After House and Senate lawmakers compromised on several points in the Medicaid expansion bill, there is still one major hurdle to clear: the need for a work requirement.
Any bill that contains the expansion to pass a work requirement will likely be null and void, due to federal regulations that have prohibited work requirements.
The House and Senate compromised last week on a major point of contention between the two chambers, income eligibility: The Senate agreed to cover people making up to 138 percent of the federal poverty level, about $20,000 for one person, and the House agreed to have those making more than 99% of the federal poverty level enrolled in subsidized private insurance instead of direct Medicaid, which would be made affordable by state Medicaid funds.
They are still far away in the details of a job requirement. On Monday afternoon, the House proposed a counteroffer to the Senate’s strict work requirement, one in which Medicaid would be expanded either way, but Mississippi would have to reapply for the work requirement each year and would have to immediately adopt a work requirement. if the federal government ever changed its policy.
READ MORE: House and Senate Leaders Trade Medicaid Expansion Proposals As Monday Night Deadline Approaches
Here’s a breakdown of the various expansion plans proposed this session to provide health insurance to low-income, mostly working-class people in the nation’s poorest and unhealthiest state.
Original House bill, February 28
House Bill 1725, authored by Speaker Jason White and Medicaid Chair Missy McGee, R-Hattiesburg, was originally written as a mostly traditional expansion bill, similar to the programs that have adopted most of the other states. I would:
- they cover eligible adults with incomes up to 138% of the federal poverty level, about $20,000 for an individual.
- include a work requirement that would be removed if not approved by the federal government.
- cuts $1 billion in federal dollars by increasing the federal matching rate.
- qualify Mississippi for a two-year, $650 million bonus offered to newly expanded states that would make the program free for the state for a total of four years.
It overwhelmingly passed the House 98-20 in late February.
Original Senate proposal, March 28
In late March, the Senate Medicaid Committee passed House Bill 1725 with a blanket strike and replaced the bills’ original language with its own language, which Medicaid Chairman Kevin Blackwell, R-Southaven , referred to as light expansion.
The plan proposes:
- which covers Mississippi workers who make up to 99 percent of the federal poverty level, about $15,060 a year for an individual.
- leaving out those who make between 100% and 138% of the federal poverty level, and as a result, the federal $1 billion would be reduced.
- requiring quarterly proof of employment, leaving experts concerned that the plan would be administratively burdensome and costly, as well as confusing for enrollees. That’s if the federal government approved the necessary waiver for the work requirement, an unlikely scenario under the Biden administration, which has rescinded those waivers previously granted under the Trump administration and has not approved new ones .
This austere version of the expansion passed the full Senate in late March with a veto-proof majority, an important detail since Gov. Tate Reeves has indicated he will veto any expansion bill that reaches his door
The House’s response to the total strike of the Senate, on April 3
The House invited the Senate to a conference call in early April to iron out the details of House Bill 1725.
House leadership countered the Senate’s austere version of the expansion with a compromise: a hybrid model that would cover those making up to 138 percent of the federal poverty level, but put those making between 100 percent and 138% on private health insurance policies through the federal. exchange
The cost of these policies would be subsidized through federal-state Medicaid funds.
Answer of the Senate to the compromise of the House, April 26
Senate lawmakers sent the House a plan with a hybrid model, similar to what the House introduced, but kept a firm stance on a work requirement, though they scaled back the annual quarterly employment verification.
The following Sunday, Senate congressmen retracted the requirement in their initial proposal that Mississippi sue the federal government if the Centers for Medicaid and Medicare Services did not approve the work requirement waiver.
House Democrats reportedly said they would not vote on any measure with the latter provision.
If the federal government initially rejected the work exemption, the new Senate proposal would require the state to appeal to the agency again if another state later gets a similar program approved.
The last offer of the House, April 29
House lawmakers on Monday countered the Senate’s strict work requirement plan with a plan that would expand Medicaid with or without the work requirement, but would require the state to apply for a waiver initially and continue to do so once in the year. It would also include an “active law,” similar to North Carolina’s, that would mandate that if the federal government ever changed its policy to allow states to implement a work requirement, Mississippi would move to implement one immediately.
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