House, Senate leaders swap Mississippi Medicaid expansion proposals as Monday night deadline nears

Published 4:12 pm Monday, April 29, 2024

by Taylor Vance, Mississippi Today
April 29, 2024

House and Senate leaders ahead of a major Monday night deadline continued to trade proposals back and forth on Monday attempting to find a compromise plan to expand Medicaid coverage to poor Mississippians.

House Medicaid Chair Missy McGee, a Republican from Hattiesburg, told Mississippi Today that she delivered another compromise proposal to Senate leaders Monday afternoon that would direct the Division of Medicaid to apply for a federal waiver to allow Mississippi to implement a work requirement for Medicaid recipients.

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However, if the Centers for Medicare and Medicaid Services denies the state’s waiver for work requirements, the proposal would still expand either traditional Medicaid coverage or government-subsidized private insurance policies to people who make up to 138% of the federal poverty level, or about $20,000 for an individual.

The House’s latest measure also contains “trigger language,” similar to North Carolina’s, which requires the division to reapply for a work requirement waiver as soon as the CMS approves work requirements in other states.

The House’s Monday offer follows a plan Senate leaders sent to the House on Sunday evening that also would expand eligibility to 138% of the federal poverty level still but contains an ironclad work requirement for expansion to take effect.

READ MORE: Lawmakers negotiate Medicaid expansion behind closed doors, hit impasse on state budget

The reason the two chambers are haggling over work requirements in the bill is because the Affordable Care Act, the federal legislation that allows states to expand Medicaid coverage, does not authorize work requirements. However, states can seek a federal waiver to implement them.

CMS under the Trump administration did sign off on some states using work requirements, but under the Biden administration, the federal agency has not approved requests and rescinded the ones that had been approved.

The House is willing to establish an expansion plan without a work requirement, but Senate leaders have maintained they will only support an expansion program that mandates work requirements — a stance that would at the least delay expanded coverage — perhaps for years, or prevent it from ever happening.

House leaders have pointed out that people with income above the federal poverty level are likely working.

Lawmakers have for the past couple of months been debating on how to expand Medicaid coverage for poor working Mississippians and help the state’s struggling hospitals.

The House initially voted to expand coverage to an estimated 200,000 people, and accept more than $1 billion a year in federal dollars to cover the cost, as most other states have done. The Senate initially passed a far more austere plan, that would cover about 40,000 people, and would decline the extra federal money to cover costs.

Since those plans passed, each has offered counter proposals, but no deal has been reached.

Senate leaders have indicated they might not be able to secure enough votes for the House’s proposals. Facing a threat of a veto from Gov. Tate Reeves, lawmakers would have to have a two-thirds vote in each chamber to override him.

The three senators and three House members tasked with reaching a compromise face an 8 p.m. deadline to agree on an initial Medicaid expansion plan, but that deadline could be suspended if two-thirds of the lawmakers in both chambers agree to the suspension.

The six negotiators could also agree to file a “dummy” bill, or a bill with no substantive plan, to meet the 8 p.m. deadline and continue to negotiate on a final plan.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.