Medicaid Expansion – Mississippi
Medicaid expansion was one of the components of the Affordable Care Act passed by Congress during the Obama Administration. It covers parents and single adults with incomes less than 133% of the federal poverty level — $15,000 for 1 person, $31,000 for a family of four. Basically, it’s the working poor.
Florida and other states challenged the ACA’s requirements that states expand their Medicaid programs to cover the working poor. The Supreme Court in a narrow decision upheld the ACA, but interpreted the Medicaid expansion as voluntary with each state. https://www.kff.org/wp-content/uploads/2013/01/8347.pdf and https://www.kff.org/affordable-care-act/issue-brief/a-guide-to-the-supreme-courts-decision/
Ten states have not yet enacted the Medicaid expansion; they include Mississippi, Alabama, Georgia, South Carolina, Florida, Texas, Kansas, Wyoming, and Tennessee. https://www.kff.org/affordable-care-act/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/#:~:text=Coverage%20under%20the%20Medicaid%20expansion,%2C%20Virginia%20(1%2F1%2F Wisconsin has a long-standing waiver from the federal government which covers this population.
The federal match for coverage is 90/10 – i.e. the federal government pays 90% of the cost of covering this group. Under President Biden, states also get an additional bump in the federal match on their existing Medicaid program for two years if they extend coverage. It is a huge financial incentive for states to cover their uninsured. https://www.kff.org/medicaid/issue-brief/how-many-uninsured-are-in-the-coverage-gap-and-how-many-could-be-eligible-if-all-states-adopted-the-medicaid-expansion/ North Carolina and South Dakota are the most recent states adopting and implementing the expansion.
Mississippi is the poorest state in the nation, and it has one of the highest rates of uninsured in the nation. https://mississippitoday.org/2023/10/02/mississippi-people-without-insurance/#:~:text=“Mississippi%27s%20uninsured%20rate%2C%20though%20often,64%20was%2016.4%25%20in%202022. Its lack of coverage for the uninsured hurts its hospitals, its doctors, its small businesses, and its larger employers. Many of the states essential rural hospitals are in danger of closing. https://mississippitoday.org/2023/03/21/mississippi-rural-hospitals/#:~:text=A%20report%20from%20the%20Center,other%20states%20with%20worse%20prognoses. Mississippi ranks poorly on many indicators from health to education, from infrastructure to its economy. https://www.usnews.com/news/best-states/mississippi The expansion is just what the state’s citizens need to get better and more affordable access to health care and spur its economic growth.
The Mississippi House of Representatives has overwhelmingly (98-20) approved Medicaid expansion. https://mississippitoday.org/2024/02/28/mississippi-medicaid-expansion-house-legislature-passes-work-requirement/ The Mississippi Senate is considering linking Medicaid expansion to a work requirement. https://www.clarionledger.com/story/news/politics/2024/03/10/ms-senator-would-sue-federal-government-for-more-conservative-medicaid-program/72863955007/# Recent polling of likely Republican primary voters in Mississippi found that 55% supported expansion and 1/3rd opposed it. https://www.youtube.com/watch?v=i7SCzomYoDs
The state’s Republican Governor, Tate Reeves, is opposed to expansion, but business leaders, voters, and Republican legislative leaders, including the state’s Lieutenant Governor are pushing ahead. https://mississippitoday.org/2024/02/26/tate-reeves-fight-against-medicaid-expansion/
It has been a long and lonely fight for Southern GOP lawmakers to convince their colleagues to expand Medicaid. https://www.npr.org/2024/02/21/1232827248/some-gop-lawmakers-in-the-south-may-be-open-to-expanding-medicaid-coverage#:~:text=A%20decade%20after%20the%20Affordable,open%20to%20expanding%20Medicaid%20coverage. But there is increasing openness to expansion as a new generation of GOP legislative leaders takes over the reins of power in the South. https://www.politico.com/news/2024/01/31/southern-republicans-obamacare-00138109 One Southern leader put it succinctly; we need workers, we need healthy workers for our employers, and we are in competition for scarce workers and expanding businesses with other states like North Carolina where working people can get this health coverage.