Mississippi’s House Republicans unveiled a Medicaid expansion proposal on February 26th, 2024, sparking renewed debate over healthcare access in the state. House Bill 1725, authored by House Speaker Jason White and Chairwoman Missy McGee, represents the first significant Republican-backed expansion plan in Mississippi, which remains one of the 12 states yet to expand Medicaid under the Affordable Care Act (ACA).
The bill presents a mostly traditional expansion, extending coverage to individuals earning up to 138% of the federal poverty level. However, this Medicaid expansion comes with a notable caveat that applicants might take into consideration.
Who Qualifies for the New Expanded Medicaid Coverage
Remember how we just mentioned an important thing to considerate? Well, that’s a work requirement included in the Medicaid expansion bill: a work requirement that mandates enrollees work or participate in approved activities for at least 20 hours per week.
This requirement, however, faces a significant hurdle: federal approval. The current Biden administration has rejected similar proposals and rescinded work requirement waivers previously granted by the Trump administration.
Recognizing this potential roadblock, the bill offers an alternative path if the work requirement isn’t approved by September 30th, 2024. In such a scenario, the state could either pursue legal action, as Georgia has done, or adopt traditional expansion without the work requirement.
New Medicaid Enrollees Have to Follow This Rules
Additionally, the House bill introduces a $10 copayment for non-emergency use of the emergency room, regardless of the work requirement or federal approval. This provision aims to encourage responsible healthcare utilization by promoting cost-sharing.
Interestingly, the bill doesn’t include a private-care option unlike the proposal put forward by House Democrats earlier this year. The Democratic plan offered a pathway for individuals earning up to twice the federal poverty level to gain coverage through private insurance options, a model favored by some conservatives open to expansion. Including a private option is generally viewed as a pragmatic approach, as it draws more individuals into the system and utilizes private insurance when applicable.
With two other expansion bills already introduced in the legislature, one solely focused on legislative framework and another proposed by Senate Republicans with a work requirement and a private option, Mississippi finds itself at a critical juncture in its healthcare access debate.
The Affordable Care Act (ACA) does not directly mandate states to expand Medicaid. It incentivizes states to expand Medicaid with enhanced federal funding for newly eligible individuals.
The ACA originally intended for expansion to be mandatory nationwide, but a Supreme Court ruling allowed states to choose whether or not to participate. Currently, some states have expanded Medicaid while others have not, creating a difference in healthcare coverage across the country.