Mississippi lawmakers have embarked on negotiations for a potentially groundbreaking plan that aims to extend Medicaid coverage to a substantial number of residents in one of the poorest states in the United States. However, despite Republicans holding a majority in both the state House and Senate, it remains uncertain whether a consensus can be reached during the remaining days of their four-month legislative session, which is set to conclude in early May.
Mississippi is among the ten states that have not yet expanded Medicaid coverage to individuals employed in low-wage positions that do not offer private health insurance. The option for expansion emerged as part of a comprehensive federal overhaul initiated in 2010 under then-President Barack Obama.
Republican Governor Tate Reeves has consistently expressed his opposition to expanding government programs. Nonetheless, this year’s Mississippi legislative session has witnessed the first serious discussions on expansion, primarily due to the support of Republican House Speaker Jason White, who has made it one of his top priorities.
In late February, the House overwhelmingly approved a bipartisan measure to extend Medicaid coverage to approximately 200,000 individuals earning up to 138% of the federal poverty level, which equates to $20,120 annually for a single person. Mississippi’s population stands at roughly 3 million, with its Medicaid program serving 374,823 individuals as of March.
The Senate subsequently passed its own scaled-down version in late March, proposing eligibility for individuals earning up to 100% of the federal poverty level, which is slightly over $15,000 for one person. Senator Kevin Blackwell, a Republican from Southaven and Chairman of the Senate Medicaid Committee, estimated that around 80,000 people would qualify for coverage, but he anticipated only half of that number would enroll.
Republican Missy McGee, Chairwoman of the House Medicaid Committee, put forward a compromise proposal on Tuesday that would enable Mississippi to secure the maximum amount of federal funding available for Medicaid expansion. According to her plan, individuals earning up to 100% of the federal poverty level would be covered by Medicaid, while those earning between 100% and 138% of the poverty level would receive subsidies to purchase insurance through a federal health insurance exchange.
Senators did not present any new proposals during Tuesday’s meeting and did not immediately respond to the House’s compromise proposal. Blackwell emphasized the significance of the ongoing dialogue between the two chambers regarding expansion but cautioned against hasty action.
Blackwell stated, “In the House’s case, I believe you all want to jump in the sports car and zoom straight to expansion — damn the roadblocks and let’s get there.” He continued, “Those of us in the Senate prefer a more gradual approach to this matter.”
McGee countered, “I don’t believe we have been in a rush. We have been waiting for ten years. … It’s time to act for our low-income yet hardworking Mississippians.”
Traditionally, Mississippi legislators conduct negotiations on the final versions of bills in private. However, this year, they have agreed to hold open meetings specifically on the topic of Medicaid expansion. The meeting held on Tuesday was standing-room only, with some attendees arriving hours in advance.
