The Mississippi Legislature is considering a Medicaid expansion plan that includes a work requirement, which is expected to face challenges in receiving federal approval. The state House Democratic leader, Rep. Robert Johnson, expressed concerns that approving the plan with a work requirement could create false hope among people seeking Medicaid coverage, as it may not meet federal guidelines. House and Senate leaders are working to secure bipartisan support, as they will need a two-thirds majority in each chamber to override a potential veto by Republican Governor Tate Reeves.
Mississippi is one of the poorest states in the U.S. and one of 10 states that have not expanded Medicaid under the Affordable Care Act. Democrats have long advocated for Medicaid expansion to help individuals receive care for chronic conditions like asthma and diabetes, as well as to support financially struggling hospitals. Governor Reeves criticized the proposed Medicaid expansion plan on social media, likening it to “FULL Obamacare Medicaid Expansion” and attributing it to former President Barack Obama’s vision.
The proposed plan would require new Medicaid recipients in Mississippi to be employed for at least 100 hours per month in a job that does not offer private health insurance, or meet other criteria such as being a full-time student or parent of a young child. Georgia is currently the only state with a Medicaid work requirement, and they are appealing the Biden administration’s decision to revoke approval. If the federal government rejects Mississippi’s work requirement, the state Division of Medicaid will need to seek approval annually, acknowledging the potential for differing decisions from future administrations.
In late February, the Mississippi House passed a Medicaid expansion bill with bipartisan support, extending coverage to approximately 200,000 individuals earning up to 138% of the federal poverty level. The Senate passed a more limited version in March, expanding eligibility to those earning up to 100% of the federal poverty level. Senate Medicaid Committee Chairman Kevin Blackwell estimates that around 80,000 people would be eligible for coverage under the Senate’s proposal, with an expectation of about half that number enrolling. The new Speaker of the House, Republican Jason White, views expansion as a priority to assist individuals in low-wage jobs without insurance.
As Mississippi continues to grapple with high poverty rates and poor health outcomes, Medicaid expansion remains a critical issue for many residents. The debate over including a work requirement in the expansion plan highlights the challenges of reaching consensus across party lines. With the possibility of a veto from Governor Reeves, legislators are working to garner support from both Democrats and Republicans to move forward with Medicaid expansion efforts in the state. The outcome of these ongoing deliberations will have significant implications for the healthcare access and well-being of thousands of Mississippians.
