Thursday, July 24, 2014

Mississippi History 101 Part 1: The Yazoo Land Scandal

As a part of explaining why Mississippi is the way it is, we must first recognize and understand its history from as objective of a standpoint as possible. This is why I am launching a new series on Mississippi History as a part of the Left of the Pearl blog. I hope to use this series to examine the different events, people, and ideologies that have shaped this state over time. Part 1 will focus on the founding of the Mississippi Territory as a distinct entity from the State of Georgia.

At the end of the French and Indian war, the British agreed to limit their North American colonists to the eastern side of the Appalachian mountains. To this end, King George III issued the Royal Proclamation of 1963, after which the continent looked like the map below. (Source)


Most of the land that is today Mississippi and Alabama (excluding the coastal areas which were at the time Spanish West Florida, (given to the British at the end of the 7 Years War, but returned to Spain upon the end of the American Revolution)) was claimed after the American Revolution by the state of Georgia. After the Treaty of Paris 1783, the American states under the Articles of Confederation were free to offically settle west of the Proclamation Line of 1763. This meant that most states simply extended their north and south borders all the way to the Mississippi River. The map below illustrates what those claims looked like. (Source)

When the war ended in 1781, the slow trickle of settlers to the western lands that had been reserved for Native Americans by the Proclamation Line sped up. In 1795, once all of the Yazoo lands had been ceded by Spain, the Georgian legislature passed the Yazoo Land Act. This split the territory into districts and sold it at below market costs (about 1.4 cents an acre). Most of the people who bought the land at that price, then went on to resell it at a significant markup, making lots of private money at the expense of their state government.

The details of the scheme got out and the Georgian voters were outraged. They replaced nearly all of their incumbents (most whom profited off of the scheme personally) and about a year later, the bills of sale were repealed by the Georgia state government. Due to disputes with the settlers, some of whom decided that they had paid for the land and it was thus theirs, Georgia sold the land back to the US Government in exchange for their assuming the legal responsibility for the land. This land became the Mississippi Territory.

The case made its way to the Supreme Court in the 1810 case of Fletcher v. Peck, when Chief Justice Marshall ruled that the sale was binding, and that Georgia had no right to repeal the bills of sale, no matter if they were corrupt or not.

So there you have the birth of the territory; concieved in corruption and dedicated to the proposition that all men ought to make a buck off of the public's trust if they are able to do so. And while the corruption was found out and repudiated by the voters, it nonetheless stuck and the land speculators were able to pocket their money from the public largesse.

Source

All of this ignores the fact that the lands west of the Proclamation Line were very much not empty, and that various native tribes (in Mississippi's case the Choctaw and Chickasaw at that time) were already settled on the land. The next Mississippi History post will deal with how the early settlers and the native tribes got along, as well as the development of the slave economy in the new territory.

Monday, July 21, 2014

Medicaid Expansion in the Magnolia State

It's no secret that many Republican states have rejected the Medicaid expansion offered as part of the 2010 Patient Protection and Affordable Care Act, to much sound and fury. Thanks to the ruling issued by the Supreme Court in the case of NFIB v. Sebelius, Chief Justice John Roberts ruled that because Medicaid is partially funded by the states, they could not be required to expand it.

But what does that mean for the average working person in the State of Mississippi? Well it's like this: let's say you aren't covered by your parents insurance, either because they don't have a plan that offers family coverage, or you're too old. You work a job that is not required to offer you insurance (say at a small business, with less than 50 employees) or you work two part time jobs where you don't get the hours required to qualify for coverage. This leaves you with the option to use the exchanges set up by the law to purchase your own insurance. 


However, once you do that you find that the premiums are still too steep for your budget. Not to worry, you think, there's still subsidies that will make it affordable right? Wrong, because the design of the law had not considered the potential of the ruling offered by the Supreme Court, many Mississippians are finding themselves caught in the dreaded coverage gap highlighted here.


This leaves you with the other option of applying for Medicaid coverage. But there's a problem there, Mississippi didn't vote to expand Medicaid. So how does one qualify for Medicaid coverage as a working adult? Simple, get pregnant. It seems counterintuitive doesn't it? You're already on a tight budget and can't afford health care premiums so why have a baby? Because part of the Medicaid statute is that it must cover all new mothers and their babies up until five years of age. And it's a good thing; it was originally devised in order to lower the infant mortality rate by increasing the number of babies born in hospitals, and improving access to prenatal care in order to prevent birth defects. And it has worked marvelously:



















(Source)
Note the sharp decrease around 1965 in figure 11. Which almost directly coincides with the passage of the Medicaid act of 1965, as part of LBJ's Great Society programs.


But let's say you're a man, does fathering a child qualify you for Medicaid coverage? It does not. So how else could you get Medicaid coverage as an adult male? Well first you have to quit your job or jobs, and try to apply for Social Security disability coverage. And if you don't want to apply for disability? Well then you're yet another statistic in the nations falling, but still large number of uninsured adults. 


