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House, Senate unable to reach compromise on Medicaid expansion proposal during initial conference meeting

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Leaders within the Mississippi House of Representatives and Senate failed to reach a compromise during the initial round of conference meetings over Medicaid expansion.

Conferees on the House side were Representatives Missy McGee (R-Hattiesburg), Sam Creekmore (R-New Albany), and Joey Hood (Ackerman). Senators Kevin Blackwell (R-Southaven), Nicole Akins-Boyd (R-Oxford), and Brice Wiggins (R-Pascagoula) represented the other chamber during the discussion on Tuesday.

The House’s Medicaid expansion plan would provide coverage for those up to 138% of the federal poverty level (FPL) with a tentative work requirement attached in order to draw down the maximum amount of federal dollars possible. The proposal would cover an estimated total nearing 200,000 Mississippians.

To cover those up to 138% of the FPL, House conferees offered a compromise for individuals between 0-99% of the federal poverty level to remain under the scope of managed care organizations. People between 100% and 138% of the federal poverty level would remain on the federal insurance exchange. McGee believes this would best entice the Centers for Medicare and Medicaid Services to foot 90% of the cost to run the program, leaving the state to cover 10% to expand coverage.

CMS would have had until September 30, to approve Mississippi’s bid to require people to work 20 hours a week for an employer who does not offer insurance if they want to receive government-provided coverage. If CMS denied the application, full-force Medicaid expansion would then go into effect, according to the House’s proposal.

“We do believe that this is a program for working Mississippians. In our bill, we have a work requirement in the first section, but we are not willing to hold back 80% of the hard-working Mississippians because we fear that maybe a small percentage somehow may game the system,” McGee said.

“We’re willing to load the bill up as much as we can, should a work requirement be denied, with plenty of things that show that the intent of the legislature is for this program to be a working program.”

The Senate, on the other hand, did not budge from its position. The proposal offered by the chamber hinges on a 30-hour-a-week work requirement being approved by CMS, or the plan would be null and void.

Individuals earning up to 100% of the federal poverty level would receive expanded coverage. The federal government would cover 77% of the program leaving the state to fork up the rest of the money. Around 80,000 Mississippians are anticipated to receive expanded care under the Senate’s plan.

“While I realize that our efforts today may not have resulted in a compromise, I think at least, despite our differing opinions, have begun a dialogue,” Blackwell said. “I view our situation as a journey.”

Mississippi is one of just 10 states that has not expanded Medicaid coverage. However, Governor Tate Reeves, an ardent foe of expansion, announced a round of Medicaid reimbursements back in September. Both legs of the governor’s plan were approved by CMS, freeing up around $818 million to be given to hospitals statewide amid a healthcare crisis.

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