FODEMAN: Arizona’s expansion of Medicaid provides a cautionary lesson for Mississippi.

BY: Dr. Jason Fodeman

When our state of Arizona announced last year that it would participate in “Obamacare’s” Medicaid expansion, the law’s supporters declared a victory for the poor and their health care. Reality hasn’t been so cut-and-dried.

As a physician, I have dealt with Medicaid on a regular basis. In my experience, the program, while well-intentioned, does not live up to its expectations and is not on par with private insurance. Expanding this broken program will only further ingrain its problems into our health-care system.

Medicaid’s flaws ultimately stem from its rigid, one-size-fits-all nature. Far too much of the program is decided by bureaucrats in Washington and not by local leaders at a municipal or state level. Ultimately, this lack of local control undermines Medicaid’s ability to help the poor.

First and foremost, Medicaid’s top-down approach misallocates money and resources. Since it isn’t personalized, the program in general treats every patient the same. This inefficiency drives costs up. States, trying to keep the program affordable, respond by driving reimbursements to doctors down. State governments can also take money away from other priorities such as education, transportation and security.

Most of the time it’s a mix of these two options. According to the National Association of State Budget Officers, in Arizona, 32 percent of state expenditures was spent on Medicaid in 2012. This is already significantly above the national average of 23.7 percent; it is also significantly more than the 22.8 percent spent on Medicaid in 2008. Over this same period, spending on elementary and secondary education has decreased from 27.5 to 19 percent of state spending.

At the same time, states are often forced to slash already low Medicaid provider reimbursements. According to health-care policy expert Avik Roy, in Arizona in 2008, Medicaid payments to primary-care physicians were only 78 percent of private rates. As costs increase under the Affordable Care Act, it is very likely that these already low reimbursements will decrease even further.

For doctors, these low reimbursements sometimes don’t even cover the costs — both medical and administrative — that Medicaid patients incur at their office. As a result, along with the administrative hassle of the program, more and more doctors are refusing to participate in the program.

This perverse turn of events — the result of poor policy — ultimately leaves Medicaid patients with substandard health care. With fewer doctors to see them, they often experience lengthy wait times. The longer they wait, the worse their health problems get and the more likely they are to turn to expensive and overcrowded emergency rooms for help.

Multiple studies bear this out. One recent study found Medicaid patients have higher death rates following surgery. With throat cancer, Medicaid patients are 80 percent more likely to have tumors that spread to one lymph node than patients with private insurance.

After heart angioplasty, they are 59 percent more likely to have “major adverse cardiac events” like strokes and heart attacks. Other studies show similarly depressing trends in other medical fields. Health-care policy expert Scott Gottlieb has called Medicaid “worse than no coverage at all.”

This is what Arizona’s Medicaid patients now face. What will really help them is Arizona getting more control over Medicaid. We need the flexibility to work with local and regional resources to meet the local needs of the underinsured and uninsured. Most importantly, Arizona needs the flexibility to tailor benefits to individual beneficiaries.

Ultimately, Medicaid is a program in need of more reform, not more beneficiaries. Yet that’s not what Obamacare’s Medicaid expansion has done.

In Arizona, as elsewhere, expansion will only extend Medicaid’s problems to more people. This is not a victory, especially for the people trapped in this broken program.

Jason Fodeman practices medicine in Tucson, Arizona.

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PULLMAN: #CommonCore Chaos: More evidence that states should get out now.

BY: Joy Pullman | Heartland Institute

Last week, an ed pundit and a mom faced off to debate whether repealing Common Core had plunged Oklahoma into “chaos,” as pundit Michael Petrilli had asserted on Twitter. This week, new information suggests states clinging to Common Core are in for even more chaos than those that exit into a more productive course. From Politico’s Morning Education newsletter Tuesday:

… hiring people to read all that student writing [on PARCC Common Core tests] is expensive. So Pearson’s four-year contract to administer the exams bases the pricing on a phase-in of automated scoring. All student writing will be scored by real people this coming spring. The following year, the plan calls for two-thirds to be scored by computer. The year after that, all the writing is scheduled to be robo-graded, with humans giving a small sampling a second read as quality control.

