Mississippi lawmakers haggle over possible Medicaid expansion as their legislative session nears end

JACKSON, ma’am. — Top Mississippi lawmakers began negotiating Tuesday on what could be a landmark plan to expand Medicaid coverage to tens of thousands of people in one of the poorest states in the U.S.

But even with Republicans in control of both the House of Representatives and the Senate, it is far from clear they will reach a compromise in the final days of their four-month session, which is expected to end in early May.

Mississippi is one of 10 states that have not expanded Medicaid coverage to people who work low-wage jobs and do not provide private health insurance. Expansion is an option under federal health care reform signed into law by then-President Barack Obama in 2010.

Republican Governor Tate Reeves has said for years that he opposes putting more people on government programs.

Expansion is getting its first serious discussion at the Mississippi Capitol this year, as the new Speaker of the House of Representatives, Republican Jason White, says it is one of his priorities.

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.

House Medicaid Committee Chairman Missy McGee, a Republican from Hattiesburg, offered a compromise on Tuesday. It would allow Mississippi to receive the full amount of federal money possible for Medicaid expansion. People earning up to 100% of the federal poverty level would be covered by Medicaid, while those earning between 100% and 138% of the federal poverty level would receive subsidies to purchase insurance through a federal health insurance exchange.

Senators did not come up with any new proposals on Tuesday and did not immediately respond to the proposal from the House. Blackwell said it is significant that the two chambers are discussing expansion, but he cautioned against moving quickly.

“In the case of the House of Representatives, I think you guys want to jump in the sports car and go straight to expansion — screw the roadblocks and let’s go there,” Blackwell said. “Those of us in the Senate want to take a slower approach to that.”

McGee replied: “I don’t feel like we’ve been in a Ferrari for very long. I think we’ve been waiting for ten years. … We don’t have to delay this any longer for our hard-working, low-income Mississippians.”

Mississippi lawmakers usually meet privately to negotiate final versions of bills, but this year they agreed to hold open meetings on Medicaid expansion. Tuesday’s meeting ended as standing room only, with some spectators arriving hours early.