Hospital closures

54% of Mississippi’s rural hospitals are at risk of closing in the near future, driven by rising costs and depleted savings.

“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.”

The crisis is largely a self-made one, created in part by the state’s refusal to expand Medicaid to cover more low-income Americans. Instead of the federal government paying for the healthcare of low-income Mississippians under the expansion, hospitals have to cover more uncompensated care. About 14% of the state’s residents are uninsured, four percentage points higher than the national average.

For years, health-care professionals, including those at MSMA, have said that the State’s refusal to expand Medicaid to more working Mississippians has contributed significantly to hospital closures…Since 2013, Mississippi’s Republican leaders have rejected more than $10 billion from the federal government that could have been used to expand Medicaid, even with the federal government offering to pay between 90% and 100% of the cost.”

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Maternity care

Faced with unsustainable costs, hospitals across Mississippi have begun cutting services. Maternity care is usually one of the first to go, a devastating loss for a state with the nation’s highest fetal mortality rate, highest infant mortality rate, and highest pre-term birth rate. Mississippi is also one of the most dangerous states to give birth, with a maternal mortality of 22.1 per 100,000 live births — well above the national average of 17.47.

Some lawmakers have attempted to address the state’s poor maternal and infant outcomes by passing bills to extend postpartum care for new mothers from 60 days to 12 months. Each time, however, Mississippi House Speaker Philip Gunn (R) blocked the legislation:

Gunn told The Associated Press he did not want anything that would appear to be a broader expansion of Medicaid… “As I’ve said very publicly, I’m opposed to Medicaid expansion,” Gunn said Wednesday. “We need to look for ways to keep people off, not put them on.”

Tellingly, Gunn said the potential to save lives was not “a part of the discussions” around the bill.

The Mississippi State Department of Health issued a report in April 2019 about maternal mortality in the state from 2013 to 2016…[The report found that] 86% of pregnancy-related deaths occurred after birth, including 37% after six weeks.

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Abortion

People who wish to avoid the state’s poor maternity care, and potentially save their own lives, must be able to travel hundreds of miles for an abortion due to the state’s trigger law.

Pregnant individuals in Mississippi lost the right to abortion after the U.S. Supreme Court overruled Roe v. Wade last summer, allowing Mississippi Attorney General Lynn Fitch to certify the state’s 2007 trigger law banning abortion except in cases where the mother’s life is in danger or a rape has been reported to law enforcement. As a recent New York Times article points out, however, the exceptions to abortion bans are misleading—very rarely do hospitals permit doctors to act in cases of exceptions due to fear of legal repercussions.

“Having the legal right on the books to get an abortion and getting one in practice are two distinctly different things,” said Laurie Bertram Roberts, the executive director of the Mississippi Reproductive Freedom Fund, a group that supports abortion rights.

Take, for example, the story of a woman in Mississippi who was raped by a friend and became pregnant. According to Stephanie Piper, the sexual assault program manager at the Gulf Coast Center for Nonviolence, the woman could not legally obtain an abortion in the state because she did not file a police report.

Ms. Piper said the Mississippi woman found a clinic appointment more than 600 miles away in Indiana. The woman and three friends pooled the several hundred dollars needed for gas, lodging and medical fees and drove together, trying to keep her spirits up.

She got the abortion just weeks before Indiana’s own abortion ban briefly took effect.

Even if a person can legally obtain an abortion under the state’s exceptions, there are no abortion clinics left in the state. Mississippi’s only abortion clinic, Jackson Women’s Health Organization, was forced to permanently close on July 6, 2022. Like the woman in the Times article, pregnant individuals seeking abortions are forced to travel hundreds of miles out of state. Every state surrounding Mississippi also has laws banning all abortions or banning abortion at either 6 or 15 weeks.