Mississippi House committee passes Medicaid expansion bill for first time

The Mississippi House of Representatives Medicaid Committee has pushed forward a bill to federally expand Medicaid to potentially more than 210,000 Mississippians for the first time.

House Bill 1725, which was sponsored by first-year House Speaker Jason White, R-West, took less than 15 minutes to discuss with almost no contention from committee members Tuesday afternoon at the Mississippi State Capitol.

"The priority of this committee for this session and the speaker of the house has been to find health care options and insurance for our low work, low income workers in Mississippi," House Medicaid Committee Chair Missy McGee, R-Hattiesburg, said. "We know that we are the No. 1 state in preventable deaths. Mississippi has the shortest life expectancy of any state in our country. We are No. 1 in infant maternal and fetal mortality, and so we know that we've got to do better on giving our Mississippians access to care."

If passed by both legislative chambers, the bill would call on the Mississippi Division of Medicaid to enter into negotiations with the federal government to obtain a waiver to expand Medicaid for only working poor who make no more than 138% of the federal poverty line, which is about $20,000 per year for one person.

Those who would be eligible are people who work 20 hours per week or are full-time students, to name a few.

Under expansion, the federal government would cover 90% of the cost to expand, and the state would cover 10%. According to a recent economic study by the Hilltop Institute, the state would also be eligible for other federal funds, such as American Rescue Plan Act money on top of receiving increased tax revenues to fully cover the cost of expansion for the first two years.

McGee added that the bill also has a repeal date of 2029, which will act as a reverse option if lawmakers determine by then that program is either unviable or too costly to the state to run.

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Will Mississippi's Medicaid program end up like Georgia's?

The bill, if passed, is still unlikely to receive federal approval from the Center of Medicaid and Medicare Services.

Georgia previously tried to expand Medicaid with a work requirement. That request was approved by CMS during the Donald Trump administration but thrown out after Joseph Biden took office in 2021. Georgia sued the federal government to have its program reinstated and won, but the state is now suing again to have the program renewed until 2028.

Georgia is the only other state to have a work requirement.

"We plan on there being a work requirement," McGee said. "We want to take care of folks who are working. So, we have this work requirement in the legislation. What happens in Washington, obviously, that is out of our control."

If CMS rejects MDM's proposal by Sept. 30 2024, Section 2 of White's bill would expand Medicaid to residents within the state who make 138% of the federal poverty line, and it would not include a work requirement.

However, McGee told reporters after the meeting that section does not mean traditional Medicaid expansion. The goal is to help put more people who need health insurance on Medicaid, she said.

"Section 2 of the bill provides a state plan amendment that has copays in it, it requires (managed care organizations) to engage this population in workforce training, financial literacy and all sorts of things like that," McGee said. "So you know, it is not a traditional expansion."

The bill that passed through the Medicaid Committee also falls short of what House Democrats have been pushing for years, according to several lawmakers who spoke during a House Democratic Caucus press conference earlier Tuesday.

Rep. Robert Johnson, D-Adams County, told reporters he and his fellow lawmakers are still pushing for outright expansion, which he believes would cover an additional 20,000 people in Mississippi.

"This is a fluid process," Johnson said. "We have ideas, we have things that we like about their plan and things we don't, and we have things we're trying to get them to incorporate from our plan. We're going to continue to work together."

Despite the disappointment, Johnson indicated that the caucus would vote for any bill that expands Medicaid in the state.

Reeves still publicly opposed to Medicaid expansion

While both House and Senate leadership have been pushing the Medicaid envelope for the past several weeks, Republican Gov. Tate Reeves has posted several times about his disapproval of the move from lawmakers on X, formerly known as Twitter.

Reeves even posted just hours before McGee and her committee voted to send Medicaid expansion to the House floor for further consideration.

"The Biden Team is overjoyed with what some in Mississippi are planning right now," Reeves posted. "Count me amongst those “extreme MAGA Republicans” who think Government should not run health care."

When asked if they believed if Reeves would make further attempts to curb the implementation of a federally funded Medicaid program, both Johnson and McGee said they hope he would follow the law.

"I would hope that the governor would do what he's always done, and what any governor would do if they've been overridden, and that is let the law do what it's supposed to do," Johnson said.

Despite the disapproval from the governor, McGee said she is confident there is very wide support at least in the House.

Grant McLaughlin covers state government for the Clarion Ledger. He can be reached at gmclaughlin@gannett.com or 972-571-2335.

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This article originally appeared on Mississippi Clarion Ledger: Mississippi House moves forward with Medicaid expansion