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Her grandfather helped bring Medicaid to Mississippi 55 years ago. Today, she’s pushing for expansion.

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Supporters of Medicaid expansion would argue that it is wholly appropriate that Leah Hendrix has recently been a featured speaker in rallies at the state Capitol in favor of providing health care coverage for primarily working poor Mississippians.

No doubt, her activism brings symmetry.

Hendrix, a Jackson mother of four and the wife of a physician, is the granddaughter of Alton Cobb, the state’s former longtime state health officer who played a pivotal role in Mississippi opting into the original Medicaid program 55 years ago.

In more recent times, her father, Tim Alford, a Kosciusko physician, was beating the drums in favor of Medicaid expansion longer than almost any other Mississippi health care provider.

“He said he was leaving that to me because no one had listened to him,” she joked in an interview with Mississippi Today this week after one of the Capitol rallies.

Medicaid expansion has become the major focus of a contentious 2024 legislative session, with hundreds of Mississippians, top state business leadershealth officials and even religious leaders publicly advocating at the Capitol for full Medicaid expansion that stands to significantly help the poorest, unhealthiest state in the nation.

For the first time, state lawmakers are earnestly debating expansion. Hendrix has been on the front lines of the fight to get it across the finish line.

“It seems we have been talking about this for more than 13 years,” she said, referring to the fact that the Affordable Care Act was passed in 2010 with the provision allowing Medicaid expansion to cover those earning up to 138% of the federal poverty level or about $20,000 annually for an individual. “But it really has been going on much longer than that. When did Al work on that?”

READ MORETop Mississippi business leaders endorse full Medicaid expansion


The story of Alton Cobb and Mississippi’s reluctant decision to opt into Medicaid in 1969 is one of an unlikely alliance and political courage by a governor who eschewed his political philosophy to do what he believed was right for the people of Mississippi.

That governor was John Bell Williams. And Cobb, an employee at the state Department of Health who was initially reluctant to take a key position on Williams’ staff, helped the governor reach that decision.

“I didn’t vote for him,” Cobb told Mississippi Today in 2019, recalling when he was approached to work for Williams. “I think he probably knew that.”

But former U.S. Rep. David Bowen, who had joined Williams’ staff, was a friend of Cobb and convinced him of the potential of Williams’ health advisory board.

“I wanted to be part of that,” Cobb said.

READ MORE: Is history repeating itself on Medicaid expansion in Mississippi?

The panel held hearings across the state, listening to health care providers and others. Cobb said Williams attended the meetings, though he seldom spoke. He primarily listened.

At the end of the process, Williams informed his staff he was calling a special session to take up the issue of opting into the Medicaid program. That special session lasted from July 22, 1969, until Oct. 10. In the midst of the long and extraordinary session, Hurricane Camille ravaged the Mississippi Gulf Coast.

But by the end, Mississippi opted into the Medicaid program as most other states had already done.

The Williams-backed move was a shock to many political observers. As a U.S. House member prior to being elected governor, Williams had voted against the legislation to create the Medicaid program and had campaigned for governor railing against the excesses of the federal government.

But in a joint session of the Legislature on the first day of the special session, he told members, “In fairness, I must point out that my philosophical reasons for resisting the program as a member of the United States Congress is neither relevant nor applicable to the present issue before us. The program is a reality. It is available to our state and now devolves wholly into a question of whether you, in your wisdom, should determine our participation will be in the best interests of our state and people.”


Back in 1969, Williams’ argument for opting into the original Medicaid program sounded much like the one made today for Medicaid expansion. He said the program would provide health care for a segment of the population that needed it, it would help the state’s health care providers, and it would benefit the whole state by pumping more funds into the economy.

“Al used to love to tell about becoming John Bell Williams’ chief ambassador for starting Medicaid in Mississippi,” Hendrix said. “… After having several meetings, a light came on for Williams.

“… Two opposites politically flew around the state (on the state plane) selling Medicaid,” Hendrix continued. “Al did not like to fly.”

But she added it was “a good example of a politician who did a 180 because it just made economic sense.”

Hendrix said her grandfather, who died in 2021, wanted his support for Medicaid expansion to be included in his obituary.

Hendrix is hopeful that current Mississippi politicians will do as Williams did back in 1969 and set aside their previous political beliefs and do what is right for the people of Mississippi.

“Despite the stereotypes, Medicaid does so much good,” she said. “This is the insurance that helps children who have no other choice. Where are the Beatitudes when our neighbors need them? I will never understand why Mississippi politicians of late have decided we should not expand — turning down millions of federal dollars our state so desperately needs because of politics while we’re all still paying into a system that’s funding states that did expand.”

Perhaps today’s politicians need someone like Alton Cobb to help them reach that decision. Maybe that person is already part of the debate and is advocating for it at the Capitol every day — if only those Mississippi politicians would do like John Bell Williams did in 1969 and listen.

READ MORE: Medicaid expansion negotiators still far apart after first public meeting

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