Let's say you get hurt on the job or have some pre-existing condition that you believe might qualify for disability. Then you can get Medicaid right? Wrong, not until you are approved for disability. And how long might that take you? According to the Social Security guidebook it can take anywhere from 3 to 5 months to process you
r first claim. 


And that assumes that you get it on the first try, many don't! Hence the proliferation of lawyers advertising disability services on TV in the last several years. And all the while you are waiting for a disability claim, you have no income, no insurance, and you must pay for all medical costs out-of-pocket. If you managed to make it this long, then congratulations, you can get back payments and retroactivMedicaid to pay for the expenses that you incurred during this time. There is one other option to acquire automatic Medicare coverage even if you were under the age of 65, that involves being in renal failure and needing dialysis treatment. So there you have it, as it stands those are the perverse incentives and obstacles that one has to navigate in order to find affordable healthcare if you are a low income Mississippian.

The conservative leadership of the state of Mississippi justifies their rejection of the Medicaid expansion by saying that it will cost of the state too much money. But let's look at a breakdown of where our Medicaid funding comes from at the present moment.


As you can see the federal government already pays for the lion's share of Mississippi Medicaid dollars. This is owing to the fact that Mississippi is, by almost all metrics, the poorest state in the union. But our state government, never one to eschew ways of cutting costs or privatization, has in the past several years found a new way to save a few extra dollars that we spend towards Medicaid, through the MississippiCAN program. What this program aims to do is to encourage a reduction in healthcare costs among the neediest patients by taking state and federal Medicaid money and enrolling those patients in a Managed Care Organization through private insurance providers, Magnolia Health Plan, and United Healthcare Group. So, by giving private companies financial incentive to reduce access to services, and requiring prior authorization for specialty services, these companies aim to make money through the department of Medicaid. However this has created problems for healthcare providers, by creating extra paperwork and delaying payment up to three months. Kingfish blog had a pretty good piece on it from back in 2011: 


Nationwide 56% of Medicaid patients are now on Managed Care Plans. This can create problems for both Medicaid patients and the providers who bill them as highlighted in this recent article in Modern Healthcare.


"Primary care Physicians say it's hard to find specialists who will take the Medicaid managed-care patients on referral" said Dr. James Rish, President of the Mississippi State Medical Association.


So these private managed-care private insurance companies are supposedly saving the state money. But at what cost? Clearly it affects the ability of patients to access medical care, and providers say that the additional paperwork has made their jobs more onerous to do, while denying payments, or delaying payments for services delivered months ago. All to enrich the bottom lines of private insurance companies and saving the state some money, at the expense of Medicaid beneficiaries and healthcare providers.


And all of this brings me to the grand overarching point. Mississippi is in trouble, we have the worst statistics on health care in the nation. Some of it's self-inflicted, we eat too much, smoke too much, and we don't get enough exercise. Many of those things are symptomatic of the culture of poverty, a persistent, inescapable fact. We have a rural population and a poor population.


Not only does rejecting Medicaid expansion hurt our healthcare delivery, it hurts our economy. According to Reuters "
In rejecting the Medicaid expansion, Republican Governor Phil Bryant is turning down an estimated $426 million in federal funds for next year." These are funds that would go towards paying more doctors to move into the improverished Delta region, among other expenses. These funds would improve our healthcare, allow our citizens to keep their money in their own pockets and contribute to the consumer economy, and would bring in more wealth to the state. Imagine if you will, hundreds of new doctors moving into Mississippi. Imagine the economic impact that would have on our communities. Imagine what would happen to consumer demand? How many jobs could be created? 
It is a travesty that accepting Medicaid expansion is not the first priority in the statehouse. 

Friday, July 11, 2014

Cochran vs McDaniel: The Primary


The Primary

So obviously my first substantive post needs to address the elephant that trampled through the proverbial room earlier this summer; Senator Thad Cochran's surprising upset of State Senator Chris McDaniel in the Republican primary runoff election.

Here is the geograpic breakdown of the votes from the first round of voting. Source for maps here. (Cochran shown in blue, McDaniel in red)



As you can see, McDaniel did best in his home base in the Pine Belt region. Were it not for his gaudy totals here, this election would not have been close and the incumbent would have cruised to another reelection. The converse is also true, had Senator Cochran not performed so well in his base, Hinds County, the Delta, and the North MS Hill Country, this race would have gone to the upstart. They battled to a near draw. This map however is incomplete, it is only a rough tool for understanding the electorate. Rankin County is a high population county, but the candidates battled out nearly to a draw there, so Mr. Cochran's victory there is less indicative of his real performance.



When we add gradient to look at competitive vs non-competitive counties, a clearer picture of both candidate's bases develops, and this is more telling.  I put the cut off for a "competitive county" at 55%, it is an arbitrary line, but any line I draw will be necessarily arbitrary so that's just the line I picked. So much digital ink has been spilled regarding what both candidates represent for the modern GOP that it is hardly worth me retreading, but I shall sum it up anyway; the septugenarian Cochran represents the collegiality and "practical conservatism" that once marked the Senate as a governing body, and the upstart McDaniel represents the "tea party" whose ideals include more fiscal austerity, a sharp reduction in government, and all that stuff.

