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Legislative Update - February 6, 2017
This Thursday is the deadline for the House and Senate to pass bills that were approved by their own committees. The exception to that are bills that take your money and spend your money, otherwise known as Appropriations and Revenue bills. That deadline comes later this month.
Although bills died that would have made blue the official state color, classified venomous snakes as inherently dangerous to humans, required contracts to be written in large print, require a "probable cause" hearing for legislators who are arrested, and require school districts to serve low-fat meals and snacks to students diagnosed as overweight, there are still plenty of bills still alive.
Out of 2,300 bills that were introduced to change or create state laws (called “general bills”), 91% of them died in committee, leaving 429 to consider. Many of those are duplicate or similar bills in the House and Senate, and many are to simply extend current laws that would otherwise expire this year.
Below are significant bills that are still alive. If you click on the bill number, it will take you to the legislature’s status page for that bill, where you can read the original and current versions, and if it has been voted on in the full House or Senate, you can see who voted for or against it.
IMPORTANT NOTE: Listing of the bills below should NOT be taken as our endorsement of them. To the contrary, there are some horrible bills that somehow made it out of committees with generally conservative majorities.
Accountability and Transparency |
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| HB 396 | Prohibit elected state officials from visibly or audibly participating in the making of state funded advertising. Awaits House Floor. |
| HB 479 | Prohibit personal use of campaign contributions and revise law to require detailed reporting. Passed House 104-12. |
| HB 555 | Require approval by Outside Counsel Oversight Commission for Attorney General to bring certain suits. Passed House 63-58 after initially failing 58-60. |
| HB 812 | Revise regulations regarding Civil Asset Forfeiture. Passed House 118-3. |
| HB 938 | Prohibit state agencies from purchasing motor vehicles for one year. Passed House 115-5. |
| HB 974 | Remove most civil service protections for employees in several agencies by exempting those agencies from the Personnel Board rules, regulations and procedures for three years. Passed House 62-58. |
| HB1109 | Provide standards for state agencies to follow regarding Requests for Proposals (RFPs). Awaits House Floor. |
| HB1112 | Agency Accountability Review Act of 2017. Require legislature's watchdog, the PEER committee, to regularly evaluate state agencies' effectiveness and efficiency, including whether they are achieving ther goals. Awaits House Floor. |
| HB1127 | Revise Open Meetings Act to require minutes to be posted on public bodies' websites within certain time after the meeting. Awaits House Floor. |
| HB1296 | Financial Transparency in Education Act - require school districts to post their revenue and expenditures online in a searchable format. Awaits House Floor. |
| HB1330 | Abolish certain boards and commissions that have not met in more than a year. Awaits House Floor. |
| SB2567 | Mississippi Health Agency Reorganization Act of 2017 - give governor the power to appoint the executive directors of several agencies, including the Health Department and the Mental Health Department, among others. Awaits Senate Floor. |
| SB2572 | Abolish certain boards and commissions that have not met in more than a year. Passed Senate 51-0. |
| SB2632 | Prohibit state agencies from using state funds to hire contract lobbyists. Awaits Senate Floor. |
| SB2634 | Transfer BP Settlement Funds into Gulf Coast New Restoration Reserve Fund. Awaits Senate Floor. |
| SB2642 | Require state agencies to report to the Legislative Budget Office any "Maintenance of Effort" agreements or "Memoranda of Understanding" between the agency and the federal government. Passed Senate 51-0. |
| SB2645 | Impose moratorium on the acquisition of State vehicles. Passed Senate 51-0. |
| SB2689 | Prohibit personal use of campaign funds. Awaits Senate Floor. |
| SB2846 | Provide standards for state agencies to follow regarding Requests for Proposals (RFPs). Awaits Senate Floor. |
Business |
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| HB 883 | Authorize natural gas public utilities that are rate-regulated to undertake economic development activities. Passed House 119-0 |
| HB 928 | Allow Qualified Small Employer Health Reimbursement Arrangements to allow empoyers to provide health insurance while limiting its cost. Passed House 117-2. |
| HB1076 | Allow counties and cities in high-poverty or high-unemployment areas to exempt an area within their jurisdiction to exempt businesses from certain regulations, in an effort to draw investment into these communities. Awaits House Floor. |
| HB1322 | Authorize small craft breweries to sell light wine or beer they produce on the premises of the brewery. Passed House 94-23. |
