JACKSON, ma’am. — Mississippi lawmakers are expected to vote this week on a proposal that would expand Medicaid coverage to tens of thousands of additional people, but it includes a work requirement that may not receive federal approval.
The state House and Senate passed separate expansion plans earlier this year. As the four-month legislative session entered its final days, negotiators from the two chambers submitted a compromise just before Monday evening’s deadline. They declined to answer questions after emerging from a closed-door meeting, but the proposal was submitted to the legislative clerks.
The plan would require new Medicaid recipients to work at least 100 hours a month in a job that does not provide private health insurance. Or they may fit into other categories, such as full-time student or parent of a child under age 6.
If the federal government rejects Mississippi’s work requirement, the state’s Department of Medicaid would have to continue seeking approval every year — an acknowledgment that another federal government could come to a different decision.
Georgia is the only state with a Medicaid work requirement and is suing the federal government to try to keep the mandate in place. The work requirement was approved by then-President Donald Trump’s administration, but the Biden administration announced in December 2021 that it would withdraw the approval. That prompted Georgian officials to file a lawsuit.
Mississippi is one of the poorest states in the U.S., and advocates say covering tens of thousands more people with Medicaid could help them manage chronic health conditions like asthma and diabetes.
Federal health care reform signed by then-President Barack Obama in 2010 allowed states to expand Medicaid, largely to people working low-wage jobs without insurance. Mississippi is one of 10 states that have opposed expansion.
Republican Governor Tate Reeves has said for years that he does not want to subject more Mississippians to government programs. But the dynamic in the Republican-controlled Legislature changed this year with the selection of a new House Speaker, Jason White, who said expansion could help some of Mississippi’s financially struggling hospitals.
The House voted by a wide bipartisan margin in late February to expand Medicaid coverage to about 200,000 people earning up to 138% of the federal poverty level, or $20,120 a year for one person. Mississippi has a population of about 3 million and its Medicaid program covered 374,823 people in March.
In late March, the Senate passed its own pared-down version, which would expand eligibility to people earning up to 100% of the federal poverty level, just over $15,000 for one person. Senate Medicaid Committee Chairman Kevin Blackwell, a Republican from Southaven, said about 80,000 people would qualify for coverage, but he thought about half that number would enroll.