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Medicaid expansion dies after lengthy battle between lawmakers

Mississippi legislature
The top of the Mississippi State Capitol in Jackson (Photo by SuperTalk Mississippi News)

In an expanded session, lawmakers spent months battling over if and how to expand Medicaid in Mississippi with opponents of the idea winning out at Thursday’s deadline.

Mississippi, which is one of 10 states that has not expanded government-provided healthcare coverage to the working poor, had yet to have a serious discussion on the matter until this session when the House passed a bill in February to expand up to 138 percent of the federal poverty level (FPL) with a tentative work requirement in place.

The Senate balked at the idea of expansion going into place without approval of a work requirement by the Centers for Medicare and Medicaid Services (CMS). Led by Lt. Gov. Delbert Hosemann – who said prior to the House’s passage that a strict work requirement was a prerequisite for any expansion plan – the chamber fired back with a bill to expand up to 100 percent of the FPL while not drawing federal funds at the 90% match rate like the House’s. During conference meetings over the past two weeks, the Senate conceded some ground by moving the FPL number up to the House’s but refused to give way on a hard work requirement that has resulted in expensive litigation in other states like Georgia. Speaker Jason White responded with an idea to allow Mississippi voters to decide on expansion through a ballot referendum but that was quickly shut down by Hosemann.

“We had some discussions with senators today about the possibility of a nonbinding referendum on the idea was not well received,” Hosemann said on Wednesday night. “We are disappointed in the outcome this year, but value the discussions occurred this session – the first time this legislature has seriously considered healthcare reform in our state.”

While an eleventh-hour effort by House Minority Leader Robert Johnson III on Thursday to convince Hosemann and company to try a plan that would only apply for a work requirement to CMS once and see what happens did not garner enough traction, Hosemann assured the idea of expansion will be revisited in the 2025 session.

“I remain committed to finding ways to increase access for working Mississippians who otherwise do not have the resources for a simple check-up or an extended hospital stay,” Hosemann said. “A strong work requirement, with necessary exceptions, is a bottom line for many senators. We look forward to continuing the conversation on access to healthcare in the future.”

Many Republican and Democrat legislators in both chambers remain in favor of some sort of expansion plan as thousands of workers with modest pay and no insurance are in need of coverage. However, finding a consensus on what expansion looks like is the main issue as Republican Gov. Tate Reeves vouches that he will veto any Medicaid plan as he refers to it as “welfare.” Lawmakers would need at least a two-thirds vote to override a veto.

“We should have expanded Medicaid more than a decade ago. We should still simply expand Medicaid,” Sen. Hob Bryan, D-Amory, said. “We should do the same thing 40 other states are doing.”

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