Mississippi’s Republican-led House will consider Medicaid expansion for the first time
JACKSON, ma’am. — Mississippi is one step closer to what would be a landmark health care policy as the Republican-led House prepares to debate expanding Medicaid benefits to hundreds of thousands more residents in one of the poorest states in the US.
The House of Representatives Medicaid Committee on Tuesday advanced the bill, which would expand access to Medicaid, a health insurance program that covers low-income people. Those at 138% of the federal poverty level, or $20,120 a year for a single person, would qualify under the proposal. The measure could extend benefits to about 250,000 people.
“Our health metrics will improve, we will see greater access to care and hopefully see a healthier Mississippi where our people get treatment sooner rather than later,” said Republican Missy McGee, chairwoman of the committee.
Mississippi has the highest number of preventable deaths in the US. The country’s top health official has said the country is at the bottom of almost every health care indicator and at the top of every inequality. Hospitals are struggling to stay open. The state also has one of the lowest labor force participation rates in the country. Expansion advocates have said the policy could help improve these conditions.
The move follows years of Republican opposition to the expansion allowed under the Affordable Care Act, a 2010 federal health care overhaul signed by then-President Barack Obama. Opponents of the Medicaid expansion say the program would increase dependence on the government, increase wait times for health care and turn people away from private insurance.
Until this year, Mississippi’s legislative Republicans never held a hearing to consider Medicaid expansion. The debate stalled amid opposition from party leaders, including Gov. Tate Reeves, who on Tuesday reiterated his position that the government “shouldn’t be running health care.” But new Republican House Speaker Jason White, who co-sponsored the Medicaid expansion bill with McGee, says he wants lawmakers to view the policy as a way to bring hundreds of millions of federal money to the state each year.
McGee touted a financial incentive for Medicaid expansion provided by Congress in the American Rescue Plan. The bonus helped pass Medicaid expansion in North Carolina. In Mississippi, the incentives and other cost offsets, such as higher tax revenues, could fund the program for about four years, McGee said.
“It would more than pay for itself,” McGee said. “You can almost think of it as if the federal government is giving us a free pilot program that will last four years.”
Legislative Democrats on the committee have a competing plan that would go further, but they all voted in favor of the Republican-sponsored plan on Tuesday. MPs have until March 14 to adopt the bill.
At the center of the debate is a provision that requires people to work at least 20 hours a week to qualify for the expanded benefits. Of the 10 states that have not expanded Medicaid, only Georgia has managed to attach a work requirement to a partial expansion of benefits.
The Trump administration allowed 13 states to impose work requirements on some Medicaid recipients. Then, in 2021, the Biden administration revoked all those waivers, arguing that people should not face barriers to getting health care. Republican Gov. Brian Kemp’s administration won a federal court battle in 2022 to temporarily keep Georgia’s plan in place, but a legal battle remains ongoing.
Republican Lt. Gov. Delbert Hosemann of Mississippi, who will play a key role in shepherding any Medicaid expansion bills through the Senate, said Georgia offers a model for Mississippi.
But the Biden administration could likely refuse to grant a waiver for Medicaid expansion that includes a work requirement. If that were to happen, Mississippi could sue the federal government or implement expansion without a work requirement.
McGee said the state Department of Medicaid would do its best to negotiate with the Centers for Medicare and Medicaid Services, the agency that would have to approve a work requirement waiver.
“The purpose of the plan is to provide health insurance to working Mississippians,” McGee said. “We believe that at least 75-80% of this population is working, so we certainly don’t want to not help them just because we might be helping another population that may not be working or can’t work at the time.”
At an event in Jackson on Monday, Xavier Becerra, the U.S. Secretary of Health and Human Services, urged lawmakers to take advantage of the federal program.
“You need to take charge of your state until your state finally takes care of all its families,” Becerra said.
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Associated Press reporter Devna Bose contributed to this report. Michael Goldberg is a staff member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.