MS Legislature beats deadline by minutes, set to vote on Medicaid expansion

With only minutes to spare, a group of Mississippi lawmakers came to a final compromise on a version of Medicaid expansion Monday that is now heading to both the Senate and House of Representatives for a vote.

Before the bill was filed into the Legislature's website, House and Senate Medicaid Committee Chairs Missy McGee, R-Hattiesburg, and Kevin Blackwell, R-Southaven, both declined to comment on the deal made just barely before a legislative deadline to file conference reports.

"We will talk tomorrow," McGee said. McGee also did not answer calls or messages made after the bill was made available to the public.

If passed by both legislative chambers, the bill would expand Medicaid for those aged 19 to 64 working 100 hours per month making up to 99% the federal poverty line, or about $15,000 per year for one person. Those making between 100-138% FPL would be covered under the Federal Insurance Exchange, which offers private insurance options, and the state of Mississippi would cover the bills on copays, deductibles and premiums.

Those additional funds to fund the exchange users would come from a $600 million per year federal incentive to expand Medicaid for two years. The federal government would also pay 90% of the cost to operate the state's Medicaid program, leaving lawmakers to pay for 10%.

The bill mirrors a provision of the original Senate Medicaid bill by including exceptions for full time students and people in a workforce training programs, parents and caregivers for children 6 years old or younger, and those with proven physical or mental disabilities preventing them from working.

While the bill represents yet another large step for Mississippi toward Medicaid expansion, it will likely still need a veto proof two-thirds majority in both chambers to survive the legislative process. Republican Gov. Tate Reeves has said publicly he is opposed to any attempts to expand Medicaid in Mississippi.

Even if either passed by Reeve's desk or via a two-thirds veto proof vote, the federal government is highly unlikely to approve of the plan because of the 100 hours per month work requirement.

Under the Donald Trump Administration that ran 2017 through 2020, the Centers for Medicare and Medicaid Services approved several states that expanded Medicaid with work requirement waivers, which are special exceptions since the Affordable Care Act does not strictly allow for it.

When Joseph Biden entered office in 2021, those waivers were rescinded, and future waivers were denied. Senate leadership previously told the Clarion Ledger that their approach to Medicaid expansion lies nearly entirely on the uncertain victory of Trump in this year's presidential election.

To address that specific hurdle, the bill now includes language designating the Mississippi Division of Medicaid to reapply for the work requirement waiver every year until CMS approves.

Previously, the Senate introduced a proposal for the state attorney general to challenge the decision in court, and the House's version would have simply expanded Medicaid without a work requirement if it wasn't approved by CMS.

Neither House Speaker Jason White, R-West, nor Lt. Gov. Delbert Hosemann were available for comment after the bill was made available to the public Monday night.

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

This article originally appeared on Mississippi Clarion Ledger: MS Legislature beats deadline by minutes, set to vote on Medicaid expansion