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Hosemann confident Medicaid expansion plan with work requirement will pass legislature

Delbert Hosemann
Photo by SuperTalk Mississippi News

With Monday’s deadline to introduce legislation quickly approaching, both chambers of the Mississippi legislature are planning to drop bills that would expand Medicaid in a state that continues to suffer from a widely publicized healthcare crisis.

As opponents of Medicaid expansion vouch that the idea is nothing but another avenue for welfare, Lt. Gov. Delbert Hosemann argues the opposite. The Republican leader said the Senate’s bill would expand coverage to roughly 230,000 working adults with that being the key word – working.

“You’d have to be making higher than the federal poverty rate to be eligible for this,” Hosemann said, adding that he would also want to see a requirement for participants to make a contribution toward their health insurance. “It’s not just a gift program for people who are not working. Those people, quite frankly, are already covered. This is aimed strictly and solely at working people that are making in that $20,000 to $40,000 range.”

Somewhat based on Georgia’s partial Medicaid expansion model that was implemented in 2023, the working requirement included in the Senate’s bill would ensure people who are employed but don’t make enough to afford private health insurance are still granted access to healthcare. Currently, this group does not qualify for Medicaid, exempting pregnant or disabled adults, which has taken a toll on emergency rooms across the state required by law to provide treatment regardless of insurance or ability to pay.

Hosemann – who before the session announced that his top priority is bettering the state’s struggling labor force participation (LFP) rate – said by expanding Medicaid with the working stipulation in place would result in a booming increase in the number of employed people in Mississippi. By essentially requiring people to work if they want health insurance through Medicaid, he said this combined with the state’s recent strides in education make for the perfect recipe to get the 53.8 percent LFP rate up.

“To be competitive, we have to have two things. We have to have an educated workforce, and this year, we’ll propose last-dollar tuition free community college. Our grade scores have accelerated and rocketed up. We have career coaches at almost every school, so a lot of positive things on the education point that will allow our workforce to be competitive with anybody,” Hosemann explained.

“The second part of that is you have to be healthy or you’re not going to show up for work. So, this part of the fact that we have an unacceptable labor force participation rate…to get that number up, we have to have an educated workforce.”

Hosemann revealed that the idea of expanding Medicaid in Mississippi was solidified in his mind after he saw Louisiana’s success with it. At first, there were concerns over people jumping from employer group coverage to enroll in Medicaid. He said that’s been virtually a non-issue for Mississippi’s westward neighbor.

“The other thing that moved me about this was I started watching Louisiana in the last year or two. They started theirs in 2016 and the number of people who were on private healthcare was like 51 percent and the number of people who are on private healthcare is now like 49 percent, so you don’t have this mass migration to the public sector,” he said.

As for how Mississippi would pay for its share of Medicaid expansion – another argument critics have stood on – Hosemann believes the idea is to get the federal government to help. Under the 2021 American Rescue Plan Act, the door has been opened to a five percent additional incentive for two years along with the already 90 percent matching rate for the 10 states that have yet to participate to opt in. That would easily offset Mississippi’s 10 percent cost for that period. Hosemann also said a portion of hospital revenue could also be used to pay for the state’s stake. The result, according to him, would be anywhere from $500 million to $800 million annually returned to the state.

The lieutenant governor, who considers former President Ronald Regan a “personal hero,” is encouraging lawmakers to wipe their partisan lenses and take a serious look at Medicaid expansion for the sake of Mississippians – especially those who live in rural parts of the state – and their access to affordable healthcare. While many often argue that former President Barack Obama was the mind behind Medicaid expansion, the idea was actually a brainchild of Reagan but just wasn’t put into action until the 21st century.

“I often think how pleased [Reagan] would be to watch our state lower taxes and pay off debt. In any event, that’s where the antithesis and the genesis of this was and then we lost sight of that in a series of presidents,” Hosemann said. “We can’t be held by nomenclature. This is about the future… This is about if our grandchildren are going to be healthy and educated enough to stay in Mississippi and get a meaningful economic job.”

As for the House side, Hosemann said Republican lawmakers such as Speaker Jason White, Missy McGee, and Sam Creekmore have been working on a similar bill. Unclear if it aligns with one House Democrats announced earlier this year, the basis of Medicaid expansion with a work requirement will be the same.

“I’m sure they’ll have their bill and we’ll have one, and I imagine between the two, we’ll have a really good bill,” Hosemann said, adding that he’s hopeful Gov. Tate Reeves – a vehement opponent of Medicaid expansion – will come around since the goal is to provide coverage to those with jobs. “I think we step a long way forward toward what the governor’s position has always been and that’s not just to give a handout to someone.”

With confidence that whichever bill the House and Senate agree on will pass both chambers before going to Reeves’ desk, Hosemann made it clear that it will be one he feels the general Mississippian can get behind.

“I have received, unexpectedly and unsolicited, a lot of really positive emails about this, so I’m thinking you’re going to find the business community, the medical community, and the economic developers support this. Everyone sees we need more people working, and they see the need for more people who are working to stay healthy.”

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