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A bill in the Mississippi legislature would require sports teams at the state’s public schools, universities, and community colleges to be designated only for one biological sex.

Senate Bill 2536 would require any public school, university, or community college team to be either designated for those of one biological sex or the other (in addition to an exception for co-ed teams).

The legislation also has a clause that would allow any student who reports a violation of the law and is retaliated against by the school or other athletic association to have the right to injunctive relief and damages. 

Another would allow a student whose bodily privacy was violated to have the same rights.

The bill is sponsored by state Sen. Angela Hill (R-Picayune).

Recent polling suggests that 79% of all Mississippians support such legislation. The same poll also revealed that the bill has broad support across political demographics. 87% of Republicans support the legislation along with 83% of Independents and 65% of Democrats.

While there have not been any cases of those born as males competing against girls in Mississippi, the issue has become a nationwide one as 16 states allow transgender high school athletes to compete without restrictions. 

Three high school girls who run track in Connecticut filed a lawsuit last year to challenge Connecticut’s policy of allowing male athletes to compete with girls in sports. They are represented by the Alliance Defending Freedom.

The three — Selina Soule, Alanna Smith, and Chelsea Mitchell — have been beaten consistently in track meets by a pair of transgender athletes born as males. 

The lawsuit says the Connecticut Interscholastic Athletic Conference’s rules allowing transgender athletes to compete with girls poses a threat to Title IX because of physiological differences between men and women after puberty. Boys and men have more muscle mass and thus have the capacity to run faster and jump farther than most girls and women.

Title IX is a federal civil rights law that prohibits sex discrimination in educational institutions that receive federal funds. The law, which was passed in 1972, has led to a massive growth in the number of number of athletic opportunities for women. According to the NCAA, the number of female athletes in in 1982 was 74,239. By 2019, that number grew to 221,042, an increase of 197 percent.

Mississippi is one of only ten states that has no policies toward male athletes competing against females.

HB 1263, sponsored by Rep. Becky Currie, would recognize occupational licenses issued by another state. A companion bill (SB 2187), sponsored by Senator Kevin Blackwell, would do the same. Each bill must pass its respective chamber by February 11, 2021.

The two bills advance a workforce freedom agenda long advanced by the Mississippi Center for Public Policy. Last year, we worked with lawmakers to pass legislation that helps military families move to Mississippi and take advantage of their licensing credentials to get a good job. We are looking to expand upon this achievement by opening up this reform to more families.

MCPP recently had an opportunity to sit down with Rep. Currie and talk to her about this important legislation.

1. Tell our readers about HB 1263 and what it would do.

Last year, we made it easier for military families who move to Mississippi to obtain a Mississippi license to work. This bill expands upon that reform. Many skilled jobs require a license to work. By this, I mean a license to teach or a license to be a dietician or a license to practice as a nurse. We have teacher shortages in many areas. This bill will help address that. We have serious health care access problems in Mississippi. This bill will help address that too. What the bill does is make it easier for new residents to use the training they already have to help Mississippians get a better education, get better health care, and get access to more services.

2. What inspired you to push this bill forward?

Rep. Currie: Mississippi is the best kept secret in the South. I want to see Mississippi grow. One way we can do this is to allow people who move here, who have a license to work in another state, to easily transfer that license to Mississippi. Other states, like Arizona, Missouri and Utah, are making it easier for new residents to have their hard-earn credentials honored by their licensing boards. Why make someone jump through the same hoop twice? If we want to grow, we need to open the door to skilled labor. That is what my bill does.

3. With the economy still reeling from 2020, how do you think this bill could help contribute to greater prosperity for Mississippi?

Rep. Currie: COVID is obviously encouraging people to consider moving out of certain areas that might not be as good a place as Mississippi to raise a family or start a business. As more states make it easier for new residents to work, we have to keep up. Arizona passed this reform in 2019. Today, they are one of the fastest growing states in the country. When new residents move here, that helps everyone. It increases tax revenue and increases the money that goes to schools and roads. It creates new energy and helps us learn about ideas that are catching on in other states. It also, ultimately, increases property values and opportunities for those of us who are already here.

