Mississippi Republican Leaders Open to Medicaid Expansion With Work Requirement
JACKSON, Miss. — Republican leaders in Mississippi are now considering expanding Medicaid, but with a work requirement for new enrollees. This change in policy, following years of refusal to expand Medicaid, could potentially be influenced by presidential politics and an ongoing legal battle in Georgia.
Working Towards Improving Labor Force Participation and Health Outcomes
Lt. Gov. Delbert Hosemann stated that Mississippi must explore all options to improve its labor force participation rate and address poor health outcomes, both of which are among the worst in the country. He pointed to Georgia’s successful implementation of a work requirement for Medicaid recipients as a potential model for Mississippi.
Mississippi and Georgia are two of the ten states that have not expanded Medicaid eligibility to include individuals earning up to 138% of the federal poverty level. Georgia introduced a program in 2023 that extended coverage to adults earning up to 100% of the poverty level. However, this expanded coverage in Georgia is only available to able-bodied adults who are working, volunteering, studying, or in vocational rehabilitation.
Revoking of Work Requirement Waivers
The work requirement waivers that were permitted by the Trump administration in 13 states were revoked by the Biden administration in 2021 due to the COVID-19 pandemic. The Centers for Medicare and Medicaid Services emphasized the importance of ensuring access to healthcare without unnecessary obstacles. Although Georgia’s work requirement plan was preserved in a federal court battle in 2022, it is set to expire in September 2025.
Considerations by Other States
The discussion around work requirements for Medicaid eligibility is not limited to Mississippi and Georgia. The South Dakota Senate has also passed a bill that would link a work requirement to Medicaid eligibility, awaiting a House hearing. However, the enactment of these requirements could face legal challenges, including any new Medicaid waivers granted under the new presidential administration.
Steadfast Opposition and Potential Overrides
Opposition to Medicaid expansion has been persistent in Mississippi, with Republican leaders, including Gov. Tate Reeves, strongly against it. Gov. Reeves maintains his opposition, invoking former President Donald Trump’s animosity towards the Affordable Care Act (ACA). Meanwhile, Mississippi lawmakers are now weighing the financial incentives provided by the American Rescue Plan for Medicaid expansion, with the potential to fund the program for approximately four years.
Unique Medicaid Programs
Although expanding Medicaid would potentially bring economic benefits to Mississippi, tracking the outcomes of each state’s unique Medicaid program’s expansion is necessary. Each state has its own distinctive program with its own set of challenges, and the same approach may not yield identical results in all states.
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