The contract required Pearson to submit a proof-of-concept study demonstrating the validity of automated grading by mid-October. … So where’s the Pearson study? PARCC spokesman David Connerty-Marin told Morning Education it’s being revised – but he declined to say who had asked for the revisions or what they entail. Pearson wouldn’t answer any questions on the subject, referring them all to PARCC. … Connerty-Marin wouldn’t answer questions about whether a vote has already taken place or will be held in the future.

Ahh, look at all that transparency in government! Oh, wait … Common Core testing organizations aren’t technically government agencies, just federally funded and monitored. So your tax dollars are paying for psychometricians to muck about with students and not release the studies and votes that result. So we have no idea if these Common Core tests can even be graded accurately, or at what cost. Government of the people, by the people, for the people, right?

PARCC is not the only Common Core test in trouble. The other federally backed testing consortia, Smarter Balanced, won’t be ready for true tests this coming spring, says psychometrician Doug McRae
, who reviewed test items recently:

The odds are that if a student uses a random marking strategy, he or she will get a proficient score quite often. This circumstance would result in many random (or invalid and unreliable) scores from the test, and reduce the overall credibility of the entire testing program. …

California plans to use the cut scores recommended by the panels that met in October for disseminating millions of test scores in spring 2015. These plans are faced with the prospect that those scores will have to be “recalled” and replaced with true or valid scores just months after incorrect scores are disseminated. This is not a pretty picture for any large-scale statewide assessment program.

He says the 2015 tests, the first “real” Common Core tests nationwide that will replace state tests, cannot offer valid data and really will only provide the information necessary for getting real tests in 2016. This would eliminate, for four to five years, the ability to know how students are doing nationally in grades 3 and 5–8 (since NAEP will still test grades 4, 8, and 12). In short, further evidence indicates withdrawing from Common Core could create less chaos for children, teachers, and taxpayers than remaining in its clutches.

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Congressman Gregg Harper named Vice Chair of the Environment and the Economy Subcommittee.

Energy and Commerce Committee Chairman Fred Upton (R-Mich.), today named Rep. Gregg Harper (R-Miss.), Vice Chair of the Environment and the Economy Subcommittee. The subcommittee is led by Chairman John Shimkus (R-Ill.).

“Congressman Harper will play a key role as Vice Chairman of the Environment and the Economy Subcommittee,” Upton said. “During his tenure on the Energy and Commerce Committee, he’s been a leader in promoting job growth, reducing burdensome regulations, and investigating wasteful government programs that hinder America’s small businesses and industry. I am confident Congressman Harper will continue to further our record of success in the 114th Congress and I welcome him into his new leadership role.”

The subcommittee, with its oversight of key environmental laws and programs, focuses on the intersection of regulations and jobs. As a longtime advocate for American-made energy, Harper believes that Congress must advance ideas that safely promote and build a steady supply of American energy.

“I am honored to be named Vice Chairman of the Environment and the Economy Subcommittee and I look forward to working closely with Chairman Shimkus,” Harper said. “At a time when our economy is still struggling to recover and accelerated job creation is needed, I look forward to working with my colleagues on the committee to promote common sense policies that will spur economic growth and innovations, achieve meaningful regulatory reform, and protect consumers and the environment.”

Harper Press Release

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ObamaCare annual enrollment begins in Mississippi with 3 insurance companies participating.

Three companies are now selling health insurance in Mississippi through a federal website created under the health overhaul that President Barack Obama signed into law.

That’s up from two in the state last year.

A three-month annual enrollment period started Saturday for consumers seeking coverage through the online marketplace, or health exchange. It’s an option for those who don’t have health insurance that comes with a job, or who don’t receive Medicare or Medicaid coverage.

People shopping on the federal website,, can choose from more than one company in 77 of Mississippi’s 82 counties, according to the state Department of Insurance.

About 61,500 Mississippi residents bought coverage on the federal website during the first open-enrollment period a year ago. That was about 21 percent of the potential market.

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Gov. Bryant wants $78.7 million tax cut for families making under $50,000

Gov. Phil Bryant wants to cut income taxes for low-earning Mississippians as part of his 2016 budget proposal.

Bryant, a Republican, said Monday that he’s seeking a $78.7 million tax cut for families earning less than $50,000 a year.

It’s the centerpiece of his spending plan for the 2016 budget year, which begins July 1. Bryant is expected to seek re-election next November.

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DeSoto Superintendent Kuykendall to announce retirement at school board meeting tonight.