4. What is the next step for the bill?

Rep. Currie: HB 1263 is now ready to go to the House floor for a vote by the full assembly. It has to pass out of the House before February 11. After that, it crosses over to the Senate, for consideration in a Senate committee. This is a team effort. I want to thank my cosponsor, Jansen Owen, for his help. I also want to thank the Workforce Development Chairman Donnie Bell and Speaker Philip Gunn. I also appreciate those in the Senate who are working hard on this same reform.

5. How can people help?

Rep. Currie: This bill is a win-win for the people of Mississippi and for new residents. We all benefit when skilled workers move here. These people are going to get good jobs and help grow our state. They are going to stay off welfare and pay taxes and discover that Mississippi is a great place to raise a family and retire surrounded by your grandkids. That’s the Mississippi that I love. People can help by talking to their state lawmaker and telling him/her you support this bill. Also, even if you disagree with them, say a prayer for your local and state lawmakers. As people like to say these days, we’re all in this together. We are all working hard to write the next chapter in the Mississippi Success Story.

The COVID-19 pandemic has demonstrated the need to update Mississippi’s K-12 education funding model, in particular the way that the school finance formula counts students.

Mississippi differs from most states in the fact that they currently use an average daily attendance (ADA) model to count kids. This way of counting students is not all bad, but the COVID-19 pandemic has brought to light the already existing deficiencies of the ADA model and some Mississippi school districts are at risk of losing a significant amount of funding because their ADA has declined during the COVID-19 outbreak.

Surprising variation exists in how states measure public school enrollment. These measurements are important because they ultimately affect how education dollars are allocated to students and schools. Every way of counting kids  comes with important tradeoffs: some are more accurate than others; some impose a greater administrative burden; others result in more budget stability. This commentary will survey the current student counting methods used across states and make policy recommendations that Mississippi policymakers could employ to address funding shortfalls resulting from a decline in ADA counts.

Key Considerations: Accuracy, Predictability and Budget Stability

There are some key considerations states make when they take different approaches to counting students. Keep in mind that there are drawbacks to each of these considerations.

The first priority for legislators weighing different student count methodologies should be accuracy. Accuracy is the key to fair funding insofar as the entire point of counting student enrollment is to correlate enrollment with funding. To be funded, a student must be counted.

To the extent that any other factors obscure the principle that funding should be determined by the true number of students a district currently has enrolled, inequities will emerge. Concerns over accuracy and funding equity are the reason some states opt to use average daily membership (ADM). This way of counting differs from ADA in that ADM averages student enrollment numbers—rather than attendance numbers—over much of the school year. Enrollment is considered more accurate in this case because it counts the number of students a district expects to serve, not the number that show up on a given day. North Carolina, Tennessee, and West Virginia, along with many other states, use ADM.

Second, there is generally some acknowledgement that school districts must be able to reliably craft their yearly budgets. If state funding varies too much over the course of a year due to attendance fluctuations , districts won’t be able to make confident hiring or programmatic decisions. If, as it’s generally assumed, student bodies are largest at the beginning of a semester, districts must structure their staffing and budgets without good knowledge of which students and how many of them will end up withdrawing. These budget concerns are the reason some states use single-day enrollment counts at the beginning of the year (Colorado, Maryland, Massachusetts) or at only several points over the course of the year (Georgia, South Carolina, Louisiana).

A third key consideration for state lawmakers when deciding on a student counting system is that districts struggle to adjust their cost structures when student bodies are changing substantially over a short span of years. When student bodies are shrinking or growing rapidly, districts must make long-term decisions about consolidating or expanding school facilities. With staffing, they often can only downsize through attrition when populations are shrinking. Likewise, schools face additional hiring costs when student populations are growing. Because these long-term investments take time and often lag behind the speed at which student populations are changing, some states (Maine, Nevada, North Carolina) allow districts to incorporate older or projected student counts so that they have a financial cushion to accommodate substantial increases or decreases in student populations.

Lastly, many state policymakers believe funding decisions should emphasize school attendance metrics. Under this model, the reigning assumption is that time spent in a physical classroom directly translates into student achievement. A primary rationale for the small number of states (Mississippi, California, Illinois) that count students through attendance, rather than enrollment, is that they want to encourage districts to get students in their classrooms.

