What’s in the House Republican Mississippi Medicaid expansion bill?

The House Republican leadership’s Medicaid expansion bill, House Bill 1725, was made public early Monday and assigned to the Medicaid Committee. 

The bill, authored by House Speaker Jason White, R-West, and Medicaid Chairwoman Missy McGee, R-Hattiesburg, is a mostly-traditional expansion bill – with the addition of a work requirement, as well as several other services aimed at enhancing workforce opportunities.

Those services include skills-building training and appointing a special case liaison to enrollees incarcerated in the last three years to help with finding housing, food, health care and workforce training.

The work requirement mandates Mississippians be employed for at least 20 hours a week to be covered by expansion – but it would be subject to approval by the federal government. The Biden administration has rescinded such waivers granted previously and rejected new requests for work requirements. 

If a work requirement is not approved by CMS before Sept. 30, 2024, Mississippi under the House plan would have the option to either pursue litigation – as Georgia has done – or adopt traditional Medicaid expansion without a work requirement. 

Regardless of whether or not the federal government approves the waiver, this bill would mandate a $10 copayment for nonemergency use of the emergency room.

The bill would increase eligibility to those making up to 138% of the federal poverty level, and would not include a private-care option.

Earlier this year, House Democrats introduced an expansion plan including a private-care option that would allow Mississippians who make up to twice the federal poverty level to qualify for Medicaid. Some conservatives who are open to expansion have said in the past they would favor such a private insurance option, and Democrats hoped that by including this expansion would gain more traction this session.  

Including a private care option, first modeled in Arkansas’ version of expansion, is generally considered a more pragmatic approach because more people are paying into the system and utilizing private insurance when possible. 

Many Capitol observers expected Republicans to come back with a proposal even more austere than the Democrats’ bill. But the GOP leadership’s bill, with the exception of a work requirement – which likely will not be approved – is more of a traditional expansion bill. 

Senate Bill 2735, authored by Kevin Blackwell, R-Southaven, is the third major expansion bill this session. The bill is structured so as to only bring forth the necessary code sections for expansion – with details to be hammered out through the legislative session. 

According to Lt. Gov. Delbert Hosemann, the Senate expansion bill will contain a work requirement and a private premiums plan.