| SB2542 | Authorize natural gas public utilities that are rate-regulated to undertake economic development activities. Passed Senate 51-0 |
| Crime and Courts | |
| HB 645 | Increase penalties for capital and first-degree murder committed against police officers. It differs from the Senate version in that it does not place this under the "hate crimes" statute. Awaits House Floor. |
| HB 805 | Allow challenges to MS laws to be filed in any county circuit court, not only in Hinds County (which is the current requirement). The Chief Justice of teh MS Supreme Court would then appoint a judge to hear the arguments in whatever location he or she chooses. Awaits House Floor. |
| HB1033 | Remove the automatic action of sending criminals to prison if they miss a payment on their fines; prohibit suspending driver licenses for crimes that do not involve driving. Awaits House Floor. |
| HB1039 | Creats severe penalties and prevents due process for alleged sexual assault perpetrators on college campuses. Awaits House Floor. |
| SB2302 | "Ban the Box" & expunction: Prohibit employers from asking on employment applications about criminal convictions. They may ask that in interviews, but cannot preemptively ask. This and other provisions of the bill are part of the recommendatinos of the "Re-Entry Council" made up of judges, attorneys, and others seeking to enable former offenders to gain employment and thus reduce the likelihood of commiting another crime. Awaits Senate Floor. |
| SB2469 | "Blue, Red, and Med Lives Matter": Places violent offenses against law enforcement officers, firefighters and emergency medical personnel under the "hate crimes" law. Passed Senate 37-13. |
| SB2710 | Prohibit sanctuary cities and require local cooperation with federal immigration control. Awaits Senate Floor. |
| SB2842 | Authorize mental health court intervention programs. Passed Senate 51-0. |
| SB2907 | Criminalize the posting or other sharing of explicit photos or videos without the subject's consent. Awaits Senate Floor. |
Education |
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| HB 32 | Require appointment (rather than election) of school superintendents in the event of vacancy in elected office before January 1, 2019, when all superintendents must be appointed. Passed House 113-4 and Senate 49-2. Signed into law by the Governor. |
| HB 263 | Require school districts to adopt policies to notify parents of alleged bullying incidents involving their children. Also broadens the definition of bullying to include words or actions that "exploit an imbalance of power" between the perpetrator and the victim. Awaits House Floor. |
| HB 267 | Elect all school boards during statewide general election or presidential election for four-year term. Awaits House Floor. |
| HB 293 | Reduce the number of days in a scholastic year from 180 to 170. Awaits House Floor. |
| HB 312 | Authorize inclusion of hunter safety education program in school curriculum. Awaits House Floor. |
| HB 433 | Require citizenship exam as part of U.S. History or American Government courses. Awaits House Floor. |
| HB 442 | Revise the qualifications for school superintendents to allow someone with a master's degree, or a bachelors degree if he or she has at least 10 years of management experience, to be appointed as a superintendent. The latter is only an option where all members of the school board that appoints the superintendent are elected. Awaits House Floor. |
| HB 503 | Direct the State Board of Education to incorporate cursive writing into elementary education curriculum. Awaits House Floor. |
| HB 544 | Authorize the State Dept of Education to issue Nontraditional Route Standard Licenses to certain teachers and administrators with advanced degrees. Awaits House Floor. |
| HB 866 | Limit the number of days a student may be required to take standardized assessments: State-required tests no more than 3 days; for district tests, no more than 20. Awaits House Floor. |
| HB 875 | Revise the process of state school accreditation in failing school districts through a process of district transformation. Awaits House Floor. |
| HB 905 | Require uniform accounting system for all school districts to address local, state and federal funds. Also, transfer audit powers from State Auditor to the State Department of Education. Awaits House Floor. |
| HB1036 | Expand eligibility for the MS Dyslexia Therapy Scholarship to 12th grade (it's now 6th), as would HB1046, but also expand the universe of schools at which the scholarship may be used. Also requires a school district to test a student for dyslexia if a parent requests it. Awaits House Floor. |
| HB1046 | Expand eligibility for the MS Dyslexia Therapy Scholarship to 12th grade (it's now 6th). Awaits House Floor. |
| HB1050 | Allow unspent funds from a special-needs education scholarship account to remain in the account to be used the following school year. Awaits House Floor. |
| HB1224 | Exempt school districts with "A" and "B" accountability ratings from certain duties. Awaits House Floor. |