Click here to read the rest of this report.

In a surprising move, Facebook has now taken down the SuperTalk Mississippi Facebook page. According to SuperTalk, the supposed violation occurred when the page shared news of an update from Governor Tate Reeves regarding new vaccine appointments.

Paul Gallo, host of SuperTalk’s Paul Gallo Show, stated in a tweet today, “Breaking! SuperTalk Facebook has been pulled for the reasons attached. Seems we committed a violation for sharing a story from the Governor’s office pertaining to expanded vaccines available for appointments.”

The move raises serious questions about Facebook’s community standards and its algorithm for determining potential violations. SuperTalk was distributing important news about vaccine appointment updates to the public. Now, the station that helps to provide news to the entire state, has been restricted from doing so.

This effort unfortunately censors SuperTalk for the time being from being able to distribute news on one of the largest online platforms. Furthermore, this move produces a dangerous potential chilling effect on speech. How many other news providers, influencers, or everyday Facebook users might think twice before a post in fear of similarly being shut down?

Multiple state officials spoke out against the move from Facebook. Governor Tate Reeves tweeted, “Unbelievable! Please fix quickly, @Facebook. Local news outlets like @SuperTalk are essential, and they should not be punished by big tech companies for simply sharing important vaccine information!”

Attorney General Lynn Fitch noted in a tweet, “Big tech is an elite, unelected, and unchecked group that should not have the power to silence and erase anyone. We don’t lose our First Amendment rights just because the town square has moved online.”

The move is likely to bring renewed scrutiny of the tech giant in Mississippi. Several bills in the Legislature address the growing issue of social media giants, like Facebook and Twitter, censoring speech.  These include bills by Rep. Becky Currie (HB 151) and Sen. Angela Hill (SB 2617).

Hopefully SuperTalk’s page will be quickly restored and substantial actions will be taken to ensure this doesn’t happen again.

In our Tech Talks series, we engage with tech leaders, policymakers, and entrepreneurs to discuss the tech world in the Magnolia state and promote public engagement on key tech issues.

For this edition of Tech Talks, we are featuring state Senator Scott DeLano. Senator DeLano serves as the Technology Committee chairman and the vice-chairman of the Veterans and Military Affairs Committee.

Let’s hear from Senator DeLano …

I have served in the Mississippi Legislature for the last 12 years. After having spent ten years in the state House, I was elected to the state senate.

When I served in the House, Speaker Philip Gunn originally appointed me to be the Constitution Committee chairman. I also served as the Appropriations Subcommittee chairman for ITS, MDA and MEMA. In these roles, I found that I worked on a lot of technical questions, so the Technology Committee was created to facilitate these technical matters more effectively. I served in this capacity for the remainder of my time in the House.

In 2019, I successfully ran for an open Senate seat in Harrison County. Upon my arrival in the Senate, the Lieutenant Governor appointed me to be the chairman of the newly created Technology Committee, with a key focus on the modernization of technology services for state agencies. However, the committee is also intended to address tech issues that impact the private sector in the state. This is a significant part of the committee’s purpose as well.

One important issue that we worked on last year is computer science in public education. The legislature is working on creating a clear pathway for computer science and technology classes to be taught in every public-school district in the state. The main element of this entails integrating computer science courses into existing school course curriculum. This is a significant issue that we are working on in the Education Committee.

A second priority was emergency communications as it relates to Next Generation 9-1-1. This program brings internet communications into the dispatches across the state and insures all 911 service fees collected go to the benefit of each county’s Emergency Communication District.

Currently, our first responders are primarily limited to telephone traffic. They cannot currently integrate communications, such as texting and other forms, into 9-1-1 emergency calls. For example, we have technologies such as wireless help buttons for the elderly and telehealth video options. We want to integrate these technologies into our existing emergency dispatch systems.  

These two issues that we worked on last year will be a priority in 2021, as well. However, this is just the beginning. We are looking to explore what further reforms we can make to encourage tech advancements in the state.

