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Mississippi’s health-care crisis is worsening, and an overhaul of the state’s “current system of care is unmistakably essential,” a leading medical group warned hours before the State Legislature was set to begin its 2023 session at noon Monday. “The lack of access to healthcare for many Mississippians is currently a crisis, not a new crisis, but one that has been fermenting—and is getting worse,” the Mississippi State Medical Association said in a press release this morning. “As hospitals close across Mississippi, access to life-saving medical care becomes a real threat to all Mississippi. While the debate rages on as to why our hospitals are closing, the immediate crisis progressively engulfs us.” Across the state, several hospitals have closed or cut services in recent months. During a hearing with lawmakers in November, Mississippi State Health Officer Dr. Daniel Edney warned that 38 of Mississippi’s rural hospitals, or about 54%, could close. Mississippi is already the poorest state with some of the worst health outcomes, including during the pandemic. “That is a situation that is intolerable from an economic standpoint—to lose 54% of our hospitals in the state—much less from an access to care perspective,” PBS reported Edney saying in November.

State Senate Medicaid Committee Chair Kevin Blackwell, R-Southaven, is not the first politician to look to Arkansas as an example of how to provide health care coverage to more Mississippians. “No, I don’t believe in it,” Blackwell said of Medicaid expansion after a recent legislative hearing on the financial crisis facing Mississippi hospitals and their possible closure. Blackwell was echoing the positions of many Republican politicians in Mississippi who say they oppose Medicaid expansion that would provide health care coverage for primarily the working poor. But then Blackwell went on to say that “there might be some alternative to Medicaid expansion for the state to consider.”

Mississippi legislators return to the Capitol on Tuesday, and their three-month session could be dominated by debates over taxes. This is the final year of a four-year term. Most members of the Republican-controlled House and Senate are expected to seek reelection, but the Republican speaker of the House, Philip Gunn, announced months ago that this will be his final year in office. During the 2022 session, legislators passed and Republican Gov. Tate Reeves signed a plan to reduce the state income tax over four years — the state’s largest tax cut ever. That reduction starts this year. Gunn says he wants legislators this year to finish the job of eliminating the income tax. He points to a budget estimate that shows Mississippi with a surplus of about $1 million.

To reach Gunnison, Mississippi, from Cleveland, the quickest path – though not the route with the best-paved streets – takes you off Highway 8, down miles of narrow roads slicing through some of the most fertile land on earth. In early December, the fields are still but not empty. Silvery water pools in gashes in the dirt, and cardinals settle on shoots of electric green gleaming in the gray light of winter. When you reach Highway 1, you’ve arrived in Gunnison, with a population of 425 and only two businesses: a gas station and Healthy Living Family Medical Clinic, opened by Gunnison native Wyconda Thomas in 2019. The squat brick building is decorated for the season, with a wreath on the door and letters out front spelling “Merry Christmas.” When Thomas decided to open her own practice, she chose the place where she saw the greatest need, which also happened to be the community that raised her.

With the Mississippi legislature’s next regular session less than two weeks away, Lt. Gov. Delbert Hosemann laid out a number of priorities he’d like to see pass in 2023. Atop his list were healthcare and infrastructure, with education and taxes also being mentioned during a meeting with news media Wednesday. Hosemann, who leads the state Senate, said people often have preconceptions about legislative sessions during election years. State offices, including his own, will be up for grabs in November.

The state of Mississippi isn’t getting anything past Danielle Thomas. Thomas is a bright, young single mother raising her six kids in south Jackson. Because she lives in poverty, Thomas is also an expert in the convoluted policies and bureaucratic red tape surrounding one of the biggest scandals in state history: the TANF program. Despite recent attention on the graft and corruption within the state’s Temporary Assistance for Needy Families block grant, Mississippi is still pumping less than 5% of the money directly to mothers like Thomas. “I really think it’s still them stealing from people, to be honest,” Thomas, 34, said. “I really feel like they feel like a lot of us aren’t smart enough, or they feel like we probably don’t know the system in and out well enough.”

Gov. Tate Reeves has joined with 24 other states to ask President Joe Biden to end the Federal Public Health Emergency for COVID-19, which would allow the state to remove some people from Medicaid coverage.  First declared in January 2020 under the Trump Administration, the public health emergency gives health care providers flexibility in how they operate. This public health emergency has been extended repeatedly since — it was last extended again in October and set to end in January 2023, though the department has not indicated it will not renew. The department has said it will give governors at least 60 days notice before a declaration ends.

The State of Mississippi is leaving millions of dollars on the table that could directly benefit families in deep poverty, witnesses emphasized repeatedly during a public hearing Thursday before the Mississippi House and Senate Democratic caucuses. LaDonna Pavetti, senior fellow at the Center on Budget and Policy Priorities, noted that the accumulated unspent Temporary Assistance For Needy Families (TANF) funds could be used to assist low-income families with children in any given year. “The important takeaway here is that Mississippi has TANF funds available to provide extra cash,” Pavetti said. “The last report, which was for 2020, (showed) that Mississippi had $47 million in unspent TANF funds. Those are funds that are just sitting (where) Mississippi can draw on them any time it wants … and in 2020, Mississippi left $31 million unspent. It’s just sitting there.”

The state of Mississippi was entering a new day in the fight against poverty.  At least that’s what conservative talk radio station SuperTalk would have you believe. It was the summer of 2018, and radio host Paul Gallo was visiting with John Davis, then-director of the Mississippi Department of Human Services, and nonprofit founder Nancy New on site during a government summit at the Westin luxury hotel in downtown Jackson.

Extending postpartum Medicaid, creating a foster care bill of rights and building a new website to help moms and families find resources are all among the policy priorities backed by the Senate Study Group on Women, Children and Families, Sen. Nicole Boyd, R-Oxford, told Mississippi Today. Lt. Gov. Delbert Hosemann tasked the group with reviewing the needs of Mississippi families and children from birth to age 3, following the Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization that allowed the state’s near-total abortion ban to take effect. The ban will result in an estimated 5,000 additional births each year, a 14% increase in the state with the country’s highest rates of infant mortality and preterm births; a foster care system in which children are often abused and neglected; and the most restrictive Medicaid policies for new moms in the country.