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Democratic legislative leaders will propose a plan this week to address a problem they say most of their Republican counterparts won’t even fully acknowledge: the Mississippi hospital crisis. State health officials have warned lawmakers that 38 rural hospitals across the state are in danger of imminent closure because of budget problems. Some of those hospitals are larger regional care centers, such as Greenwood Leflore Hospital. Even the large metro hospitals are understaffed and struggling to provide adequate care due to rising costs. Physicians and other health care leaders are sounding the alarm about the entire state’s ability to maintain a reliable system of care. Given the growing urgency of the crisis, Democratic leaders under the dome say they can’t wait around for their Republican counterparts to propose solutions. “I feel silly trying to explain to (Republicans) why we need to do something about this quickly when the need is right there smacking them in the face every single day,” said Rep. Robert Johnson, the House Democratic leader. “These people have the best possible access to the best possible information about the state, and they’re ignoring it. They’re running away from the problem. The house is fully on fire right now, but it’s fine because Republicans say it’s not really burning.

In Mississippi, where elected officials have a long history of praising self-sufficiency and condemning federal antipoverty programs, a welfare scandal has exposed how millions of dollars were diverted to the rich and powerful — including pro athletes — instead of helping some of the neediest people in the nation. The misuse of welfare money rankles Nsombi Lambright-Haynes, executive director of One Voice, a nonprofit that works to help economically vulnerable communities in Mississippi. “It’s shameful and disgusting, especially when we’ve been a state where we hear discussion every year about poor people not needing resources and poor people being lazy and just needing to get up to work,” she said. The state has ranked among the poorest in the U.S. for decades, but only a fraction of its federal welfare money has been going toward direct aid to families. Instead, the Mississippi Department of Human Services allowed well-connected people to fritter away tens of millions of welfare dollars from 2016 to 2019, according to the state auditor and state and federal prosecutors. Former Human Services Director John Davis has pleaded guilty to charges tied to welfare misspending in one of the state’s largest public corruption cases. The scandal has ensnared high-profile figures, including retired NFL quarterback Brett Favre, who is one of more than three dozen defendants in a civil lawsuit that the current Human Services director filed to try to recover some of the welfare money wasted while Davis was in charge.

Senator J. Walter Michel represents District 25 and also serves as the chairman for the Senate Insurance Committee. Many of his accomplishments in the 2022 Legislative Session revolved around this committee and the American Rescue Plan Act (ARPA) and he hopes to see more bills come from these two areas in 2023. This year, the insurance committee has a piece of legislation they are working on called Prior Authorization. Currently, if a person in Mississippi needs a medical procedure, the insurance company wants the doctor to pre-authorize the procedure before they’ll agree to pay for it. This can cause delays in getting the patient that procedure. The committee is working to allow doctors who have a very successful rate with certain procedures to receive “a gold card status,” which means they won’t have to get prior approval with the insurance company before they do the procedure. “The doctor has the right to go ahead and do the procedure and be reimbursed by the health insurance plan, and the insurance company still has the right at the end of the six months to audit all of the operations that were done to see if there was one or two that might have been done,” Michel said. “It streamlines the process and speeds it up.”

With the Mississippi Legislature getting ready to enter its second week, some holdovers from the 2022 session could be back on the table. The Legislature closed 2022 with some unfinished business in the form of a revised ballot initiative bill that failed to clear both houses before the session ended and the elimination of the state’s income tax. The House and Senate failed to reach an agreement on a ballot initiative bill, to replace the present law that was struck down by the Mississippi Supreme Court in a suit filed by the city of Madison to overturn Initiative 65. In November 2020, voters overwhelmingly approved Initiative Measure 65, a citizen-driven ballot initiative. Initiative 65 would have amended the Mississippi Constitution to create a state medical marijuana program. However, on May 14, 2021, the Mississippi Supreme Court overturned Initiative 65, ruling that the state election law governing voter ballot initiatives was out-of-date and unworkable.  

A wide majority of Mississippians across partisan and demographic lines supports expanding Medicaid to provide health coverage for the working poor, according to a newly released Mississippi Today/Siena College poll. The poll showed 80% of respondents — including 70% of Republicans — either strongly agree or somewhat agree the state should “accept federal funds to expand Medicaid.” The numbers appear to show a continued shift of voter sentiment in what has long been a partisan battle. Mississippi’s elected Republican governors and other leaders for the last decade have blocked Medicaid expansion via the Affordable Care Act and the billions in federal dollars that would have come with it. This resistance continues even as struggling hospitals and more citizens in the poorest, unhealthiest state cry for help. “Yes, I support it,” said Joy Cevera, 60, a Republican voter from Oxford who said she generally supports Gov. Tate Reeves but disagrees with him on Medicaid expansion. Several poll respondents agreed to talk with Mississippi Today about their responses. For Cevera, a disability-retired cook, the issue is personal.

