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The Mississippi House is preparing to debate a landmark Medicaid expansion bill that would extend benefits to roughly 250,000 more residents. Despite previous Republican opposition to similar policies, the advancement of this bill signals a shift in perspective, fueled by the state’s poor health metrics and the potential influx of federal money. The bill includes a divisive provision requiring recipients to work at least 20 hours per week, a model aligned with Georgia’s approach but likely to face opposition from the Biden administration.
Mississippi Moves Towards Medicaid Expansion
In a potentially significant shift in health policy, Mississippi is progressing towards expanding Medicaid benefits, with the Republican-led House set to debate the matter. This policy change could extend Medicaid to hundreds of thousands of residents in one of the poorest U.S. states.
The House Medicaid Committee recently advanced a bill that proposes broadening Medicaid eligibility to include those earning up to 138% of the federal poverty level ($20,120 annually for single individuals). This move could extend benefits to an estimated 250,000 people.
“Greater access to care will improve our health metrics and contribute to a healthier Mississippi where treatments are begun sooner,” said Republican Missy McGee, the committee chair.
Hospitals in Mississippi, a state suffering from the highest rate of preventable deaths in the U.S., are struggling to keep their doors open. The state also has one of the country’s lowest labor force participation rates. Advocates believe this policy can help address these issues.
This move succeeds years of Republican opposition to the Affordable Care Act’s expansion which aims to bring federal funding to the state. Critics argue that the expansion fosters government dependency and pushes people off private insurance.
Mississippi’s legislative Republicans, including Gov. Tate Reeves, have previously avoided considering Medicaid expansion. However, House Speaker Jason White now supports the policy for the financial support it promises from the federal government.
According to McGee, the financial incentives offered by the American Rescue Plan’s Medicaid expansion, similar to those that contributed to North Carolina’s expansion approval, would fund the program for roughly four years.
“It would more than pay for itself. It’s like the federal government is providing us a free pilot program for four years,” McGee commented.
While legislative Democrats have a rival plan, they all supported the Republican-sponsored proposal. The bill must pass the House by March 14.
A key issue in the debate is a provision requiring beneficiaries to work at least 20 hours per week for the extended benefits. Only Georgia among the 10 states that haven’t expanded Medicaid has linked a work requirement to benefit expansion.
Despite the Biden administration revoking all waivers in 2021 that allowed work requirements, Georgia’s plan temporarily survived a federal court fight in 2022. Mississippi Republican Lt. Gov. Delbert Hosemann views Georgia as a model for Mississippi.
However, the Biden administration might refuse a waiver for a work requirement. Should this occur, Mississippi could either sue the federal government or proceed with expansion without a work requirement.
Mississippi’s Division of Medicaid will negotiate with the Centers for Medicare and Medicaid Services for a work requirement waiver, McGee affirmed.
“This plan aims to provide health insurance for working Mississippians. We think that the majority of this population is working, and we don’t want to exclude them because we might also be helping a non-working or disabled population,” said McGee.
Finally, Xavier Becerra, the U.S. Secretary of Health and Human Services, urged lawmakers to capitalize on the federal program at a Jackson event early this week.
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