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How Medicaid expansion & criminal justice reform intersected, spotlight on disenfranchisement in Mississippi, and more

The Appeal: Political Report digs into efforts to expand Medicaid in GA, ID, and NE, disenfranchisement in MS, and two new NH prosecutors.


In This Edition of the Political Report

November 29, 2018: The Appeal: Political Report is still exploring the impact of November’s elections on criminal justice reform:

  • Georgia, Idaho, and Nebraska: How criminal justice reform and Medicaid expansion intersected in 2018

  • Mississippi: Spotlight on disenfranchisement in Mississippi

  • New Hampshire: New prosecutors elected in two of the state’s largest counties

  • Election update: States complete counts in tight races around the country

You can visit The Appeal: Political Report to read about the local politics of criminal justice reform, revisit our coverage of the 2018 election, and consult other features like a map of recent reforms.

Georgia, Idaho, and Nebraska: How criminal justice reform and Medicaid expansion intersected in 2018

The Idaho ballot initiative to expand Medicaid got a lift in September when the Idaho Sheriffs Association endorsed it, citing in part the effect it could have in relieving the criminal justice system. “Their endorsement was a big boost to our campaign,” Luke Mayville, a founder of Reclaim Idaho, the group that put this initiative on the ballot, told me. “They’ve seen the extent to which drug addiction problems are interwoven with criminal justice and incarceration, and they believe that the kind of drug treatment and addiction treatment that Medicaid would provide would be an aid to their effort to reduce crime.”

Calls for criminal justice reform and efforts to expand Medicaid boosted one another nationwide during the 2018 campaign.

Stacey Abrams, Georgia Democrats’ gubernatorial nominee, explicitly connected these dots in a detailed criminal justice reform platform that featured the expansion as a core plank. “When individuals receive Medicaid and can finally access mental health and substance abuse treatment in their communities, crime rates drop,” the document states, describing the expansion as “a vital investment in public health and public safety.”

The Affordable Care Act (ACA) significantly expanded Medicaid eligibility for low-income people. But some states have refused to expand the program, depriving millions of the public insurance that the ACA was meant to provide. This harms people released from incarceration. “They most likely will be uninsured because they won’t come out and have a job with employer benefits, and they’re unlikely to be able to afford private insurance,” Robin Rudowitz, an associate director for the Program on Medicaid and the Uninsured at the Kaiser Family Foundation, told me. “Without coverage, those individuals do not have access to affordable, comprehensive medical care.” It also leaves many individuals who experience mental health or addiction issues unable to afford treatment, making them more vulnerable to punitive policies.

Stacey Abrams fell short in Georgia. But voters in Idaho, Nebraska, and Utah all voted to expand Medicaid via referendums.

Molly McCleery, the deputy director of the health care program of Nebraska Appleseed and an adviser for Nebraska’s expansion campaign, and Mayville both said that criminal justice reform messaging did not feature prominently in their states’ campaigns. But they both also believe that it proved potent with conservative voters worried about the opioid crisis and “the severity of drug addiction,” as Mayville put it.

Mayville recalls encountering criticism that expansion meant providing public benefits to people who are addicted to drugs. “I made the case that far from it being a problem that people on drugs would be on Medicaid, that’s one of the main positives, a tool to fight drug addiction,” Mayville said. “Once I framed it in terms of, we’re trying to give people a way out of addiction, rather than just simply giving benefits to people who are wallowing in addiction, once I framed it as these benefits giving people a way out of addiction and the incarceration that comes with it, I found that to be a good argument.”

Similarly, McCleery told me that the opioid crisis came up during community presentations in Nebraska, and that expansion proponents emphasized the care that Medicaid coverage enables.  “One thing people really understand is that if you don’t have insurance you are relying on safety net services, a patchwork of services, and you may not get the full scope of treatment you would get if you had insurance,” McCleery said. She noted that this resonated in rural areas, which have been hit by hospital closures nationwide and in Nebraska.

The successful referendums are just the beginning for Idaho, Nebraska, and Utah. Beyond the questions about how officials will implement them, eligible individuals who interact with the criminal justice system still encounter obstacles to coverage. The Kaiser Family Foundation has released multiple reports on how to facilitate actual access to care, for instance by helping people sign up before they are released or suspending rather than terminating their coverage while they are incarcerated. “The Medicaid expansion created more incentives for states to link [the justice-involved] population to coverage and care,” Rudowitz said.

