and reduced how much they would pay.

“I thought county boards of supervisors had no business trying to run a hospital.” Danny Jordan, past President, Union County Board of Supervisors
The cost of operating hospitals in America continued to increase, while third-party payers reduced the flow of available money. Small town hospitals, like the new Hill-Burton financed Union County General Hospital, were caught in a tight squeeze.

County officials, medical professionals and business people in Union County and elsewhere began looking for ways to meet assure the survival of their small town community hospitals.

Northeast Mississippi Medical Center (NMMC) in Tupelo continued to grow, but a great deal of that growth was driven by the Tupelo hospital acquiring small town hospitals — in Pontotoc, Baldwyn and Fulton, for example. NMMC closed or radically reduced services at the small hospitals they bought in this part of the state. It increased the cash flow to NMMC, and may have been more efficient overall, but it meant medical care became less available and more expensive for people in the small towns that lost their hospital services.

Danny Jordan retired earlier this year after 30 years on the Union County Board of Supervisors. He said turning operations of the county-owned hospital over to the Baptist Memorial Health Care organization is "one of the decisions I'm proudest of during my time on the county board."

Danny Jordan retired earlier this year after 30 years on the Union County Board of Supervisors. He said turning operations of the county-owned hospital over to the Baptist Memorial Health Care organization is “one of the decisions I’m proudest of during my time on the county board.”

Danny Jordan retired early this year after 30 years on the Union County Board of Supervisors, the last 12 years as president of the board. He has vivid recollections of the hospital situation when he first went on the county board in 1985.

“In the late 1980s the Union County-owned hospital was not doing very well,” Jordan said.”A great many hospitals around were not doing well at that time. The management at the hospital was not what it needed to be. The county board had started the hospital, which was good, but it was time to turn it over to some good business people. I thought county boards of supervisors had no business trying to run a hospital.”

The board studied its options. NMMC would have gladly taken over the hospital in New Albany, but, said Jordan, “We were afraid that Tupelo would turn it into a first aid station.”

In 1987 the Union County Board of Supervisors negotiated a management contract with Baptist Memorial Health Care of Memphis. Two years later the board leased the hospital to the Baptist organization on a long-term basis.

“We picked Baptist because we believed they would give Union County a full service hospital, not a first aid facility from which patients would be taken to another city for treatment,” says Danny Jordan. “It was done during the early part of my time on the board, but it is one of the decisions I’m proudest of.”

Baptist Memorial Health Care Corporation(BMHCC) did not turn the Union County hospital into a first aid station. In fact, since 1989, BMHCC has invested $70-million of its money into improvements at the hospital in New Albany.

The Baptist organization took control of a 65-bed hospital in 1989. Several major construction projects during the intervening 27 years have increased the hospital to today’s 153-bed facility. The types and scale of medical services available in New Albany have also increased dramatically under Baptist leadership.

Baptist Memorial Health Care invested in a new Women’s Center at the New Albany hospital in 2008. The expanded facility includes 10 suites for labor, delivery and recovery. There are now 18 post partum rooms in the Women’s Center. There are special suites for Cesarean delivery, an expanded nursery and an enlarged and improved waiting room in the new Women’s Center. About 1,000 babies are delivered here each year. Nearly all the babies born to Union County mothers are now born at Baptist Memorial Hospital-Union County. Additionally, a great many babies are born here each year from mothers who live outside Union County.

Baptist Memorial Health Care has invested more than $70-million in Baptist Union County since 1989. This is the new Emergency Department with 22 examination rooms completed in July 2014 at a cost of $12 million.

Baptist Memorial Health Care has invested more than $70-million in Baptist Union County since 1989. This is the new Emergency Department with 22 examination rooms completed in July 2014 at a cost of $12 million.

Less than two years ago, Baptist Memorial Health Care invested $12-million in a new, expanded emergency department at the New Albany hospital. The new emergency department opened in July of 2014 with 22 examination rooms, compared to seven examination rooms in the old. The new facility also has two trauma rooms and two triage rooms.

It enjoyed growth of 23 percent in its first 12 months of operation in its new facilities, and has enjoyed additional growth of 12-13 percent in the first two months of 2016 over the same period in 2015.

