JACKSON, Miss. Mississippi lawmakers are expected to vote this week on a proposal that would expand Medicaid coverage to tens of thousands of people but includes a work requirement that may not win federal approval.
The state House and Senate approved separate expansion plans earlier this year. With the four-month legislative session reaching its final days, negotiators from both chambers offered a compromise moments before the Monday night deadline. They refused to answer questions after leaving a closed-door meeting, but the proposal was filed in the legislative secretaries’ offices.
The plan would require new Medicaid beneficiaries to work at least 100 hours a month in a job that does not offer private health insurance. Or they may 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 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 was revoking approval. This prompted Georgia authorities to sue.
Mississippi is one of the poorest states in the U.S., and advocates say covering tens of thousands more people with Medicaid could help them manage chronic health problems such as asthma and diabetes.
The federal health reform signed by then-President Barack Obama in 2010 allowed states to expand Medicaid, largely to people working in low-wage, uninsured jobs. Mississippi is among 10 states that resisted expansion.
Republican Gov. Tate Reeves has said for years that he doesn’t want to put more Mississippi residents into government programs. But the dynamic in the Republican-controlled Legislature changed this year with the selection of a new House Speaker, Jason White, who said the expansion could help some of Mississippi’s financially struggling hospitals.
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, but he thought about half that number would sign up.