| HB1227 | Discontinue MS Statewide Teacher Appraisal Rubric (M-STAR) and require local districts to adopt teacher evaluation system. Awaits House Floor. |
| HB1294 | Revise education funding formula. So far, this bill simply includes the current law with no changes, in order to have all the necessary "code sections" necessary once they decide what to propose. Awaits House Floor. |
| SB2036 | Sets all school board elections to be held in November general elections beginning in 2019. Awaits Senate Floor. |
| SB2042 | Establish Early Childhood Services Interagency Coordinating Council. Considered on Senate Floor but was sent back to committee, which effectively killed it. |
| SB2273 | Direct the State Board of Education to incorporate cursive writing into elementary education curriculum. Awaits Senate Floor. |
| SB2328 | Increase minimum GPA to qualify for the MS Resident Tuition Assistance Grant Program (M-TAG). Awaits Senate Floor. |
| SB2398 | Revise the qualifications for school superintendents, but differently from HB442. This bill would require at least 6 years of classroom or administrative experience, at least 3 of which must have been as a principal of a school rated A or B or a school that improved at least a letter grade. However, the State Board of Education may approve rules that allow someone without direct experience to be a superintendent. Passed Senate 34-17. |
| SB2431 | Authorize the State Board of Education to place failing school districts into "District Transformation Status." Awaits Senate Floor. |
| SB2459 | Expands compulsory school age from the current 6-17 to the ages of 5-18. Awaits Senate Floor. |
| SB2461 | Require school district consolidation in Perry County. Passed Senate 33-18. |
| SB2463 | Require school district consolidation in Chickasaw County. Passed Senate 35-16. |
| SB2607 | Revise education funding formula. So far, this bill simply includes the current law with no changes, in order to have all the necessary "code sections" necessary once they decide what to propose. Awaits Senate Floor. |
Elections |
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| HB 228 | Authorize pre-election day voting. Passed House 113-8. |
| HB 373 | Allow first-time voters to register online. Awaits House Floor. |
| HB 467 | An almost-300 page bill to revise election laws. Awaits House Floor. |
| SB2468 | An almost-300 page bill to revise election laws. Awaits Senate Floor. |
Family |
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| HB 853 | Revise Power of Attorney to authorize parents to delegate care and custody of a child. Awaits House Floor. |
| HB1210 | Require Youth Court to provide redacted copy of child's record to child's parent/guardian upon request of the parent/guardian. Awaits House Floor. |
| HB1298 | Create MS Advisory Council on Faith-based Initiatives. Awaits House Floor. |
| HB1451 | Increase fee for marriage certificates from $10 to $20, and for processing marriage license applications, from $20 to $30. House voted 70-47, but it needed 71 votes. It was later reconsidered and approved 84-29. |
| SB2311 | Create MS Achieving a Better Life Experience (ABLE) Act, to provide accounts for individuals with disabilities. Awaits Senate Floor. |
| SB2342 | Termination of parental rights - technical corrections. Passed Senate 48-1. |
| SB2483 | Divorce - add 2-year separation as a ground for. Awaits Senate Floor. |
| SB2520 | Require Youth Court to provide redacted copy of child's record to child's parent/guardian upon request of the parent/guardian. Passed Senate 51-0. |
| SB2514 | Create MS Advisory Council on Faith-based Initiatives. Awaits Senate Floor. |
| SB2680 | Clarify alternative of relative care for abused and neglected children. Awaits Senate Floor. |
| SB2695 | Sheriff or police chief to notify parent or guardian of minor released after arrest. Awaits Senate Floor. |
| SB2703 | Divorce - add domestic violence as a ground for. Awaits Senate Floor. |
| SB2704 | Increase marriage license processing fee from $20 to $50. Awaits Senate Floor. |
Health |
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| HB 318 | Authorize grants to rural hospitals to help them stay alive or adjust to new opportunities. Passed House 113-8. |
| HB 909 | Require State Health Plan to cover annual pap smears and PSA tests. Awaits House Floor. |
| HB 926 | Allow the University of MS Medical Center to form Health Care Collaboratives - joint ventures that are exempt from antitrust laws, to the extent possible, as well as the Open Meetings and Public Records Acts. Awaits House Floor. |
| SB2214 | Allow acupuncturists to provide care without a referral from a physician if they have been practicing in MS for at least 5 years. Awaits Senate Floor. |
| SB2511 | Provide for the licensing of Naturopathic medicine practitioners. Awaits Senate Floor. |
| SB2610 | Clarify the allowable use of Cannabidiol in research of seizures and other medical conditions. Awaits Senate Floor. |
Regulation |
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| HB 539 | Require seat belts for all passengers. Awaits House Floor. |
| HB 967 | Regulate and tax fantasy sports games in the same way the state regulates and taxes casinos. Awaits House Floor. |