You can find a stand-alone version of this item here.

Mississippi: Spotlight on disenfranchisement in Mississippi

Now that Florida has adopted an initiative to automatically restore the voting rights of people upon completion of most felony sentences, Mississippi will inherit the dubious distinction of being the state that disenfranchises the highest share of its residents.

Nearly 10 percent of Mississippi’s otherwise eligible residents were disenfranchised in 2016 because of a past felony conviction, according to a Sentencing Project report. The extent to which Mississippi elections are exclusionary was largely absent from coverage of the U.S. Senate runoff held this week. Corey Wiggins, the executive director of the Mississippi NAACP, told me that the state’s “overall culture” has been “aimed at limiting folks’ ability to vote,” and that this “tends to be baked in policy and how we govern.”

Mississippi permanently disenfranchises anyone convicted of one of 22 offenses, which range from perjury and theft to murder. To regain the right to vote even after they have completed their sentence, individuals need the governor to issue a pardon or the legislature to adopt legislation in the form of a suffrage bill that enfranchises them individually. Only 335 people regained their right to vote between 2000 and 2015, according to the Sentencing Project. That’s a tiny fraction of the nearly 220,000 Mississippians who were disenfranchised in 2016.

Mississippi’s disenfranchisement rules date back to its 1890 Constitution, whose drafters were looking to exclude African Americans from political life. Paired with the vast disparities in the state’s law enforcement practices, these rules have strengthened the political power of white Mississippians. Sixteen percent of Black adults were disenfranchised as of 2016, compared with 6 percent of the rest of the population. Wiggins links felony disenfranchisement to other devices like poll taxes that “aimed to decrease the power of Black Mississippians.” Mississippi has historically “been intentional about limiting the power of voting of African Americans,” he said.

David Blount, the Democratic vice chairperson of the state Senate’s Elections Committee, told me that he would push for automatically restoring the rights of people who complete a felony sentence. “The Florida vote [on Amendment 4] shows that there is strong bipartisan support” around that idea, he said. “I think people recognize that it’s a fair thing to do.” He told me that he and other lawmakers were currently reviewing possible constitutional or statutory changes that would enable automatic rights restoration. Wiggins is advocating such a change as well. “If someone has completed their time and they’ve completed their debt to society, we should be ensuring that these folks can fully participate as citizens and exercise their voice,” Wiggins said, adding that Florida’s referendum “shows where we are as a nation in trying to push back against policies that limit voter participation.”

Republicans control the Mississippi legislature and governorship. In 2017, the state House voted unanimously to create a task force to review disenfranchisement rules, which signaled some openness to reform among lawmakers. But the bill died in the state Senate and Governor Phil Bryant has said he opposes any changes.

I asked state Senator Kevin Blackwell, the Republican chairperson of the Senate Elections Committee, whether he would support automatic restoration. “Changes to our Constitution should be a decision left to the people of Mississippi,” he said via email. He did not respond to a follow-up about whether he would support a legislatively-initiated constitutional amendment that would put such a change on the ballot.

Amendments can also be placed on the ballot through a popular initiative in Mississippi. This process is difficult in the state, but Blount said that it is something that should be looked at.

Mississippi’s disenfranchisement rules are also a barrier to the participation of people who have not lost their right to vote but have interacted with the criminal justice system. Confusion around disenfranchisement rules and lack of adequate communication on the part of public authorities is a problem nationwide, and Wiggins says that the burden of educating eligible people about their rights in Mississippi falls largely on local groups and organizers. “If we were serious about Mississippians having the right to vote,” he said, “then there is responsibility that falls on the state to make sure that returning citizens are informed about their rights.”

You can find a stand-alone version of this item here.

New Hampshire: New prosecutors elected in two of the state’s largest counties

Hillsborough County, New Hampshire’s largest, ousted its reform-skeptic county attorney Dennis Hogan. And Merrimack County, the state’s third-largest, elected Robin Davis, a public defender who was recruited through a last-minute write-in effort. (Davis and Michael Conlon, Hogan’s opponent, were both the Democratic nominees.)

Merrimack County: Davis put the opioid crisis at the forefront of her campaign. “This mindset that we have about crime—that if you commit the crime, you’re going to do the time—has got to change,” she told the Concord Monitor. “Just incarcerating someone is not going to change his or her behavior.” She called for devoting more resources to addiction treatment and to programs that enable people to stay in their communities. “I think if you treat [addiction] then you won’t need to spend the money putting those folks in the jail,” she said during a candidate forum. “If you treat it, then … you’re keeping those folks with their families, with their children, you’re keeping them employed, but you’re keeping them supporting their families in their homes and things of that nature, and I think that’s a greater benefit to the community than just incarceration.” (You can watch her full answer here.)