Mississippi PEP has learned from two sources that Desoto County Superintendent of Education Milton Kuykendall will announce his retirement tonight at the meeting of the county school board.

Kuykendall is often referred to as “King K” for using his office to influence both local and state politics.

Stay tuned for more as it becomes available.

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Legislators may place alternative education funding on ballot in 2015, MAEP supporters vow to fight it.

Mississippi voters may be faced with two proposed constitutional provisions in November 2015 dealing with the funding of public education.

Two key legislators have indicated it is likely there will be an effort to place on the November 2015 ballot an alternative to the school funding initiative being supported by the grassroots Betters Schools, Better Jobs group.

“We’re looking at it,” said Senate Education Chair Gray Tollison, R-Oxford. “There is nothing final.”

His counterpart in the House, Education Chair John Moore, R-Brandon, in a separate interview concurred, saying, “I think the leadership is working on something right now.”

Patsy Brumfield, a spokeswoman for Betters Schools, Better Jobs, said any effort by the Legislature to place an alternative on the ballot would be opposed by her group.

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Still Human!

BY: Oswald Chambers

…whatever you do, do all to the glory of God. —1 Corinthians 10:31

In the Scriptures, the great miracle of the incarnation slips into the ordinary life of a child; the great miracle of the transfiguration fades into the demon-possessed valley below; the glory of the resurrection descends into a breakfast on the seashore. This is not an anticlimax, but a great revelation of God.

We have a tendency to look for wonder in our experience, and we mistake heroic actions for real heroes. It’s one thing to go through a crisis grandly, yet quite another to go through every day glorifying God when there is no witness, no limelight, and no one paying even the remotest attention to us. If we are not looking for halos, we at least want something that will make people say, “What a wonderful man of prayer he is!” or, “What a great woman of devotion she is!” If you are properly devoted to the Lord Jesus, you have reached the lofty height where no one would ever notice you personally. All that is noticed is the power of God coming through you all the time.

We want to be able to say, “Oh, I have had a wonderful call from God!” But to do even the most humbling tasks to the glory of God takes the Almighty God Incarnate working in us. To be utterly unnoticeable requires God’s Spirit in us making us absolutely humanly His. The true test of a saint’s life is not successfulness but faithfulness on the human level of life. We tend to set up success in Christian work as our purpose, but our purpose should be to display the glory of God in human life, to live a life “hidden with Christ in God” in our everyday human conditions (Colossians 3:3). Our human relationships are the very conditions in which the ideal life of God should be exhibited.

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Gov. Bryant: Trip to Israel produced “best opportunity for Mississippi”.


Gov. Phil Bryant on Friday declared a Mississippi business development mission to Israel this week the best such trade trip he’s had as governor.

“There’s no doubt about that,” said Bryant, who had left Sunday and arrived home Thursday night. “This is the best opportunity for Mississippi since we began our relationship with Japan.”

While on the trip, Bryant said, two Mississippi business leaders secured large orders for their companies and, “That almost never happens.”

To cap things off, a meeting with Israeli Prime Minister Benjamin Netanyahu that Bryant expected to be an obligatory handshake and hello turned into a 45-minute sit-down talk.

Bryant said the prime minister was very interested in Ingalls shipbuilding (they’ve built ships for Israel before) and in an electromagnetic rail-gun missile defense system General Atomics produces in Mississippi.

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Rep. Baria wants to convene panel to investigate “systemic corruption” of MDOC scandal.


State Rep. David Baria, D-Waveland, wants to convene a legislative panel to look at the charges against Epps, who was indicted along with former lobbyist Cecil McCrory last week on 49 counts involving an alleged bribery and kickback scheme, as well as Epps’ reappointments to head MDOC.

Baria believes the MDOC scandal represents systemic corruption throughout state government, pointing to the 2013 Department of Marine Resources scandal that resulted in multiple federal convictions of former DMR officials. Baria also took direct aim at Republicans in his criticisms.

“At a time when we are told by Republican leadership that the state does not have the money to adequately fund education and ensure that working-class Mississippians have access to healthcare, there never seems to be a shortage of funds to enrich those who feed at the trough of state government,” Baria said.

Gov. Phil Bryant has said he would appoint a special task force to review MDOC’s contracts and has ordered the agency to terminate agreements with one McCrory-affiliated company, Adminpros LLC.

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