| HB1076 | Allow counties and cities in high-poverty or high-unemployment areas to exempt an area within their jurisdiction to exempt businesses from certain regulations, in an effort to draw investment into these communities. Awaits House Floor. |
| HB1216 | Direct agencies to report on laws and regulations that were put in place as a result of Obamacare, and the impact of those laws and regulations. Awaits House Floor. |
| HB1265 | Require all state agency rules to be repealed after certain time unless the agency readopts them through the normal public-comment process. Awaits House Floor. |
| HB1425 | Require occupational licensing boards, if they are controlled by people who are in the industry they regulate - to submit their proposed regulations and enforcement actions to the governor before they are finalized. This is in response to a US Supreme Court ruling regarding executive power that is exercised independent of a governor, if the boards are controlled "active market participants." Awaits House Floor. |
| SB2896 | Regulate and tax fantasy sports games in the same way the state regulates and taxes casinos. Awaits Senate Floor. |
Tax |
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| HB 131 | Authorize the Department of Revenue to compromise and settle certain tax liabilities. Passed House 119-0. |
| HB 480 | Require out-of-state sellers who do not have a presence in MS to collect "use tax" (similar to sales tax) on purchases made by Mississippi residents. Any money collected from this requirement would be used for road and bridge repair, with 70% going to the state department of transportation and 30% going to local governments. Originally passed House 77-40. A normally-routine procedural vote to send it on to the Senate failed, leaving the bill in limbo for the moment. |
| HB 687 | Allow public community and junior colleges to collect a debt by obtaining from the Dept of Revenue a set off against a debtor's state tax refund. Because of where it appears in the MS Code, it would also allow community and junior college officials to obtain the state and federal tax returns of the debtor. Passed House 104-14. |
| HB 699 | Authorize the Dept of Revenue to disclose certain taxpayer information to law enforcement entities. Brought up on House Floor but debate has been suspended on it. |
| HB 711 | Extend authority of Dept of Revenue to approve applications for certain "rebates" given to Hollywood and other producers under the MS Motion Picture Incentive Act. Passed House 107-15. |
| HB 804 | Require MS Gaming Commission to establish a lottery. Awaits House Floor. |
Welfare |
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| HB1090 | Requires Medicaid to contract with a company to identify dead people and non-Mississippi residents who are on the Medicad rolls, among other provisions to combat fraud in welfare programs. Awaits House Floor. |
| HB1186 | Require Medicaid to apply for waivers from Federal requirements in order to conduct pilot projects to best meet needs and control costs. Awaits House Floor. |
| SB2330 | Requires Medicaid to contract with a company to identify dead people and non-Mississippi residents who are on the Medicad rolls. Awaits Senate Floor. |
By Forest Thigpen
To hear this commentary click here.
Governor Bryant is drawing some criticism for saying he was driven by his Christian faith to sign a particular law. Let's think about that.
All public officials have a reason for the position they take on a piece of legislation. In some cases, it's a desire to be re-elected; in other cases, they might want to reflect the majority of constituents they've heard from. But often, their votes are driven by a philosophy or ideology that reflects their understanding of the purpose of government.
The reality is that such a philosophy or ideology has been influenced by someone else. Maybe a professor in college, or a favorite philosopher or writer. Bernie Sanders, as a self-proclaimed socialist, presumably was influenced by the writings of Karl Marx.
The idea that being motivated by faith is a violation of the constitutional separation of church and state reflects a significant misunderstanding of that concept, which is a subject for another time. But today's question comes down to this: Why would it be constitutional to be influenced by Karl Marx but not by Jesus Christ?
For more on this and other principles of governing, go to GoverningByPrinciple.org.
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Air Date: August 8, 2016
Listen Here
What do you think would happen in our society if we treated people with respect when we disagree
with them politically? Instead of name-calling, which is common on social media, or saying their disagreement with us is driven by hatred, what if we actually listened to them to find out why they believe what they believe?
I'll take it a step further. What if we were to accept those people as they are, and even accept their viewpoint? I don't mean we adopt their viewpoint as our own, or approve of their behaviors or their beliefs. Acceptance does not mean approval.