What we see here are each candidate's bases. Mr. McDaniel's base in the Pine Belt stands out again, while Mr. Cochran's victories in the small counties in the north central region become less impressive. What becomes more impressive however, is Mr. Cochran's total dominance in the voting in the Delta, Jackson (and its northern, but not eastern suburbs), and the "black prarie" through the eastern portion of the state; from Noxubee County up to Prentiss, and extending over to the home of Mr. Cochran's alma mater in Lafayette County. The only counties where Mr. McDaniel won a convincing majority outside of his home turf was in the Memphis suburbs of DeSoto, Tate, and Marshall Counties.

Another thing to notice, and will become important in the runoff maps, is that Mr. Cochran won the majority of counties where it was competitive 23-11. But again, due to McDaniel's big lead in the Pine Belt and Memphis 'burbs, this one went to another round.

The Runoff

Two weeks later, voters returned to the polls. Again the vote was competitive but this time the incumbent prevailed. The same gradient map shown above applied to the election does not do it justice. An uninformed reader of the map below would believe that surely McDaniel won the runoff, after all, he flipped or solidified his leads in several competitive counties.

As you can see, Mr. Cochran's narrow lead in Panola County gave way to a McDaniel route, McDaniel also took slight leads in Scott and Newton Counties in the Pine Belt adjacent East Central MS region. Mr. McDaniel also expanded his reach into the North MS Hills region by taking commandig leads in Tippah and Benton Counties

The counties where Senator Cochran helped his cause the most were in the majority African American river counties. He solidified his leads in Warren and Adams counties, as well as the off-river Simpson and Lincoln counties.

The map at left shows you though, that often untold in the news stories about the runoff, is that rural white Republicans were trending towards Mr. McDaniel. That is an important thing to remember. Competitive counties in the runoff election split 14-14. Mississippi's rural white voters seem more attracted now to Mr. McDaniel's ideology than they did even two weeks before this contest. The next statewide primary will be very interesting to watch. I would not be surprised if a Chris McDaniel loyalist prevails in the next Gubernatorial race, I highly doubt the crossover votes will happen with any sort of regularity.

The main thrust that kept Mr. Cochran in Washington was his increase in support from black voters, who McDaniel supporters will hasten to inform you, tend to vote Democratic.

The hows and whys of partisan-racial polarization is a rich topic that I intend to explore more in future updates, but suffice it to say that in Mississippi, Democrats tend to be black people and Republicans tend to be white people. Indeed, Nate Silver of FiveThirtyEight, named Mississippi the most politically inelastic (a fancy word meaning rigidly polarized) state in the union. If the Mississippi Republican runoff had been confined to "Traditional Republicans"(white people), then Mr. McDaniel would be readying his victory speech for November right now. But because Mississippi has open primaries, those black Democrats were able to cross over and vote for the percieved "less conservative" Cochran.

There has been a storm of moralizing on the right about these crossover votes. Some say that the votes from those who don't "intend to vote GOP come November should be barred from voting in the runoff" (a ridiculous and unenforceable proposition), and yet more wring their moral hands and decry Senator Cochran's "exploitation" of the black vote. These people who see themselves as the vanguard against African American exploitation seem not to consider that black people simply voted for their preference, no something more sinister must surely be at play. But unless the McDaniel camp can prove in a court of law that these votes were illegitimate, then this election seems over.

It is the height of irony that a man who once explained his voting in Democratic primaries as attemptes to vote for the less liberal candidate is now decrying liberal Democrats crossing over to vote for the less conservative option in the Republican primary. And it is unfortunate yet predictable that he would blame Democrats for "stealing the election".

This is another instance in a long line of right wing politicians and idealogues who see black and liberal votes as illegitimate, as being bought. How many far right politicians have decried liberal preferences as solely the result of receiving kickbacks from the government? (Mitt Romney, anyone?) Though the right wing blogosphere will no doubt parrot accusations of vote buying from the Cochran camp, the fact remains that this is unlikely to hold up in a court of law, and Mr. Cochran will remain the US Senator from Mississippi barring an unlikely upset from former US Rep. Travis Childers.

Welcome to the Blog

Hello Reader,

This is a new blog I am launching to focus on politics in Mississippi from a progressive standpoint. I hope to provide dispassionate evenhanded analysis of the Magnolia state even though I will freely admit that my point of view comes from the left. Mississippi is often misunderstood by outsiders (and insiders as well) and I think part of that is that there is a lack of explanation on our part. To those who are not intellectually honest, Mississippi falls into a lot of its stereotypes. My purpose here is to help explain why Mississippi is the way it is and explain the ways it conforms to, and defies, its characterization.

Thank you for reading