A “vertical” waiting area in the new emergency department means patients spend little time in the waiting room and are actually examined by medical staff much faster than in the old emergency department. Although the new emergency department averages serving 90 or more patients each day, there are few people seen waiting. Prior to the new emergency department opening, typical patients visiting the old facility experienced a total stay of between six and eight hours. The average total length of stay in the ER has been reduced to less than two hours.

“The new emergency department at Baptist Union County is designed to see up to 45,000 patients annually,” said Walter Grace, CEO and administrator of Baptist Union County.

Dr. Robert Pitcock, MD is the medical director of the Baptist Union County emergency department. Pitcock says advanced technology has greatly improved emergency care here. He said “telemedicine” has made major improvements in treatment a reality.

Telemedicine can be defined as “the use of telecommunication and information technologies in order to provide clinical health care at a distance.” High resolution video cameras and monitors make it possible for medical specialists in other cities to see what is happening with patients in New Albany, and provide informed consultation to ER doctors. Pitcock said it is sometimes possible for the high-resolution television cameras used in telemedicine to see what is going on with the patient better than physicians can see with the naked eye.

Renovations are currently underway to create a new cancer treatment center in the space previously occupied by the old emergency department. Plans call for the full range of cancer chemotherapy treatment to be available at Baptist Union County.

This is the front of the 153-bed Baptist Union County hospital as it appears today.

This is the front of the 153-bed Baptist Union County hospital as it appears today.

The measurement of quality and performance for all hospitals in the United States, the standards by which hospitals are accredited — certified to be competent for service — are overseen by an organization now known as The Joint Commission. It is recognized throughout the world as, quite simply, the quality control establishment for all hospitals in America. The Joint Commission is headquartered in Oak Brook Terrace, Illinois, a Chicago suburb.

The Joint Commission’s fifth-annual list of national “Top Performers” was announced on Tuesday, November 17, 2015. Baptist Union County was named one of the year’s top performers, one of only 10 Mississippi hospitals to be so honored. New Albany — population 8,500 — was the smallest MS town whose hospital made the Joint Commission “Top Performers” list. Columbus, Miss., population about 25,000, was the next smallest MS town with a hospital to receive the “Top Performers” designation; the Columbus hospital is also operated by Baptist Memorial Health Care.

The Top Performers program recognizes accredited hospitals who achieve excellence on accountability measure performance. The program is based on data for certain conditions, including heart attack, heart failure, pneumonia, surgical care, children’s asthma, inpatient psychiatric services, venous thromboembolism, stroke, perinatal care, immunization, tobacco treatment and substance use. The Joint Commission Top Performer evaluation is unique in that it is based on objective data, which enables each hospital to track its progress.

Fate has indeed been more than kind as to the quality of health care enjoyed by people in Union County, Mississippi. Three fortuitous events during the last 80 years made it happen:

  • A brilliant young surgeon was “tricked” into coming to New Albany and buying a small hospital in 1936.
  • The county government took the risk of building a new hospital when the need arose in 1966.
  • The Union County Board of Supervisors decided to give Baptist Memorial Health Care control of the county-owned hospital in 1987.

To read Part One of this history of hospitals in Union County: Smart, hard work brings superior healthcare to Union County

Next week NAnewsweb.com will publish a separate stand-alone feature with additional photographs and information about Dr. Robert Shands, the Vanderbilt and Harvard-trained surgeon who operated Shands Hospital starting in 1937.

How can the poor’s healthcare crisis spill over to the not-so-poor?

A little Mississippi political history

There are a lot of really cool things about Mississippi, but our healthcare system is not among them. As leaders of the nation’s “poorest and sickest” state, Governor Phil Bryant and his Lieutenant, Tate Reeves, have made political decisions that will give Mississippi an even stronger grasp on that unenviable title for the forseeable future. What Haley Barbour built before he left office, Bryant and Reeves wasted no time in tearing down.

Mississippi could serve as a harbinger of the fate to befall the entire country, if we continue to ignore economic imperatives. America, we simply must “get real.”