Accepting others is like finding them on a map. Where they're going, or what they want to do with their beliefs is important, but accepting the reality of where they are right now, and how they got there, is an important starting point for a productive discussion.
Whether it's a political disagreement, or disagreement with a spouse or anyone else for that matter, if we listen before we speak, we might be surprised to find ways we can work together to solve some of our biggest problems.
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President Trump signs ACA executive order
Administration will need legislation or personnel change to effect reform
President Donald Trump will need legislation or to change personnel if it wants its new executive order on the Affordable Care Act (aka Obamacare) to make a significant policy change. That's according to Mississippi Attorney Pepper Crutcher who writes at the "Affordable Care Act Review," an insightful resource for anyone wanting to keep up with the ACA requirements or reform. Crutcher writes, "Perhaps President Trump hopes by this Order to induce current DOL, IRS and HHS staff to delay and relax already overdue ACA enforcement efforts. But this Order does not command any waiver, delay, relaxation or other, particular, sub-regulatory guidance, which means, practically speaking, that the new President is asking the former President's appointees to cooperate to undo years of their work. We expect few volunteers. If that's a good guess, then the new Administration will need legislation, or personnel change, or both, to effect significant policy change." Source: Affordable Care Act Review |
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Save Our Schools
Watch the Video - Sign the Petition
Charter schools in Mississippi are changing lives and this video tells some of the stories. But a lawsuit threatens to close charter schools and force children back into schools that were not meeting their needs. The Save Our Schools coalition is made up of students, parents, teachers, and concerned citizens who want children in Jackson, Mississippi to have access to high quality public charter schools. Watch the video and visit the Save Our Schools website to sign the petition to keep charter schools open.
Source: SaveOurSchools.org |
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Mississippi earns "F" in forfeiture
National study says state lacks transparency
Mississippi received an "F" on 36 metrics and an "incomplete on one metric for forfeiture transparency and accountability. That grade comes from a recently released report by the Institute for Justice. From the report: "Every year, local, state and federal law enforcement agencies across the United States seize and keep billions of dollars in cash, cars, homes and other property using a legal tool called forfeiture. With civil forfeiture, police and prosecutors can typically seize property on the mere suspicion it was involved in a crime. Most often, no charges or convictions are ever required to permanently deprive people of their property. Most of this forfeiture activity happens with little legislative or public oversight. So does most spending from forfeiture funds." Read the full report here. Source: Institute for Justice |
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The "Mother, May I" Government
Federal bureaucracies "guidance" avoids oversight
Federal agencies use "guidance" to dictate policy that is not approved by Congress or even promulgated through the Administrative Procedure Act which requires review, input and advance public notice. Clyde Wayne Crews writes when bureaucrats make up the rules as they go along, it puts citizens and businesses in a "Mother, May I" society, unsure of what can or cannot be done. Read his perspective here. Source: The Cato Institute |
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Obamacare promises largely unmet
Healthcare costs have increased; options have decreased
The promises and projections of the Affordable Care Act (ACA) have been largely unmet. Christopher Holt and Juliana Darrow write at the American Action Forum, "We were promised that we could keep our insurance plan, but at least 4.7 million people lost their plans when the law went into effect. We were promised we could keep our doctors, but the proliferation of narrow network plans has made that another false promise. We were promised the typical family would see their insurance premiums reduced by as much as $2,500. The reality is that since 2014, average premiums for exchange benchmark plans have increased by 37.1 percent. We were told that the ACA would 'bend the cost curve and start actually reducing health care costs', but it hasn't happened either. In the year prior to Obamacare's passage, health care spending grew at 4 percent, but in 2015, the second year of full implementation, it increased by 5.8 percent." ![]() Source: American Action Forum "Obamacare: Promises Versus Reality" |
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Download the PDF of the Letter
October 27, 2016
Dr. Virginia Young, Superintendent
Newton Municipal School District
205 School Street
Newton, MS 39345
RE: Constitutional Right to Freedom of Religion
Dear Dr. Young:
My name is Mike Hurst and I am the Director of the Mississippi Justice Institute ("MJI"). We are a division of the Mississippi Center for Public Policy, an independent, non-profit, public policy organization based in Jackson that works to promote and protect the concepts of free markets, limited government, and strong traditional families. MJI's mission is to represent
Mississippians whose state or federal Constitutional rights have been threatened or violated, and to defend the principles and ideals of MCPP within and throughout the courts.