During the 2020 session, the legislature passed several bills that directed over $250 million dollars from the CARES act that focused on expanding broadband availability throughout the state. For instance, the legislature appropriated matching funds for Electric Cooperative Associations that yielded over 150 million dollars in new broadband infrastructure development to unserved areas of rural Mississippi. In a separate appropriation, we provided over $100 million dollars to provide laptop computers and connectivity to all public and private schools in the state.  We are tracking these funds to make sure that these funds are used properly. This includes following up with the recipients of the funds, reviewing the recipients' use of the funds, and ensuring that the funds are actually accomplishing their intended purpose.

I have made it one of my key priorities to engage in discussions with fellow legislators about the best allocation and application of these funds. These are significant amounts of money. The legislature has a duty to ensure that these funds are utilized in a fiscally responsible way.

One of my roles as the Technology Committee chairman is to help give the state the best opportunity to attract new businesses by ensuring that we are very cautious not to stymie innovation in the marketplace.

Just as one example, automobile manufacturers such as Nissan and Toyota are developing innovative technologies such as automatic lane correction and autonomous driving right here in our State. But the development of these safety features requires tests to be conducted and data to be collected. There have been laws passed in several states that would prohibit some of this data from being collected. I am very careful, and I think our state should be very careful, not to pass legislation that could prevent innovative research and development.  We want to create a balanced regulatory environment that is optimal for us to attract companies and businesses, jobs, and prosperity into our state. This balance is critical to protect the public from harm while protecting the economy from crippling regulations. This is essential in helping Mississippi to grow.

You would be surprised at how much of a barrier different interpretations of language and terminology pose. For example, what is defined as broadband in an urbanized area of the state may have a completely different meaning than what is acceptable broadband in rural Mississippi. The technical terminology differences can be challenging to lawmakers who are trying to apply this terminology to their constituents' needs. To remedy this issue, we have had to do a lot of clarification on definitions and meaning.

As a committee chairman, I stay informed on tech issues around the country. I provide a point of reason and knowledge for the legislature. It is our goal to implement successful policies from states all over the country. I want to see these policies custom-tailored to encourage prosperity in Mississippi.

This technologically-driven prosperity should be encouraged by passing legislation that gets government out of the way and lets the free market take the lead. By pursuing this path, we want to foster innovation, because it is innovation that provides the cutting-edge technologies that will be required to drive our economy in the future. It will be exciting to see what lies ahead for our state.

Senator Scott DeLano is the Chairman of the Mississippi Senate Technology Committee.

Matthew Nicaud is the Tech Policy Analyst at MCPP and your host for Tech Talks.

The Magnolia state might be one of the most wonderful places to live, but there is no getting round the fact that it has some of the worst health outcomes in the country.

According to the Legatum Institute’s Prosperity Index, Mississippi ranks 49th out of 50 states in terms of health outcomes, health systems, and illness and risk factors.

“That’s easy to fix” some are now saying. “We just need to hose federal funds at the problem”.  When it comes to health care, one thing Mississippi does not lack are those calling for us to accept federal funding to expand Medicaid.

Under the Obama administration’s Affordable Care Act, a number of states have already gone down that road, turning Medicaid – which was designed to provide health insurance coverage to low income seniors and mothers, and those with disabilities - into a system of generalized healthcare.  Should we do the same?

No.  Expanding Medicaid would be extremely costly, without necessarily improving health outcomes.  Spraying federal funds in our direction does not mean that the money will end up going where it is actually needed.  Another large handout from DC would likely hinder, not help, the chances of us achieving the kind of health reforms we actually need.

Pouring millions of dollars of federal funds into Mississippi’s health system sounds attractive, but you won’t be surprised to learn that it comes with a price tag; a $100 million a year price tag, according to recent estimates.

Who, it seems reasonable to ask, would have to pay that?

One way of generating an additional $100 million a year in revenue from tax-paying Mississippians would be to raise personal income tax or tax businesses even more.  But Mississippi already has one of the heaviest state and local tax burdens of any state in America, and it is hard to see how our fragile economy could cope with an additional hike. 

Some have suggested that we could find this additional $100 million a year from the hospitals.  No plan I have yet seen has identified a way of conjuring up that kind of money without hospitals ultimately bumping up their costs to their patients.