Lt. Gov. Delbert Hosemann has unveiled a package of proposals aimed at saving rural hospitals from closing down, leaving Mississippians without access to reliable health care. Flanked by Senate colleagues for the announcement, Hosemann told reporters on Wednesday that the proposals would remove some restrictions on hospital partnerships, attempt to keep nurses in the state and encourage hospitals to expand physician residency programs. “We have come to the conclusion that there needs to be significant positive changes in order to provide our citizens with necessary rural health care,” Hosemann said. Legislative action under the Capitol dome this year is a matter of life and death for hospitals and rural Mississippians. State Health Officer Dr. Daniel Edney previously told lawmakers that 38 of the state’s hospitals face serious financial troubles and are at risk of closure. This represents 54% of Mississippi’s rural hospitals. One piece of legislation Hosemann is pushing is a bill that would remove several antitrust restrictions from hospitals and allow them to collaborate with other hospitals or nonprofit organizations. The legislation, for example, would allow North Mississippi Medical Center in Tupelo to partner with the Tippah County Hospital in Ripley to provide OB-GYN services for Northeast Mississippi residents.

A new Mississippi Today/Siena College poll showed wide support for Mississippi expanding Medicaid to cover the working poor, including 70% support from Republican respondents. The numbers appear to show a continued shift of voter sentiment in what has long been a partisan battle. Mississippi’s elected Republican governors and other leaders for the last decade have blocked Medicaid expansion via the Affordable Care Act and the billions in federal dollars that would have come with it. This resistance continues even as struggling hospitals and more citizens in the poorest, unhealthiest state cry for help. Several poll respondents agreed to talk with Mississippi Today about their support or opposition to expanding the federal-state health care program to cover people making up to 138% of the poverty level, or the working poor.

Amid a nursing shortage that is worsening poor health outcomes in Mississippi, nursing programs at the state’s public universities are turning away hundreds of potential students every year because of insufficient faculty sizes. Alfred Rankins Jr., Mississippi’s commissioner of higher education, said at a legislative hearing Tuesday that nursing programs have struggled to retain faculty members because of the state’s lower-than-average salaries for public university employees. “Unfortunately, our nursing programs must turn away approximately 300 qualified nursing applicants each year because of limited faculty numbers,” Rankins said. The Mississippi Institutions of Higher Learning is requesting a $5 million increase in state funds for the fiscal year that begins July 1 to beef up nursing faculties at public universities, which Rankins said will help alleviate the shortage. About 73% of nursing graduates in Mississippi still work in the state after five years, according to the agency.

Mississippi legislators had a light workload the first two weeks of their three-month session, but they are about to get busy debating proposals that could affect health care, voting rights and other issues. Monday was the deadline to file general bills. House and Senate committees face a Jan. 31 deadline to consider bills filed in their own chamber. Bills that survive will then face a Feb. 9 deadline for consideration in the full House or Senate. Then the two chambers will exchange bills for more work. Legislators face deadlines later in the session for bills dealing with budgets, taxes and borrowing. Here’s a look at some of the general bills: HOSPITALS — Multiple bills seek to help financially struggling hospitals by creating grant programs or tax credits. MEDICAID — Multiple bills seek expansion of Medicaid to people who work low-wage jobs that don’t provide private health insurance. A 2010 federal health care law allowed expansion, and Mississippi is among 11 states that have not taken the option. Other bills — including House Bill 426, which has bipartisan support — would allow extension of Medicaid coverage from 60 days to one year after a woman has given birth.

Mississippi doesn’t have the medical workforce to address a wide range of poor health outcomes, from high rates of maternal and infant mortality to severe cases of diabetes that require the amputation of limbs, the state’s top health officer said. Dr. Daniel Edney, who leads the Mississippi State Department of Health, told lawmakers Thursday that the state health department is short 150 nurses and low health care access in the state’s impoverished Delta region is becoming “scary.” The challenges have placed Mississippi near the bottom of national rankings that track the performance of state health care systems. “We may be at the bottom today, but we don’t have to stay there,” Edney said. “I’m just begging for partners to help us … because we have too many Mississippians who are dying prematurely. We have too many who are aging with poor health and we have too many people struggling for access to care.”