I read with astonishment the October 13, 2016, letter addressed to you from an out-of-state group called the Freedom From Religion Foundation ("FFRF"), threatening legal consequences for the actions of a high school football coach baptizing one of his players.
The facts as they now stand: Newton High School football coach Ryan Smith engaged in private religious expression outside school hours, after his official duties as a coach had ended, on private property, not during a school-sponsored event, and with other individuals wishing to express their own privately-held religious beliefs. He did not request, encourage, or require anyone, including his players, to attend or participate in this private expression of his and others' religious beliefs. Under these specific circumstances, there was absolutely no constitutional violation by Coach Smith, as he, like all of us, have a First Amendment right under our Federal Constitution and a right under our Mississippi Constitution to freedom of religion.
The allegations by FFRF, taken to their logical conclusion, would prevent any school or government employee from being able to attend a church where a student also attends and prohibit that government employee from ever speaking to students or others at their church about their private religious beliefs. Such allegations are outrageous, ludicrous and in direct contravention of the religious freedoms upon which our country was founded!
The First Amendment to the United States Constitution forbids the government from "prohibiting the free exercise" of religion of private individuals. U.S. Const., Amend. I. This restriction applies to state and local governments through the Fourteenth Amendment. Cantwell v. Connecticut, 310 U.S. 296, 303 (1940); Lovell v. Griffin, 303 U.S. 444, 450 (1938). In addition, the Mississippi Constitution states that "the free enjoyment of all religious sentiments and the different modes of worship shall be held sacred." Miss. Const., Art. III, Section 18 (1890). The United States Supreme Court has rejected the notion that public school employees relinquish First Amendment rights by virtue of their government employment. See Tinker v. DesMoines Indep. Cmty. Sch. Dist., 393 U.S. 503, 506 (1969) ("It can hardly be argued that either students or teachers shed their constitutional rights to freedom of speech or expression at the schoolhouse gate."); Pickering v. Bd. of Educ., 391 U.S. 563 (1968).
Government may not exclude or suppress the speech of private individuals for the singular reason that their speech is religious. See Good News Club v. Milford Cent. Sch., 533 U.S. 98 (2001); Rosenberger v. Rector & Visitors of the Univ. of Va., 515 U.S. 819 (1995); Capitol Square Review & Advisory Bd. v. Pinette, 515 U.S. 753 (1995); Lamb’s Chapel v. Ctr. Moriches Union Free Sch. Dist., 508 U.S. 384 (1993); Widmar v. Vincent, 454 U.S. 263 (1981). As the Supreme Court explained in Pinette:
[P]rivate religious speech, far from being a First Amendment orphan, is as fully protected under the Free Speech Clause as secular private expression. ... Indeed, in Anglo-American history, at least, government suppression of speech has so commonly been directed precisely at religious speech that a free-speech clause without religion would be Hamlet without the prince.
Pinette, 515 U.S. at 760. While the First Amendment forbids religious activity that is established by the government, it also protects religious activity that is initiated by individuals acting privately. As the Court explained in numerous cases, "there is a crucial difference between government speech endorsing religion, which the Establishment Clause forbids, and private speech endorsing religion, which the Free Speech and Free Exercise Clauses protect." Bd. of Educ. v. Mergens, 496 U.S. 226, 250 (1990) (plurality op.).
These assaults on our religious freedoms by those with an agenda to dismantle our Constitution and our founding principles are the exact types of cases MJI was created to litigate. Thank you for your courage in the face of such threats to protect everyone's right to express their religious beliefs privately in accordance with our federal and state constitutions.
No one likes a bully, and we will not stand by while some out-of-state group threatens our fellow citizens with legal actions for doing nothing more than exercising one's constitutional rights. The Mississippi Justice Institute stands ready, willing and able to defend the actions of those like you who seek to protect such rights as well as others who simply want to exert their unalienable rights privately, which our state and federal Constitutions were intended to secure.
Sincerely,
Mike Hurst, Director
Mississippi Justice Institute
Mississippi Center for Public Policy
Telemedicine: High-Quality, Affordable Care for Mississippi Families
Hearing on Telemedicine
Testimony before the Miss. State Senate, Public Health & Welfare Committee
October 18, 2016
(Unabridged version)
I am Dr. Jameson Taylor, vice president for policy with the Mississippi Center for Public Policy.
