Efforts to expand Medicaid in Mississippi came to a halt as top lawmakers failed to reach an agreement on a final proposal to send to the House and Senate. This year marked the first time that expansion had serious legislative discussion in the state, which is known for its poverty and poor health outcomes. Any plan would have required a two-thirds majority vote to pass, enough to survive a potential veto from Republican Governor Tate Reeves, who opposes Medicaid expansion. House Medicaid Committee Chair Missy McGee expressed disappointment at the issue being dropped, stating that it leaves hardworking, low-income Mississippians without coverage.

Medicaid is a government health insurance program that caters to individuals with very low incomes. While then-President Barack Obama’s health care overhaul law in 2010 allowed states to expand coverage, Mississippi and nine other mostly Republican-led states resisted expansion. House and Senate leaders in Mississippi missed the Thursday night deadline to file a final plan, effectively ending the issue for the ongoing legislative session. Republican Lt. Gov. Delbert Hosemann lamented the missed opportunity to provide health care coverage to 74,000 working individuals in Mississippi. He expressed readiness to make Medicaid expansion a priority in the 2025 legislative session.

House and Senate negotiators offered a proposal to expand Medicaid to tens of thousands more people, which included a work requirement. However, House Democrats objected to the plan as they believed it was similar to Medicaid expansion in name only, given the federal government’s history of blocking states from implementing work mandates. A new proposal was put forward by the House on Thursday to present two questions to voters in the upcoming November ballot: whether to expand Medicaid and if so, whether to include a work requirement. While some viewed this as a good measure of public sentiment, Senate leaders were less receptive to the idea and insisted on a work requirement with necessary exceptions.

In late February, the Mississippi House voted in favor of expanding Medicaid coverage to about 200,000 people earning up to 138% of the federal poverty level. However, the Senate passed a scaled-back version in late March, extending eligibility to those earning up to 100% of the federal poverty level. Senate Medicaid Committee Chairman Kevin Blackwell estimated that around 80,000 people would become eligible for coverage under the Senate’s proposal. Despite efforts from both chambers, a final compromise could not be reached, leading to the demise of Medicaid expansion for the current legislative session. The issue is expected to resurface in future sessions, with lawmakers committing to addressing the healthcare needs of low-income Mississippians.

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