I can see why some hospitals might be quite attracted to the idea of raising an additional $100 million a year from their patients, and in return getting a large dollop of federal funding thrown in their direction.  But I can’t quite see what is in it for those hundreds of thousands of families in Mississippi who work hard to provide health care coverage for their families, who would find themselves being asked to provide even more – so other folk could get coverage for free.

If we want better health outcomes, we should not think only in terms of how much money we spend on health care.  We need to think about the way that our health care system converts that money into improved outcomes for patients.

One low cost thing we could do would be to repeal laws that unnecessarily push up health costs, such as the 1979 Health Care Certificate of Need (CON) Law.  This legislation means that it is illegal today in Mississippi for hospitals or other healthcare providers to expand their health care services without first getting a permit, known as a certificate of need.

It’s not just that permission is needed.  The way our restrictive system works is that permission is often needed from established health care providers.  They can file objections that keep the matter tied up, often for years.  It is as if Papa John’s had to give approval before Domino Pizza was allowed to open a new restaurant in your neighborhood.

Additionally, rules on telemedicine mean that Mississippians are presently prevented from accessing health care online – unless the doctor they are dealing with happens to have Mississippi licensure. 

Why can Mississippians not deal with a doctor from Birmingham or Memphis?  Is what comprises good medical care different there?  Of course not.  The rules governing who can provide health care have been written in a way that hinders competition and limits choices, and is holding health care back for Mississippians.

These type of restrictions mean that instead of a free market in health care, with different providers competing to give patients services at a price they can afford, we have a rigged market.  The rules are written to keep new entrants out, which in turn leaves prices high and customers captive. This, not a failure to sign up to Obamacare, is one of the reasons why Mississippi does not have better health outcomes. 

Without reforming the way that our health system operates, throwing hundreds of millions of dollars at our state Medicaid system is not going to make things better. 

The secret to good legislation is much like the secret to making good, healthy food. Follow the recipe, use the right ingredients, and leave out the bad stuff. Unfortunately, there's a lot of junk that gets cooked up in the Legislature these days.

The Mississippi Center for Public Policy uses its Legislative Tracker to grade and analyze all legislation that makes its way out of committee. Recognizing this, we thought it would be appropriate to offer a clear and concise statement regarding the principles that go into evaluating legislation.

Bill analysis conducted by the Mississippi Center for Public Policy utilizes specific criteria to determine the nature, where possible, and the essential features of proposed legislation in relation to its potential impact on freedom and liberty in the state of Mississippi.

If the answer is YES to any of the guiding questions stated beneath the enumerated criteria provided below, then the proposed legislation is identified as BAD POLICY for Mississippians within our Legislative Tracker.

CRITERIA:

  1. Individual liberty
    • Would the proposed legislation, if enacted, encroach upon individual liberty?
      • Would the proposed legislation, if enacted, ALSO apply state statutes in a manner that is inconsistent with our nation’s founding principles?
  2. Scope of government
    • Would the proposed legislation, if enacted, expand the scope of government beyond its original purpose as outlined by our founding documents at either the federal or state level?
  3. Transparency and Accountability
    • Would the proposed legislation, if enacted, decrease transparency and/or accountability in government at any level or in any bureaucratic/administrative agency or its functions?
  4. Taxes
    • Would the proposed legislation, if enacted, increase taxes?
      • Would the proposed legislation, if enacted, ALSO result in a net deficit to individual liberty and/or increase the scope of government beyond its original purpose?
  5. Regulations
    • Would the proposed legislation, if enacted, create new unnecessary restrictions that limit our economic growth and unfairly restrict our personal liberties?
    • Would the proposed legislation, if enacted, amend existing unnecessary restrictions that limit our economic growth and unfairly restrict our personal liberties in a manner that sustains and/or increases the existing restrictions?
  6. Personal Responsibility
    • Would the proposed legislation, if enacted, reduce personal responsibility or create a government solution to a personal issue?
  7. Strong Families
    • Would the proposed legislation, if enacted, weaken families in any way whatsoever?
  8. God-Given Dignity of All Human Beings
    • Would the proposed legislation, if enacted, harm the unborn in any way whatsoever or encourage prospective mothers to choose death for their unborn child?