This is what we believe about telemedicine: Telemed needs to be allowed to flourish and grow and respond to consumer needs. Burdensome regulations will hinder this growth and reduce access to high-quality care. To repeat: We believe telemedicine needs to be allowed to flourish and grow and respond to consumer needs. Burdensome regulations will hinder this growth and reduce access to high-quality care.
You might say we believe in a free market for healthcare. What this really means is that we believe that a light regulatory touch will promote the supply side of healthcare and solve the problem of access by increasing quality and lowering cost. In other words, if government stays out of the way, healthcare innovation will massively increase the supply of affordable, high-quality care. This strategy has worked for computers and cell phones. Why not healthcare?
But I am here today, not as a healthcare policy analyst, but to share my own telemed story with you.
I am married and have two children. Over the past few years, our family has paired telemed with a High Deductible Health Plan. Our family deductible is typically $5,000 a year. What this means is that my insurance company does not cover a dime of my healthcare until I spend $5,000 out of pocket. In this respect, my family is not different from many others in Mississippi. For instance, if we look at the health insurance policies on the ACA exchange, we see deductibles ranging from $4,000 to $13,000.
Just yesterday, I pulled up a plan for a family of four in Hinds County. One option was a bronze plan from Magnolia Health at a cost of $800 a month and a deductible of $13,600 a year.
I guarantee that if you have a deductible of $13,000 a year, you are going to act like an informed consumer for healthcare because you are going to be paying cash, almost exclusively, for your care. That, at least is how my family and I shop for healthcare. We approach healthcare as consumers and believe that a free market for healthcare is the best way to attain high-quality care at a fair price.
When we consider taking our kids to the doctor for the usual problems: sniffles, an ear infection, a stomach ache, we have a choice between using telemed at $40 a visit or going to our pediatric specialist for $165 or going to MEA for around $120. Depending on the situation, we choose the option we think is best for our family. Sometimes it is telemed, sometimes it is an in-office visit, sometimes it is MEA.
Let me walk you through a typical telemed visit for us. Our usual provider, by the way, is connected with Blue Cross Blue Shield and is called Doctor on Demand.
Last year, our daughter had the typical crud that turned into a fever. We had a family event coming up, and my wife wanted to make sure we did all we could to get our daughter feeling better. That said, it wasn't a very serious illness. At $40 a visit, we chose to use telemed. The alternative would have been an in-office visit at $165. Under those circumstances, we would not have gone to the doctor.
I want to make this point very clear: This is not an apples to apples scenario. If you hinder access to telemed, you are not necessarily generating new business for brick-and-mortar doctors. You are, for some people - the single mom with no cash to spare, a family on vacation down in Biloxi, a truck driver on the road -eliminating that doctor's visit altogether.
Money and time are not infinite resources - at least not in my world and not for the hardworking people of Mississippi. If we did not have the option of using telemed in this case, we would not have gone to the doctor at all. We would have waited things out and hoped our daughter recovered.
Again, our situation is not unusual. We all know access to healthcare is a problem in Mississippi. One-third of our population is underserved because we do not have enough primary care physicians and rural doctors.
This problem will not be resolved by giving everyone an insurance card - whether it be private insurance or government-sponsored insurance, like Medicaid.
According to a recent study by researchers at the Social Science Research Center at Miss. State:
- "32% of adults covered by private insurance (ages 50-64) reported difficulties in obtaining an appointment when seeking an initial appointment with a primary care physician";
- "35% of Medicare-insured adults (ages 65 and older) reported problems when seeking a new appointment"; and
- "Up to half of primary care physicians' offices in Mississippi are not accepting new Medicaid patients."
All of these people have insurance, but they are having trouble obtaining primary care.
I believe we are making a fatal mistake in approaching healthcare in Mississippi from an attitude of scarcity and protectionism. We have an abundance of healthcare needs. We have so much need we can't handle it all. Why regulate a telemed market that is clearly working to address some of these needs?
The study from Mississippi State also notes the following:
"Even with health insurance, access to care may be limited by several factors, including whether one can contact doctors' offices by telephone during office hours, whether one can receive a scheduled appointment within a reasonable amount of time, lengthy waits in doctors' waiting rooms, restrictive clinic hours, and patient access to transportation."
Telemed can help with all of these access problems.
In our case, we usually use telemed early in the morning or late at night, when we are trying to figure out just how sick we are and whether we need to take a sick day from school or work.
