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Mississippi House makes history with Medicaid expansion bill that now awaits Senate’s approval

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The Mississippi State Capitol in Jackson (Photo by SuperTalk Mississippi News)

Lawmakers in the Republican-heavy Mississippi House of Representatives passed a bill on Wednesday to expand Medicaid with a work requirement tentatively in place.

The Healthy Mississippi Works Act would expand healthcare coverage to an estimated 200,000 people who are employed but don’t make enough to afford private health insurance. The work requirement, which would need approval from the Centers for Medicare & Medicaid Services (CMS), would require people to work at least 20 hours a week for an employer that does not offer insurance or have proof that they are a full-time student.

However, a second section of the legislation makes clear that if the work requirement waiver is not approved by CMS by Sept. 30, 2024, Medicaid would still be fully expanded to people up to 138 percent of the federal poverty level. The reason being is to ensure Mississippians still have better access to healthcare in case a situation like in Georgia arises, where an ongoing legal battle appears to hinge on President Joe Biden either being booted from office or having a change of heart in terms of work requirements for federally offered healthcare.

Rep. Missy McGee, who presented the legislation, delivered a speech deemed powerful by her peers in which she said expanding Medicaid is the “right thing” to do.

“Beyond the policy and politics of this issue, what we really have before us is a solution to a fundamental challenge – access to healthcare,” McGee said. “It’s a topic that should transcend politics and economics. For at its core, it is about the wellbeing and dignity of every Mississippian.”

Citing statistics such as Mississippi being the worst state for life expectancy plus having the highest rates of preventable deaths, maternal mortality, infant mortality, and fetal mortality, McGee said it is imperative state leaders offer an easier path to preventive care after over a decade of refusing Medicaid expansion under the Affordable Care Act.

“In fact, many of the leaders in our state – good, well-intentioned people – have refused to even allow a conversation to come forward in the form of a bill,” McGee continued. “Yet, we have yet to offer anything that can actually address the problem. No one has presented a more affordable way and ‘no’ is not a policy that has helped or will help low-income, working Mississippians.”

By the time the Republican from Hattiesburg was finished, lawmakers in the chamber were chanting, “vote, vote, vote.” And vote they did. In an overwhelming 96-20 count, the bill was passed and ready to be sent to the Senate where a similar piece of legislation is already being discussed.

As for how Mississippi would pay for its 10 percent share of Medicaid expansion – the federal government guaranteeing to cover the other 90 percent – House Speaker Jason White said Monday morning prior to the vote that there’s nothing to worry about there.

“Under our plan, it wouldn’t cost a dime,” White said. “We would cover our 10 percent share that the state has to pay through a tax on the managed care organizations that will manage this population.”

Another feature of the House bill is a four-year repealer that gives Mississippi a chance to withdraw from the program if leaders don’t like the statistics or the federal government decides to drop below the 90 percent margin. The legislation also contains a statute aimed at preventing people from jumping from employer group coverage to enroll in Medicaid by including a 12-month wait period before a person can enroll if they recently left their employer’s coverage plan.

As for if the House and Senate can agree on a bill to expand Medicaid, White is confident they will. The holdup might be with Republican Gov. Tate Reeves, who went to social media before the vote to voice his displeasure with the movement toward expansion.

“Representative McGee keeps saying – over and over – that her bill is for working people. The truth is this: her bill passed by the House committee yesterday is straight Obamacare Medicaid Expansion,” Reeves wrote on X. “Applies to as many as 300,000 able-bodied adults who could work but may choose not to… And there is NO (real) work requirement.”

Reeves, who went on to compare the House bill to one Chuck Schumer, Nancy Pelosi, and Barack Obama would endorse, could eventually be overridden if two-thirds of lawmakers decide to shut down a veto attempt.

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