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Reeves celebrates Medicaid expansion dying as Hosemann questions governor’s numbers

Gov. Tate Reeves (left) and Lt. Gov. Delbert Hosemann (right) are at odds over how many Republican senators are in favor of Medicaid expansion. 

Mississippi lawmakers were unable to come to terms on a plan to expand Medicaid during the recently ended session, and Gov. Tate Reeves wasted no time celebrating what he believes to be a victory.

In a lengthy social media post following Tuesday’s official sine die, the Republican governor who often refers to expansion of government-provided healthcare coverage as “welfare” or “Obamacare” blamed the media and national politicians for the idea even coming about.

“It’s official – the 2024 Mississippi Legislature is adjourned as Sine Die,” a portion of Reeves’ post reads. “And the Obamacare Medicaid Expansion scheme was STOPPED – at least for one more year!”

While Reeves went on to applaud 24 GOP senators he said “courageously opposed” Medicaid expansion, no vote count from the 2024 session reflects that many Republicans being against any Medicaid-related measure. According to the only vote the Senate held to actually expand coverage, 16 Republicans dissented while 20 were in favor. Paired with 16 Democrats, the total number of yeas could have been enough to override a hypothetical veto.

Shelby Wilcher, communications director for Reeves, explained in a text message on Friday afternoon that the governor’s number came from a silent count his office compiled as discussions on Medicaid expansion were being held in conference. Lt. Gov. Delbert Hosemann disagreed, saying his office conducted its own poll amongst senators and had enough Republicans in the Senate willing to move forward with a compromise plan before Democrats in the House withdrew their votes.

“The governor tweets a lot, which is good I guess, and probably cathartic. He has to live in a white house down there with nobody around,” Hosemann said during an appearance on The Ricky Mathews Show. “But we had 36 votes for Medicaid – for healthcare for working people – in the Senate. That’s a supermajority.”

For context of what happened during this year’s session, both the House and Senate were technically in favor of expanding Medicaid to more working Mississippians, but the two chambers could not agree on how to do it.

The House voted in February to expand coverage up to 138 percent of the federal poverty level (FPL) with a tentative work requirement in place. The Senate, which initially scrapped the House bill for a plan to expand up to 100 percent of the FPL, eventually came around to the 138 percent number but balked at the idea of expansion going into effect without a firm work requirement. For Mississippi to implement Medicaid expansion with a work requirement, the Centers for Medicare & Medicaid Services (CMS) would have to approve a waiver – something that has not been done since President Joe Biden took office in 2020 and something that ultimately resulted in talks faltering at the state capitol as House Democrats wanted to do away with the working stipulation.

Hosemann, who recently penned a column voicing his belief that CMS will consider a work requirement if submitted, added that even though the House and Senate could not pass Medicaid expansion this year, next year will be the state’s best chance yet.

“We took a whole lot of steps, and somebody said, ‘Well, you didn’t score.’ Well, we got down to about the 15 or 10-yard line and it’s usually easier to score there from when you started on your own 20,” Hosemann said, using football terms that the average Mississippian understands all too well.

Reeves, occasionally using public speeches to refer to himself as a “numbers guy,” rounded out his post by saying with the final plan debated by lawmakers, nearly 200,000 people currently on the federal exchange program would be transferred to Medicaid, and the state would have to front 10 percent of costs for that group.

Hosemann contended that Reeves’ numbers are off, and even if they were correct, no money would be leaving the state’s coffers as 90 percent of the program would be covered by the federal government and the other 10 percent would be paid through fees on managed care organizations.

“I think we made a great step forward on working people, which is about 75,000, and in that 75,000 in coverage could be as much as a billion dollars more in healthcare money that would come to the state,” Hosemann said. “And we had it paid for through a three percent fee on managed care companies, so it wouldn’t cost us any money. Actually, we would make money.”

Mississippi is one of 10 states that has not expanded Medicaid under the Affordable Care Act of 2010, which was finally implemented under Democratic President Barack Obama after first being born during Republican President Ronald Reagan’s tenure nearly three decades earlier.

While Medicaid expansion would result in healthcare coverage for more working Mississippians with Democratic lawmakers vouching that over 85 percent of the expanded group is already working but does not have employer-provided coverage, most to all rural hospitals across the state have joined in advocating for it as they currently have to cover the bulk of the cost for uninsured patients.

“The next step is to have people who are working have access to healthcare. People need to realize that’s not a check to somebody. We’re paying a nurse, a nurse practitioner, a doctor, or a rural hospital to take care of what people who are not paying at all right now,” Hosemann said. “That’s what this is about.”

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