Davis had applied the same logic earlier in the same forum to defend recent state legislation (Senate Bill 556) meant to increase the use of personal recognizance, which enables release without cash bail. “Folks [held pretrial] were losing the very things that kept them connected to the community,” Davis said. “Anytime you can keep a person connected to their community, that’s a good thing.” Elsewhere, Davis talked of developing a sentencing program to alleviate immigrants’ risk of being deported, and she listed mandatory minimum sentences as one of the top issues facing Merrimack County. Her opponent Paul Halvorsen deployed a considerably different view of the criminal justice system; he dismissed the idea that there is mass incarceration in the state, was critical of drug courts and bail reform, and spoke in favor of sentencing enhancements.

Hillsborough County: Hogan, the incumbent, ran as a strong defender of the state’s criminal justice system. Hillsborough “has applied the facts in each case to the law,” he said in answer to an ACLU questionnaire that asked him whether prosecutors contribute to mass incarceration, framing his role as a mere application of the legislature’s choices and priorities. However, Hogan opposed passage of SB 556 (the bail reform legislation) earlier this year, alongside all of New Hampshire’s county attorneys.

In his own answers to the ACLU questionnaire, Conlon (Hogan’s victorious opponent) speaks about the benefits of reduced incarceration and rehabilitative programs, though he does not specify what reforms he would implement. I asked him questions about his views on SB 556, about the racial disparities in the county reported by NHPR, and about death penalty abolition.

You can read Conlon’s answers here. In them, he expresses skepticism toward the death penalty without committing to backing its abolition; he also says that he would gather more information and engage in conversations about racial and economic injustice, though he did not outline specific policies. He also suggests that SB 556 may go too far. “I am not sure that SB556 addresses the middle ground between those two endpoints,” he wrote, referring to the overall goal to “minimize the burden of detention on our county resources while also balancing the need to keep our streets safe from dangerous offenders and ensuring that people are persuaded to appear and face justice.”

You can find a stand-alone version of this item here.

Election update: States complete counts in tight races around the country

A number of elections profiled by The Appeal: Political Report were too close to call for weeks. But the final ballots have now been counted.

California: sheriff of Los Angeles County. Alex Villanueva has ousted Sheriff Jim McDonnell and will now run the largest sheriff’s department in the country. A vocal opponent of the state’s sanctuary law, McDonnell also provides ICE with space in his jails; in addition, The Appeal reported in September on allegations of abuse against the county’s deputies. Villanueva, who will be the first Democratic LA sheriff in 138 years, pledged to “physically kick ICE out of the county jails.” But some local advocates have urged him to go further than he has said in limiting cooperation with the federal agency.

Villanueva is planning to roll back policing reforms implemented in recent years, the Los Angeles Times reports. He says that will eliminate the department’s constitutional policing advisers, officials who are involved with oversight of deputy misconduct. The union of deputy sheriffs (ALADS), which spent $1.3 million to help elect Villanueva, opposes these advisers. Villanueva has also denounced the practice of disclosing the “Brady list,” a list of deputies with a history of misconduct allegations (ALADS opposed disclosing this list). He has also proposed arming deputies with metal flashlights in jail.

California: district attorney of Marin County. Marin County processed its last ballots this week, and Lori Frugoli was left with a narrow lead (0.4 percent) over Anna Pletcher. (A recount could follow.) Pletcher ran on much stronger changes to law enforcement regarding immigration policy and juvenile justice.

New Hampshire: 23rd Senate District. A recount held on Nov. 20 confirmed that Democrat Jon Morgan has ousted Republican State Senator Bill Gannon by 105 votes. This means that opponents of the death penalty have indeed gained a supermajority in the Senate, which they will need to adopt an abolition bill over the governor’s likely veto.

Washington: 26th Senate District. With all ballots now counted, Emily Randall has emerged victorious by just 99 votes; a recount will be held in December. Randall, a Democrat, was attacked as “too soft on crime” by a GOP-affiliated PAC because of a Facebook post in which she supported the right of an individual with a criminal record to take the bar exam.

Thanks for reading. We’ll see you next week.