Likewise, the wait for a telemed appointment is usually 10 minutes or less. In our case, we are able to pull up a screen full of doctors - all of them licensed in Mississippi - and choose the doctor we want. Usually, we choose the same doctor. Her primary practice is in California.
As far as waiting rooms go, I also want to add that, frankly, as a parent, the last thing you want to do is expose your child and yourself to other sick patients in the waiting room. The last time my wife took our kids in for a routine checkup, our doctor informed her that she was seeing a lot of children with hand-foot-and-mouth disease. That is not a comforting thought when you are in a crowded waiting room trying to keep your toddler from chewing on and handling everything he can reach.
Indeed, in my research on this issue, I found several medical sources that suggested simply avoiding the waiting room altogether. Advises Dr. Hansa Bhargava, medical editor for WebMD:
"As a doctor, here are some guidelines I use for myself:
"Stay home if you can. Ask yourself: are you sick enough to need to go in? Granted, this can be a hard decision. ...
"If you are not sure whether you need to come in, try calling your doctor's office. This way, you may be able to save yourself a visit."
Telemed delivers the best of both worlds. It allows you to stay home and see your doctor. My family and I value the convenience and, if you will, additional safety, telemedicine provides. For me, a quick telemed visit may mean the difference between missing a morning of work or not. For my kids, it means the same when it comes to school. For my wife, it means access to high-quality care at the touch of a button. Imagine that, at the touch of a button. ... But isn't that the kind of service we expect today?
You can order all manner of life-saving products online - for instance, that last-minute wedding anniversary gift ... at the touch of a button.
You can book a dream vacation - instead of going to a travel agent - at the touch of a button.
You can sit in on courses at MIT and radically change the direction of your entire life - at the touch of a button.
Why is healthcare so radically different that we are going to deny consumers this same choice?
To get back to our routine telemed visit, during the last three visits, we have been offered a prescription twice. In my limited research, this is on par with the national average for in-office visits.
And, let me be honest, if you are going to pay $165 for a doctor's visit, you kind of expect to walk out of the office with some kind of vindication that you were right to go to the doctor - a prescription. Many patients want that antibiotic, even if it's just for a bad cold. When you pay $40 for a visit and you hear that all you really need is some sleep and orange juice, you feel a lot better about the hit to your pocketbook.
Before I end, one thing I want to mention is that we prefer to connect with our telemed doctor over the phone, as opposed to video feed. I live in Jackson. I have a decent internet connection. Many Mississippians do not. Just like any technology, you want multiple options: both phone only and video.
I suspect, too, that my wife prefers the phone consult because, then, she doesn't feel like she has to do her hair and make the kids picture perfect before seeing our doctor.
In any event, the phone consult has worked well for us. Indeed, I imagine nearly every person here has been on one end or another of a phone-only consult with their brick-and-mortar doctor.
Of course, most doctors doing telemed ARE brick-and-mortar doctors. As I mentioned, they are also licensed by the state of Mississippi.
And that is, really, what all this comes down to. If the state is going to license doctors, it needs to trust these doctors to serve their patients in whatever setting they choose.
Whether it's in a telemed setting or an office setting, we have to trust the doctors to make the best decisions for their patients. Otherwise, the state shouldn't license doctors to begin with. We also have to trust families like mine to make the best healthcare decisions we can for our children. ... Because I guarantee that I care a lot more about my kid's safety and health and my own health than any other person in this room.
Finally, I want to end with a quick story about Billy Durant. Durant co-founded General Motors. But before he founded GM, he worked for a carriage maker. As a carriage maker, he vehemently spoke out about how dangerous automobiles were. He called the new technology "smelly, noisy, and dangerous." He even refused to let his daughter ride in a car. Less than four years later, Durant co-founded GM.
Like the automobile revolution during Durant's day, the healthcare revolution has already begun. We can use our smartphones to monitor blood sugar levels and measure heart rates. Patients increasingly want to text and web chat their doctors. Soon, we are going to see nanotechnologies that can be implanted in patients, perhaps making routine doctor visits a thing of the past. Government cannot regulate all of these innovations. And Mississippi shouldn't let bureaucracy be the reason we don't share in this progress. Take a cue from Billy Durant and join the winning side - the side that promises to expand the supply of high-quality, low-cost care for the people of Mississippi.
Thank you.











