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Mississippi Senate moves forward with Medicaid expansion plan despite pushback from Gov. Reeves

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It did not take long for the Mississippi Senate to pass its Medicaid expansion proposal.

A measure that has been coined “Expansion Light” around the capitol passed Thursday’s floor vote 37-15 just one day after the Senate Medicaid Committee moved forward with the legislation.

The Senate allowed its expansion bill to die ahead of a legislative deadline just under two weeks ago, took up the House’s version, implemented a strike-all amendment eliminating the other chamber’s language, and inserted its own plan into House Bill 1725 in committee.

Under the Senate’s plan, residents between the ages of 19 and 64 up to 100 percent of the federal poverty level would be qualified for coverage. This differs from the House’s proposal which expanded care to those up to 138 percent of the federal poverty level.

Attempts on the floor, particularly by Democratic Senator David Blount, to persuade members to oppose the strike-all amendment and reinstate the House’s language failed. The majority of the body sided with Senator Kevin Blackwell and his insistence on taking a more “conservative” approach that narrowly avoids full-blown expansion.

That approach also entails a work requirement — one that Blackwell promised would be featured in the legislation. Those seeking coverage must work around 30 hours per week or 120 hours per month to become eligible for expanded care, with some exceptions. Around 80,000 Mississippians are expected to be eligible for Medicaid coverage under the proposal.

Georgia is currently the only state with a work requirement for those seeking Medicaid coverage and there is no guarantee that the Centers for Medicare and Medicaid Services would agree to go along with Mississippi’s plan.

Another roadblock in the way of the Senate’s measure is in the Governor’s Mansion. Mississippi’s highest elected official, Republican Governor Tate Reeves, remains an ardent opponent of Medicaid expansion, or as he calls it, an “extension of Obamacare.”

Reeves took to social media on Wednesday, ahead of the floor vote, to express his ire with the Senate’s plan, essentially accusing it of being smoke and mirrors. The Republican governor alleged that a lesser number of people should be in the coverage gap than what the committee estimated. He also anticipated that fewer than half of those within the coverage gap would actually be working citizens.

The governor objected to some of the work requirement exceptions, including automatically qualifying those with a child under the age of six, caregivers of a direct relative, and those who are deemed by a medical professional to be unable to work for Medicaid coverage. The governor finds these exceptions rife with possibilities for people to exploit the government.

“The Devil is always in the details. And the details prove that this Senate bill is not for the ‘working poor,'” Reeves wrote. “It is welfare expansion to those able-bodied adults that could work but choose not to. The Senate bill is still bad policy. And so I will continue to do what I told the voters I would do — fight Obamacare Medicaid Expansion with every ounce of my being!”

Those in favor of expansion have long argued that it would be a step in solving Mississippi’s ongoing healthcare crisis as it would allow the state to help struggling hospitals, many of which are on the verge of full closure, monetarily. Proponents of the Senate’s plan contend that it would also help the working poor in the state.

Opponents of Medicaid expansion, such as Reeves, argue that it would not fix the issues at hand and that it would further increase dependency on federal assistance, or “welfare.” Some critics of expansion have conveyed their beliefs that working individuals eligible for coverage under the expansion model would ditch employer-provided insurance for Medicaid.

Last September, Reeves announced his own Medicaid reimbursement program in the state — one that did not expand the coverage group. The plan dubbed as the Mississippi Hospital Access Program provides direct payments to hospitals serving patients in the Mississippi Medicaid-managed care delivery system where care has continuously gone uncompensated en masse. To date, more than $658.2 million has been delivered to hospitals statewide through the program, though skeptics maintain that this plan does not help small hospitals.

The Senate’s proposal now heads to the House of Representatives for consideration.

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