Though he may have held his nose the whole time, former Governor Haley Barbour had laid plans which would have, for once, put Mississippi in the forefront of efforts to improve healthcare, especially for its “working poor.” Barbour and his Insurance Commissioner, Mike Chaney, had initiated plans for MississippiOne.com, a website for marketing a state-based insurance exchange/pool for the small businesses which dominate the state’s economy and often do not provide healthcare benefits to employees.  Don’t get me wrong, this was not an esoteric undertaking; it would have, most definitely, benefitted insurance companies willing to do business in this state.

However, when the Affordable Care Act came along, the planned site was already poised to become the exchange site for Mississippi, and Barbour made that case to the federal Health and Human Services Department in 2011.

bryant on obamacareHaving completed these preparations and a great deal of other heavy lifting for the state of Mississippi, Barbour finished his last term as governor and left office. His former Lieutenant Governor, Phil Bryant, moved up into the Governor’s chair.

Hailed as “the Tea Party’s first governor,” and desirous of proving his distaste for “all things Obama,” Bryant oversaw the dismantling of the plans for the MississippiOne website. He was so successful in broadcasting his distaste for the Affordable Care Act, known as Obamacare, that MS became the only state to have its plan for establishing its own insurance exchange rejected by the federal government, for fear that adequate funds would not be forthcoming to properly launch the exchange. As a result, Washington now runs the MS exchange for individuals; the state runs an exchange for small businesses.

At the end of the Affordable Care Act’s first year, Mississippi hit another high mark — the only state whose percentage of uninsured residents went up, not down.

Who are the Mississippi working poor?

Most Mississippians know their fair share of the state’s “working poor,” those who get up every day and go to jobs that provide no health insurance and possibly pay enough to keep workers slightly above the poverty level, but still too poor to afford health insurance premiums on their own. They are cashiers and waitresses at our favorite restaurants and grocery stores; they are our housekeepers and yard workers and the aides who care for our loved ones in nursing homes and even in hospitals. Many of them hold more than one job, because part-time work is all they can find. Many of the “working poor” are single parents, some are grandparents struggling to raise youngsters. Those youngsters are also counted among the “poor.”pushing-a-mop-for-that-old-minimum-wagegarment-worker-300x200

Here is one way we produce an unending supply of uninsured “working poor.” Adults in MS must earn below $5550 ($106/week) to qualify for MS Medicaid and its insurance; most “able-bodied” adult individuals will not qualify at any income. Rules for children vary by age, but, for example, children age 1-6 must be in families making less than $34,680 (143% of federal level, $675 weekly) for a family of four.  As a result, one in four adult Mississippians (one in three blacks) is uninsured…in the nation’s “sickest” state.mcdonalds_0 pub domain

If you have a family and don’t work at all, at least your children can be insured. It’s no surprise that a parent might choose this route. The surprise is the great numbers who choose to work despite remaining uninsured.

A glimpse of Mississippi’s future finances

The Sheps Center for Healthcare Research lists 57 rural hospitals closed nationwide since 2010; 24 of those are in the deep South, with two in Mississippi.

A study by the Urban Institute estimates that failure to expand Medicaid will cost MS hospitals another $4.8 BILLION in lost revenue over 10 years. There are already small community hospitals throughout the state in danger of closing their doors; Kosciusko’s hospital narrowly avoided closing within the past few months. This is one direct way that a crisis for “the poor” spills over to the not-so-poor. There are others.

Governor Phil Bryant

Governor Phil Bryant

Bryant says Mississippi “cannot afford” to expand Medicaid– Tea Party lingo for “we must balance the budget at all costs.” Studies done for MS Medicaid estimate that Mississippi’s cost of expansion would be about $450 million over the next seven years.  That $450 million expenditure would net the state an estimated $8.6 BILLION in expansion funds over the same seven years. For the first two years, the federal government pays all Medicaid expenses, thereafter, the state will be responsible for a portion of the expenses. By 2020, the state portion rises to 10%. This is the hook where Bryant hangs his “no expansion” hat.

