Health Care

Work requirement clash spoils Medicaid expansion push in Miss.

Lt. Gov. Delbert Hosemann said an expansion plan would be a priority in 2025.
Mississippi House Medicaid Committee Chairwoman Rep. Missy McGee (R) at the state Capitol in Jackson, Miss., Tuesday, Feb 20, 2024. (AP Photo/Rogelio V. Solis)

A months-long push to expand Medicaid to up to 200,000 people in Mississippi ended Thursday when House and Senate leaders failed to come to an agreement on a final proposal before an end-of-session deadline.

“We did the very best we could to get it across the finish line, and I’m sad that it looks like we’re ending the session without something for the hardworking, low-income Mississippians,” House Medicaid Committee Chair Missy McGee (R) said.

Lt. Gov. Delbert Hosemann (R) said Thursday that an expansion plan would be a priority in 2025, when he predicted former President Donald Trump would be back in the White House and more likely to approve a work requirement that was a sticking point in the negotiations.

“In my mind, we’ve left 74,000 people, working, that could’ve had health care coverage in Mississippi,” Hosemann said, according to media reports. “We didn’t give them that.”

The House and Senate passed separate expansion plans with veto-proof majorities earlier this year, the closest the state has ever come to accepting federal money to increase the number of poor people who qualify for the government insurance program under the 2010 Affordable Care Act.

Both proposals included work requirements, which require special federal approval because they deviate from the requirements under traditional Medicaid rules. But the House bill included a provision that would allow the expansion plan to go into effect without the work requirement if the federal government didn’t sign off on it.

That was a non-starter for Senate leaders. House and Senate negotiators released a compromise plan Monday with a strict work requirement in place. But House Democrats, whose votes were needed to override a promised veto from Gov Tate Reeves (R), announced they would not support the new plan, unleashing a flurry of last-minute deliberations.

House Speaker Jason White (R) announced Wednesday that his chamber would advance a new proposal to ask voters through a ballot initiative whether they supported Medicaid expansion and if they wanted a work requirement. Senate leaders quickly shot down that idea.

They did not sign the House negotiators’ final proposal, which was hand-delivered Thursday morning, allowing the bill to die after an 8 pm deadline.