House and Senate move closer to Medicaid expansion deal

Senate leaders have agreed to expand Medicaid coverage to people who earn up to 138 percent of the federal poverty level, or about $20,000 a year, as allowed by federal law.

The move by Senate leaders to cover those earning up to 138 percent of the federal poverty level is an important step toward finally reaching an agreement to adopt a Medicaid expansion program, as 40 other states have done to cover primarily the working poor.

The House passed a bill earlier this session to cover those earning up to 138 percent of the federal poverty level. The House bill is estimated to cover at least 200,000 Mississippians. The Senate, on the other hand, passed legislation to cover those who earn less than 100 percent of the federal poverty level, or about $15,000 a year. Senate leaders estimated their plan would have covered about 40,000 people.

During open negotiations earlier this week, House Medicaid Chair Missy McGee, R-Hattiesburg, urged her Senate colleagues to agree to expand Medicaid coverage that would result in reduced funding federal maximums.

On Friday, Lt. Gov. Delbert Hosemann, who presides over the Senate, announced that his leadership team agreed to cover those earning up to 138 percent of the federal poverty level.

Earlier this week, McGee offered a compromise in which those earning less than 100 percent of the federal poverty level would be covered through traditional Medicaid. But those earning between 100% and 138% would be covered through private insurance policies through the federal marketplace exchange.

But the cost of those policies would be paid for through state funds and federal Medicaid funds. The federal government pays 90 percent of the cost for those covered by the Medicaid expansion, which is estimated at about $1 billion annually for Mississippi. In addition, the federal government is offering incentives to expand Medicaid to the 10 states that have not. These incentives will provide an additional $700 million to Mississippi over a two-year period.

The original Senate plan would not have considered the ACA Medicaid expansion and would not have qualified for increased federal funding.

In a news release, Senate leaders said they would be willing to cover people earning up to 138 percent of the federal poverty level by using private insurance policies to cover those earning between 100 percent and 138 percent .

While the Senate’s willingness to provide Medicaid coverage to those up to 138 percent of the federal poverty level is an important step, there are still issues to be resolved as the session draws to a close before the expansion of Make Medicaid a reality in Mississippi.

Senate officials said they still insist the expansion plan include a strict work requirement and tracking system for those covered by the expansion. The Senate proposal would direct the state attorney general to file a lawsuit to try to overturn the federal governments’ expected denial of the work requirement.

A news release from Hosemann’s office said a work requirement is a non-negotiable. Under the Senate proposal, Medicaid would not be expanded until the work requirement is approved through federal Medicaid officials or the federal courts.

House leaders said they also want a work requirement and included one in the original House proposal. However, if the federal government denies it, as expected, the program would still go into effect, a pragmatic move, House leaders said.

In the press release, Hosemann added: We hope that a compromise is on the horizon. When people are healthy, they are working, raising their families and contributing to their communities. Access to health care is a critical component of economic and job development efforts in Mississippi and reforming health care is the right thing to do.

The labor requirement is an obstacle that must be solved. In addition, Gov. Tate Reeves has said he would veto any bill that would expand Medicaid. A two-thirds vote of both chambers would be needed to override a veto. The House is expected to easily muster more than two-thirds of the votes. But Reeves has been pushing senators hard against the expansion, and the vote there is less assured.

Under current law, Medicaid in Mississippi covers the disabled, poor children and poor pregnant women, some primary caregivers living in extreme poverty, and certain segments of the elderly population.

The Senate, when it delivered its compromise offer, also asked the House to reconsider its initial plan, which had passed the Senate by a two-thirds margin.

Senate leaders also called for the House to consider changes to the state’s original Medicaid program that the Senate had proposed earlier in the session. Those changes include making it easier for children with severe disabilities to receive Medicaid coverage and preserving changes made last year to the hospital tax that provides additional federal money to hospitals.

Mississippi Today reporter Taylor Vance contributed to this story.

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