In a shift from their previous stance, a number of Republican leaders in Mississippi are now considering the possibility of expanding Medicaid. However, they are willing to explore this option only if it includes a requirement for new enrollees to be employed. The viability of this approach may depend on various factors, including the upcoming presidential election and an ongoing legal dispute in Georgia.
Lt. Gov. Delbert Hosemann emphasized the pressing need for Mississippi to address its low labor force participation rate and concerning health outcomes. These issues, which rank among the worst in the nation, require careful consideration and exploration of all potential solutions. Hosemann pointed to Georgia as an example, being the sole state that mandates Medicaid recipients to fulfill a work requirement. This approach could serve as a possible model for Mississippi to adopt and adapt.
According to Hosemann, having healthy working individuals in Mississippi is crucial. He believes that Georgia’s accomplishment in enforcing work requirements has paved the way for a similar discussion in Mississippi.
Georgia and Mississippi are two of the ten states that have not yet expanded Medicaid eligibility to cover individuals who earn up to 138% of the federal poverty level, equivalent to an annual income of $20,120 for a single person. However, in 2023, Georgia introduced a program that provides expanded coverage to adults who earn up to 100% of the poverty level, which amounts to $14,580 for a single person.
Georgia’s program provides expanded coverage to able-bodied adults only if they actively participate in activities such as working, volunteering, studying, or engaging in vocational rehabilitation. This plan was developed by the state of Georgia following the Trump administration’s approval of work requirements for certain Medicaid recipients in 13 states.
The Biden administration, in 2021, rescinded all of those waivers, citing the COVID-19 pandemic as one of the reasons. The Centers for Medicare and Medicaid Services emphasized the importance of ensuring that individuals are not hindered from accessing healthcare services. However, Republican Governor Brian Kemp’s administration successfully defended Georgia’s plan in federal court in 2022. It was argued that the plan only applies to new enrollees and does not affect current Medicaid recipients.
The program’s expiration date is scheduled for the end of September 2025. In an attempt to extend its duration until 2028, Georgia filed a lawsuit against the Biden administration earlier this month.
The South Dakota Senate has passed a bill that links Medicaid eligibility to a work requirement. Currently, the bill is awaiting a House hearing.
According to Robin Rudowitz, director of the Program on Medicaid and the Uninsured at KFF, a health policy research group, there is a possibility of legal challenges for the newly granted Medicaid waivers by CMS, even if a Republican candidate wins the presidential election in November.
According to Rudowitz, former President Donald Trump may have supported work requirements, but he also expressed his intention to repeal and replace the Affordable Care Act, which would involve eliminating Medicaid expansion.
According to Rudowitz, Georgia’s limited Medicaid expansion, which includes a work requirement waiver, has resulted in low enrollment numbers. The state could potentially achieve higher coverage levels if it adopted the full expansion allowed under the ACA. However, Rudowitz explains that the majority of Medicaid recipients are either employed or face obstacles to work, which hinders their ability to enroll in the program.
Georgia’s Republican House speaker, Jon Burns, hinted earlier this year that Republicans might be willing to consider further expansion of Medicaid. However, GOP lawmakers made it clear on Tuesday that this idea is unlikely to be pursued in 2024.
In an interview, Mississippi House Speaker Jason White, a Republican, emphasized that the state’s stance on Medicaid expansion remains firm – it will not consider expanding the program without implementing a work requirement.
According to White, he believes that they have successfully demonstrated their unwillingness to comply with CMS and the authorities in Washington. As a result, he suggests that they may now be more inclined to consider an alternative approach.
Debate surrounding Medicaid expansion in Mississippi has been at a standstill for years due to opposition from Republican leaders, including Governor Tate Reeves. In a recent statement, Reeves reiterated his opposition to expansion and expressed his disapproval of Obamacare, aligning himself with President Trump’s views.
Lawmakers’ decision to expand Medicaid could face a potential hurdle if Governor Reeves exercises his veto power. However, there is a possibility for legislators to override his veto with a two-thirds majority vote from both the House and Senate.
Lawmakers in Mississippi are also evaluating the potential effects of a financial incentive offered by Congress in the American Rescue Plan to expand Medicaid. The success of Medicaid expansion in North Carolina was aided by this bonus. During a legislative hearing on Tuesday, Missy McGee, the Chairwoman of the House Medicaid Committee and a Republican, highlighted that the incentive would cover the program’s costs for approximately four years in Mississippi, even without factoring in other cost offsets such as increased tax revenues.
Morgan Henderson, a data scientist at Hilltop Institute, a health care research organization, believes that the expansion of healthcare in Mississippi would bring significant economic benefits. However, it is important to note that each state has its own unique program in place.
According to Henderson, each state’s Medicaid program is unique and cannot be generalized.
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