Mississippi Medicaid expansion plan could struggle for bipartisan support, Democratic leader says
JACKSON, ma’am. — A Medicaid expansion plan approved by leaders in Mississippi’s Republican-led Legislature could struggle for bipartisan support because it includes a work requirement that is unlikely to win federal approval, the Democratic House of Representatives leader said Tuesday.
Approving the plan could raise false hopes for people who want Medicaid coverage but may not receive it, Rep. Robert Johnson told reporters after his party’s caucus met privately to discuss the issue.
“The Democratic Caucus in the House of Representatives did not want to vote for a Medicaid expansion bill that was Medicaid expansion in name only,” Natchez’s Johnson said.
House and Senate leaders worked behind closed doors to build support. They need a margin of at least two-thirds in each chamber — enough to override an expected veto from Republican Gov. Tate Reeves.
Mississippi is one of the poorest states in the US, with some of the worst health outcomes. It is also one of 10 states that did not expand Medicaid under the health care law that then-President Barack Obama signed in 2010.
Democrats have said for years that expanding Medicaid could help people get care for chronic conditions such as asthma and diabetes, and that an infusion of federal money could provide a boost to financially strapped hospitals.
Reeves said on social media Tuesday that lawmakers were about to vote on “COMPLETE Obamacare Medicaid Expansion” and that it would be “exactly what Obama-Biden wanted!”
A plan introduced Monday evening would require new Mississippi Medicaid recipients to work at least 100 hours a month in a job that does not offer private health insurance. Or they may fit into other categories, such as full-time student or parent of a child under age 6.
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.
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.
The previous speaker of the House of Representatives, Republican Philip Gunn, also opposed expansion. He did not stand for re-election. The new speaker selected in January, Republican Jason White, has said expansion is a priority to help people who work low-wage jobs that don’t offer insurance.
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 sign up.