Senator Jeremy England gave a vigorous defense of a piece of legislation that he has authored in a post published to Facebook. Senate Bill 2342 would exempt certain beauty services from licensing and registration requirements, thus reducing the stranglehold that the Board of Cosmetology has over these workers.

Many have called into question the need for hundreds of hours and potentially thousands of dollars spent on training that often does not even apply to an individual’s chosen profession. For example, while an EMT needs 150 class hours, an eyebrow threader in Mississippi must take 600 expensive class hours and not a single moment of these lessons focuses on eyebrow threading.

The fact is that rules like this one are often focused not on health and safety, but on producing a barrier to entry. Thus, obstacles are developed that help to ensure that less people try to join the industry and less competition exists for current providers.

In August 2019, Aaron Rice, Director of the Mississippi Justice Institute, the legal arm of MCPP, filed a lawsuit on behalf of Dipa Bhattarai in a federal district court. The lawsuit was filed against the Cosmetology Board.

Eyebrow threading is a safe and simple technique that uses just a single strand of cotton thread to remove unwanted hair. It does not involve skin-to-skin contact between the threading artist and customer, does not reuse the same tools on different customers, and does not involve the use of sharp implements, harsh chemicals, or heat.

Regarding this legislation from Senator England, MJI Director Aaron Rice stated, “[w]e have been fighting in court for years to protect the rights of niche beauty service providers to earn an honest living without burdensome and irrelevant licensing requirements.”

Rice continued, “[t]his legislation would solve that problem and allow more Mississippians to use their skills and abilities to provide for themselves and their families.”

In his Facebook post, Senator England noted, “[t]he Cosmetology Board in Mississippi is one of many, many departments and agencies we have in this state that requires licenses to perform certain tasks legally. In other words, if you want to do a job in Mississippi that you may be capable of doing and talented enough to earn a living doing, the Board will not give you a license unless and until you pay for a huge amount of training hours and schooling. This is VERY restrictive. I'm not saying it is not helpful, and I'm not saying that those hours in a classroom learning how to perform certain tasks aren't valuable.”

“But in a state like Mississippi, where we have a very low labor market participation rate and have a large population of individuals that feel stuck in a job with low pay, we have to reverse course on restricting people from doing jobs. It has to start somewhere - and the Board of Cosmetology is that start for me.”

“I want you to be able to earn a living and embark on the American Dream of starting a business where you have a chance to succeed (or fail). I want to help you support your family on your own, which may also help you get off and away from government assistance.”

“I don't want a Board that will require a large number of hours in a classroom learning things that have nothing to do with your selected trade, and I don't want you to be forced to take out tens of thousands of dollars in student loans in the process. That hurts people right where it counts, and it keeps them from succeeding. I am and will always be against this practice.”

“I want people to be able to work, and I don't want a government agency putting up roadblocks to prevent them from working. This is my belief as a conservative - and it is a big reason why I am here in Jackson. I am a small government guy. Deregulation is a major part of the foundation of small government, conservative principles. I ran on these principles, and I promised to be faithful to them.”

Senator Jeremy England has stepped up to the plate to support Mississippi entrepreneurs. His passionate defense of the American dream and an individual’s right to work without a government agency getting in his or her way is worth highlighting and supporting.

One of the many significant challenges that have arisen since the start of the COVID-19 pandemic is the threat of running out of ICU (Intensive Care Unit) beds. This issue is important because the inability to treat severely ill patients on an effective and timely basis unnecessarily increases the incidence of lasting complications or death.

In addition, if COVID does consume all available beds, patients with other critical care needs (e.g., heart attack, stroke, pneumonia, etc.) may be underserved due to capacity limitations. Following are findings on whether Mississippi has sufficient ICU beds and an examination of one of the causes of the potential shortage: outdated Certificate of Need (CON) laws.

