April Simpson, Center for Public Integrity - Deep South Medicaid expansion and the impact on the poor

April Simpson, Center for Public Integrity
Deep South Medicaid expansion and the impact on the poor


A guarantee of healthcare for poor Americans, regardless of race, religion, gender or geographic location.  Who could be against that?  Polls suggest the answer is white voters in a dozen states, eight of them across what is called the Old South.

The very same people who opposed almost everything in President Lyndon Johnson’s Civil Rights bill and War on Poverty in 1965.  I mean, what was in it for them?  White folks down South already had their civil rights and those who lived in poverty — well, too bad for them.

In mud-wrestling his good works through Congress, LBJ made horse-trades in the currency he knew best — political power.  To get Medicaid through Congress, to get the votes of the white males who represented the South, President Johnson gave local politicians — white males to be sure — the power to decide who was eligible for federally-funded healthcare.

Today, in Mississippi, our guest today, April Simpson has reported for the Center for Public Integrity, only a family of three with an annual income below $5,712 can qualify.

In 2010, as part of the Affordable Care Act, Congress tried to buy back the states’ eligibility power.  Let ACA cover everyone making less than four times the poverty rate, and the Federal Government will cover most of the costs. In Mississippi today, Simpson reports, the Feds would put out close to $5.50 for every dollar the state would spend, the highest reimbursement rate in the country.

Who could be against that?  Mississippi Governor Tate Reeves, for one.  Giving “300,000 additional Mississippians government-funded health care,” Gov. Reeves says,”is not good public policy.”

What Reeve’s policy is, an African-American resident of Jefferson County, Mississippi’s poorest and blackest, told April Simpson, is “modern-day slavery. It’s the new way to keep us from progressively moving forward at a faster pace than they are.” It’s the new version, he says, of “Four hundred years, of how we came to this country and then the mentalities that were birthed out of that.”


Just a few miles up the Mississippi River from Jefferson County, on the other bank, is Madison Parish, Louisiana, also very poor and very Black, but in many ways much healthier. One reason: Louisiana is the only deep south state to take the federal offer and expand eligibility for Medicaid.


April Simpson joined the Center for Public Integrity in October 2020 as a senior reporter covering racial equity. She was previously the rural issues reporter at Stateline, an initiative of The Pew Charitable Trusts.






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