Editorial Roundup: Mississippi

Columbus Dispatch. June 3, 2022.

Editorial: ARPA funds should be maximized

When Congress passed the $1.9 trillion American Rescue Plan Act in March 2021, Mississippi Lt. Gov. Delbert Hosemann called it a once-in-a-generation windfall for the state, its cities and counties and urged local governments to focus on infrastructure projects.

During the 2022 legislative session, the state set aside $850 million for water and sewer projects in cities and counties. Cities and counties who use their own ARPA funds for qualifying projects can get matching dollars from the state.

That appropriation sent a clear message to cities and counties who want to maximize their own ARPA dollars — a chance to double their APRA spending power through those matching funds.

In some cases, this may present local governments with difficult choices, especially for projects that are not eligible for matching funds but are otherwise important to their communities.

That’s a scenario the Oktibbeha County Board of Supervisors will discuss at its board meeting on Monday after learning this week that the county’s plan to repair the dam at Oktibbeha County Lake does not qualify for state matching funds. Oktibbeha County received $9.6 million in ARPA funds. With an estimated cost of $15 million to $17 million to repair the dam, the supervisors had planned to use state matching funds to cover the balance of that cost.

This new development means supervisors may have to choose between projects that do qualify for state matching funds or commit to a dam project without state funding.

One example has already emerged. In May, supervisors tabled a request for $1.7 million in ARPA funds to assist the East Oktibbeha Wastewater District’s infrastructure expansion down Old Highway 25. The project would qualify for a dollar-for-dollar match from the state’s ARPA program.

Supervisors will have to weigh the opportunity to double their spending power on projects that qualify for state matching funds against spending money on “go it alone” projects.

We believe Hosemann’s once-in-a-generation declaration. This opportunity can be maximized by pursuing projects that can be supported with matching funds.

While we acknowledge that some “go it alone” projects are important enough to pursue, the opportunity to leverage those dollars to maximum effect should be given every consideration.

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Greenwood Commonwealth. June 7, 2022.

Editorial: Rural Hospitals Are In Peril

The struggles that Greenwood Leflore Hospital has faced in recent years are replicated across the rural landscape of America, especially in the South.

Rural hospitals have a lower percentage of private-pay patients than urban ones, making rural hospitals especially vulnerable to Medicare and Medicaid reimbursement rates that don’t cover the cost of care. They have a harder time keeping an adequate medical staff of local hires, forcing them to hire travel nurses and other medical specialists whose contracts carry a hefty premium. They are in areas where the population has been in decades-long declines. Their patients tend to be more expensive to treat because of their age and multiple health problems. And they have a disproportionately large share of patients who don’t have insurance and can’t afford to pay their bill.

That last problem — high numbers of uninsured patients — is compounded in the South because of the obstinate refusal of state leaders to take the federal government up on its longstanding offer to pay for most of the cost of insuring the working poor.

Consider this correlation.

In Mississippi and four other Southern states — Alabama, North Carolina, South Carolina and Tennessee — more than 30% of their rural hospitals were deemed vulnerable to closure, the news outlet USA Today recently reported, citing a study by the Chartis Center for Rural Health. All five of these states are in the group of 12 nationwide that have refused to expand Medicaid.

“We’ve seen that really catapult the South into kind of a descending spiral with hospital closures,” said Michael Topchik, director of Chartis.

Medicaid is not the only thing that rural hospitals need to cure their ills, but it is a significant part of the remedy, even with reimbursement rates that are on the low side. It is distressing that the Republican leadership in Mississippi, most notably Gov. Tate Reeves and House Speaker Philip Gunn, absolutely refuse to see it. Do some hospitals in the most medically vulnerable parts of this state have to close in order to open their eyes?

There are so many good arguments for expanding Medicaid, and so few good arguments for not doing so.

Expansion wouldn’t just help hospitals. It would lift up the entire economy of this state with an estimated extra billion dollars a year in federal funding. It would provide more than 200,000 of currently uninsured adults with the peace of mind of having coverage. It would give them the incentive to seek care for medical problems before they reach a crisis point and send them to the emergency room.

Opponents of Medicaid expansion have erroneously claimed that the state can’t afford the cost.

The federal government, under the law that created Medicare expansion, is obligated to indefinitely cover at least 90% of the cost. That match was sweetened even more last year by Congress to try to persuade Mississippi and the other recalcitrant states to get on board. The economists who have crunched the numbers for the state government have said that Medicaid expansion will pay for itself in increased economic activity.

That math doesn’t even take into account the severe financial fallout that would be felt in rural areas should they lose their hospital.

In most rural communities like ours, the hospital is one of their largest employers. The hospital not only employs people directly but indirectly fuels other jobs by contributing to the quality of life that companies and their employees want.

A community without a hospital is a community that’s going to have a hard time retaining the economy it has, much less growing it.

It’s not just rural hospitals in this state that are in danger. Rural Mississippi itself is. Those in state government better understand that.

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