Last November, the media increasingly reported that ICU beds were at maximum capacity in Jackson, the state’s capitol and largest city. The State Health Officer, Dr. Thomas Dobbs, tweeted: “Zero ICU beds in Jackson. Very few elsewhere. Please protect yourself and your family.” In July, headlines similarly raised the alarm that “Mississippi’s five largest hospitals are out of ICU beds.” Likewise, in August, we were told that Mississippi’s largest hospital (UMMC) was “negative 14 ICU beds.”

As of January 16, 2021, the Mississippi Department of Health (MDoH) stated that there were 2,680 new reported COVID-19 cases and 70 deaths, bringing the total since June 21, 2020, to 250,869 cases and 5,481 deaths. For the same period, MDoH reported that there were 885 total adult ICU beds, 332 adult COVID patients in ICU, and 65 available adult ICU beds. That means that coronavirus patients were taking up 37.51 percent of all adult ICU beds.

If we go by these news reports and the official data, it seems clear Mississippi is suffering from a shortage of ICU beds. When we look at the big picture, however, questions arise. For instance, in 2019, the Harvard Global Health Institute found that Mississippi had 931 ICU beds available. Short of actually losing the health care professionals needed to operate the ICU beds, it’s worth asking how the total number of ICU beds decreased from 931 in 2019 to 885 on January 16, 2021.

According to the Kaiser Family Foundation’s 2018 study on the total number of hospital beds per 1,000 people in every state, Mississippi had 4.0 beds per 1,000. That is the fourth highest number of hospital beds in the country (the national average is 2.4) followed by North Dakota (4.3); the District of Columbia (4.4); and South Dakota (4.8). Further, Becker’s Hospital Review reported in 2019 that the Kaiser Family Foundation found that Mississippi ranked 7th in the nation for states with the most rural health clinics (186 clinics). There are so many rural clinics in Mississippi that, according to a Mississippi Today article, rural clinics are on the verge of shutting down because of low patient volumes.

Of course, ICU beds and standard hospital beds (not to mention rural health clinics) are not equivalent. ICU beds have more specialized equipment and accompanying staff. However, it does seem that we are better off than most states in terms of the number of ICU and standard hospital beds. Yet, according to Johns Hopkins University’s COVID-19 Mortality Analysis, the United States has a case-fatality ratio of 1.7 percent. In Mississippi, the case fatality ratio is 2.18 percent.

Presuming COVID is the immediate cause of an ICU bed shortage, there are other health care policy factors at play: one of which is Certificate of Need (CON) laws.

In Mississippi, a CON is a law that requires current and potential medical providers to apply to the MDoH in order to expand existing medical facilities, purchase new medical machines, and build new hospitals/health care practices. This requirement, even with an emergency CON process in place, discourages new and existing health care providers from opening facilities to expand medical services and access.

The rationale behind a CON is to ensure that there isn’t an overabundance of medical services/facilities offered within the same area, the idea being that too much competition could drive providers out of business. The first CON law was passed in New York in 1964. In 1974, Congress accelerated the process by tying federal funding to CON health care planning regulations, with the result that every state, except Louisiana, had passed a CON law by 1982.

In a sudden turn of events, the federal CON requirements (and funding) were repealed only five years later. This repeal marks one of the rare occasions when the federal government has retreated from a new regulatory regime and funding structure, suggesting that the economic theory behind CON state planning is, to put it simply, erroneous. Similarly, recent research confirms that CON laws contribute to fewer hospitals per capita.

Since the beginning of the COVID-19 outbreak, 20 states have suspended CON laws, with several others enacting emergency CON provisions. To date, Mississippi has not. This alone is a powerful reminder that CON restrictions are inhibiting health care access, sometimes with fatal consequences.

In conclusion, the limited data available shows that there is a shortage of ICU beds in Mississippi. The coronavirus accounts for 37.51 percent of ICU bed utilization. No data is available to break down the remainder of ICU bed utilization. Repealing or suspending Mississippi’s archaic CON laws, however, would surely help meet the urgent needs of Mississippians.

Sean Singel holds a Master of Public Health from Texas A&M University and a BS from Texas Tech University Health Sciences Center.  His policy interests lie in clinical practice, health insurance, health care administration, and general health policy. Sean enjoys hiking, reading, and spending time with friends and family.

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