Several studies theorize that states with expanded Medicaid will also benefit from increased tax revenue from new businesses and jobs spurred by the influx of more federal funds, thus decreasing states’ actual costs for any future financial obligation. This is just a theory, but it generally works out this way in disaster areas, etc. that receive huge infusions of federal money.

Additionally, Mississippi is not exempted from the federal government’s scheduled across-the-board provider cuts. Luckily, those cuts will be off-set by higher funds coming in through Medicaid expansion. Oh, wait. Mississippi won’t be getting those supplementary funds…so we will end up spending more, anyway, to provide less for our poorer citizens.

Mississippi currently has a budget surplus of about $150 million. We do not know what return on investment Bryant, et al. expect to earn on that money, but we are certain that, over the next seven years, it will not come anywhere close to the over 1900% (no, this is not a typo) we could have gotten by committing $450 million to secure $8.6 BILLION in increased healthcare funding.

Questions for the future of Mississippi

Is the future uncertain? Yes.

Does federal money usually come with strings? Yes. But,really, how much of a concern is this for a state that currently receives $3 back for every $1 it contributes to Washington. Nearly half of the MS budget already comes from one federal disbursement or another. We are already going to Washington with a very big hat in our hands.

Does anyone actually believe that Mississippi’s refusal to expand Medicaid will result in the federal government suddenly taking action to get its budget problem in hand? We must have a realistic, long-term plan that benefits those at every level of society. This is not going to be quick, easy or painless.

Are Mississippi’s “working poor” likely to become miraculously more healthy in the immediate future?

Can anyone actually say, with a straight face and a clear conscience, that budget balancing should begin with the poorest citizens’ healthcare?

There are many other places to look for immediate budget cuts. We suggest the search begin with anything that is producing unreasonable profits for some levels of our society, to the detriment of other levels.

What is the alternative?

As much as it pains us on some fronts to say this, we believe that, in the current climate, the only realistic solution for healthcare in this country is a single-payer system.

With the implementation of Affordable Care, individuals and small business alike are having difficulty affording insurance, while insurance companies continue to reap unreasonable benefits. With reference to Governor Bryant’s SCOTUS statement– it is possible that our current healthcare system needs to be destabilized, since it is clearly not working for the benefit of those who need to be insured.

The Affordable Care Act’s Individual Mandate is swelling the number of Americans seeking health insurance. The federal government is already covering the expenses of those who use most of the nation’s healthcare resources: the elderly and the poor. That leaves the rich, the healthy young working adults and the “working poor.”

The “working poor” are mostly out of luck, as we have addressed above.

The rich and the healthy young adult workers look to coverage by private insurance companies, in some form or another. That gives private insurance companies the customers who pay the highest premiums and cost their insurers the least. Not surprisingly, their profits are demonstrably outrageous, their power is great and their influence, far-reaching.

As long as private enterprise is allowed to siphon off the cream of  the customers, the government will struggle unsuccessfully to balance its healthcare budget. Everyone needs to be swimming in the same pool, and the pool needs reliable lifeguards to make sure that everyone has room to swim.

Yes, we know. Everything is not that simple.  But the financial models are irrefutable. We cannot sustain our current course.

For insight into the declining ability of small businesses to insure employees as insurance company profits soar, see: Center for Public Integrity article.

Some things we DO know

When the legislative portion of our government is not doing its job, it provides opportunity for the courts to overstep their boundaries.

Because the Democrats are not even fielding a real candidate for Mississippi Governor this year, there is little chance of this issue being addressed at the state level for at least four years. We must have a two party system to have any hope of keeping everyone “reasonably honest.”

Admittedly, there is a great deal of speculation involved in this whole Medicaid/Healthcare issue. However, one thing is sure. Bryant and his supporters knew, with a certainty, that refusing to expand Medicaid would do immediate harm to the state’s budget and to the state’s poor.

Four years is a long time to be poor and uninsured.

Lastly, a topic for future discussion: how did we get is such sad shape, both locally and nationally, for politicians?


For the disturbing details of Mississippi’s path to refusing Medicaid expansion, see: Mississippi Burned, Again.

Have some better or different ideas to share on this topic?  Share them publicly via the Comments section below, or anonymously by using NAnewsweb’s T.C.B. PAGE.