JACKSON, Miss. The Mississippi Republican-led Legislature’s first serious effort to expand Medicaid was in danger of collapsing Thursday.
Senate leaders continued to insist on a work requirement for new enrollees, and House leaders said voters should decide whether to extend coverage to more low-income people who can’t afford private insurance.
Republican Lt. Gov. Delbert Hosemann told reporters that passing Medicaid expansion would be the first order of business during the 2025 legislative session. But in answering questions, he said by the end of the current session, “nothing is dead, dead.” , dead.”
House and Senate negotiators are under pressure during the final days of a four-month session. They released a proposal Monday to authorize Medicaid coverage for tens of thousands of low-income people, but it included a work requirement.
House Democrats balked before the plan could be voted on, saying it was a Medicaid expansion only because the federal government has blocked several states from having such mandates.
Mississippi is one of the poorest states and has some of the worst health outcomes. Some business leaders, clergy and health advocates are lobbying for Mississippi to join 40 other states in expanding Medicaid, as allowed under the health care overhaul law signed by then-President Barack Obama in 2010.
After more negotiations on Wednesday, House Speaker Jason White said his chamber would come up with a new proposal on Thursday. He would put two questions on the ballot in November: Should Mississippi expand Medicaid? If so, should the expansion include a work requirement?
“For years, the response to Medicaid expansion was not just negative, but outright rejected; With this voter referendum, Mississippians will now have a seat at the table on how to improve health outcomes in our state,” White said in a statement.
Hosemann said Wednesday night that the proposal to put Medicaid expansion on the ballot was “not well received” by Senate leaders, who Hosemann said were firm on having a work requirement “with necessary exceptions.”
Faith leaders from a group called Working Together Mississippi pleaded with lawmakers Thursday to keep trying to expand Medicaid. The group does not oppose a work requirement, “but we do oppose a work requirement that impedes the advancement of this process,” said Ronnie Crudup Sr., bishop of the Mid-South Diocese of the Fellowship of International Churches.
Even if lawmakers agree to a plan, they face a likely veto from Republican Gov. Tate Reeves, who refers to Medicaid as welfare and says he doesn’t want more people dependent on the insurance program funded by the federal and state governments.
The proposal introduced Monday night would require new Mississippi Medicaid beneficiaries to work at least 100 hours a month in a job that does not offer private health insurance. Otherwise, they must fall into other categories, such as being a full-time student or parent of a child under 6 years old.
If the federal government rejects Mississippi’s work requirement, the state Division of Medicaid would be required to continue seeking approval each year — a recognition that a different federal administration could make a different decision.
Georgia is the only state that requires Medicaid work and is suing the federal government 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 was revoking approval. Georgia sued.
The House voted by a wide bipartisan margin in late February to expand Medicaid coverage to about 200,000 people who earn up to 138% of the federal poverty level, or $20,120 per person annually. Mississippi has about 3 million residents and its Medicaid program covered 374,823 people in March.
In late March, the Senate approved its own streamlined version that would expand eligibility to people earning up to 100% of the federal poverty level, just over $15,000 per person. Senate Medicaid Committee Chairman Kevin Blackwell, a Republican from Southaven, said about 80,000 people would become eligible for coverage.
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