Sunday, March 3, 2024

Bill Crawford: Medicaid Expansion Only One of Major Bills Facing Legislature

All eyes turn now to the Mississippi Senate to see if senators will approve Medicaid expansion. Rep. Missy McGee of Hattiesburg guided the House version to approval by an overwhelming, veto-proof, 98 to 20 vote last week. What a remarkable turnaround from House actions in previous years!

The bill seeks to provide Medicaid coverage for working adults age 19 to 65 without employer coverage with incomes up to 138% of the poverty level. The complex but narrowly written bill would require the Division of Medicaid to apply for a federal waiver to allow these limitations. However, should the application fail, coverage would still take effect. An automatic repealer would allow expansion to be killed in January 2029.

Working adults with coverage from employers would not be eligible for a year. Full-time students in the earnings window enrolled in post-secondary schools or workforce training programs would be eligible. A four percent tax would be levied on capitated revenues received by entities providing Medicaid coverage. Should federal matching funds drop below 90%, the program would be cancelled.

The Senate has not adopted its own version of the bill, so may work on the House’s version.

Other major legislation pending in both houses deserves attention too.

A bill pending in the Senate would create a powerful Delta Rural Health Authority. Promoted by the Delta Council, the authority would be a public entity that could take over and manage community hospitals and other health care organizations in the Delta. Promoters are also asking for $5 to $10 million in state funds to get the authority started. The bill would allow other regions to create similar authorities.

A Senate committee has passed a bill that pretends to “restore” the initiative process in Mississippi. The House passed a similar version earlier. Both bills limit initiatives to statutes while the old one addressed the state constitution. Proponents say we should be worried about out-of-state interference. Opponents say both bills are so restrictive as to be unworkable. Others wonder why legislators will not restore citizens’ constitutional right to change their constitution.

Another Senate committee has passed a bill that tweaks and fully funds the Mississippi Adequate Education Program. The bill is similar to one the Senate passed last year that died in the House. The House is looking to dump the education expert designed MAEP formula and replace it with a funding formula of its own design.

Alas, MUW dropped its substitute legislative request for a new name. Wynbridge State University of Mississippi did not catch on any better than Mississippi Brightwell University submitted in January.

“Don’t be fools; be wise: make the most of every opportunity you have for doing good,” - Ephesians 5:16.

Crawford is a syndicated columnist from Jackson.

16 comments:

Anonymous said...

"Working adults with coverage from employers would not be eligible for a year."

I'm not clear on that clause. Does it mean:

A) After retaining employer coverage for a year after passage the employee could then switch to Medicaid.

or

B) After passage, the employee covered by an employer's plan would have to drop out of that plan and have NO coverage for 12 months after which he could join the Medicaid plan.

Additionally, I don't understand the reasoning/purpose behind either. And which division of what agency is going to police which employers offer coverage and who is covered under those plans?

To be quite frank, I have personally experienced working with, through and around a number of the Medicaid employees at the 55 north frontage office and I do not believe them competent to administer such detail.

We might well be proceeding blindly into a quagmire of unintended consequences (as the legislature, after signature, steps gleefully away from it all).

Anonymous said...



Medicaid oxymoron—- “working adults”

Anonymous said...

10:55 - I'm a working adult. Aren't you?

Anonymous said...

What it means @9:56 is after you look past all the psuedo-accountability feel-goods in the House bill, in the end the House effort is nothing short of a full blown capitulation to expand Medicaid without any actual hurdles and insure the future fiscal year budget busting that will produce.

The Republicans voting for this bill are all Blue Dogs now.

Anonymous said...

"An automatic repealer would allow expansion to be killed in January 2029."

"Should federal matching funds drop below 90%, the program would be cancelled."

Nonsense - Once you start an entitlement program, it never goes away regardless of the circumstances.

Anonymous said...

“The bill seeks to provide coverage for the working poor…”

Is Bill misinformed? Is he just lying? Or is he getting paid by his hospital to say this?

The bill seeks to provide coverage for 300-400,000 able-bodied adults in Mississippi - of which 1 in 10 or less are actually working without access to health insurance!

And the “work requirement” expires on September 30 when Joe Biden says “No.”

You can always tell how bad a policy is because of the flat-out lies being told by the proponents!

Anonymous said...

"An automatic repealer would allow expansion to be killed in January 2029."

"Should federal matching funds drop below 90%, the program would be cancelled."

“The closest thing to eternal life on earth is a Government Program.”
— Ronald Reagan

Saltwaterpappy said...

Maybe we should name the W to Welty College or University. That is a name most folks will support. That way, people could continue to refer to it as the W if they want to do so.

Anonymous said...

The Republicans can talk all they want about how it's the "moral" thing to do....they're trying to save the hospitals, not the people, with this bill. The ACA changed the reimbursement rate and that is why all the hospitals are shutting down. This bill is an attempt to access those funds, not get people health insurance. oh, by the way, what about the people below 100% of federal poverty level??? Wasn't that the whole purpose of MEDICAID expansion under the ACA?

Anonymous said...

Crawford, you spent one term in the MS House - you should know better than thinking this vote is a veto-proof margin. Yes, I realize you are doing the same thing your buddies at Mississippi Today are doing in trying to trot out that dog and making people think its a horse.

This was the first vote in the House on this bill; once the Senate gets through with its version and it comes back to the House, it will end up going to a conference - where its anybody's guess as to what the final piece of legislation will look like.

This vote was one managed by the leadership; members were 'pushed' into voting for it so that it could move along the trail. They had to go along in order that 'their' pieces of pet legislation won't get killed in committee.

Once the bill comes out in the end, it may still pass, and even then by more than the 2/3 required to override a veto; but much closer. Then if Tate vetoes it, the final vote will be the tell. Many of these members are trying to get a pass on this vote but next January when its out front and will matter we will see what those members actually think about the idea - the so-called 'work' requirement will have proven to be a sham both because the Biden administration will not approve Mississippi's just as it hasn't approved of any others during this term the past four year.

Veto-proof margin at this stage of the game is a joke; you know it but since your favorite piece of welfare (along with every democratic candidate this last election and the two prior ones) made it past this stage you are dancing a jig in enjoyment. Take a pill and lets see if they really want to put more Mississippians on welfare.

Anonymous said...

Republicans aren’t restoring your constitutional right to change the constitution by ballot initiative because they know abortion would be passed and enshrined in the MS constitution. Doesn’t matter, the party is dying because of it so let them keep it for a little while longer.

Anonymous said...

How many states restrict this benefit to "working adults."

Won't we be the first?

Anonymous said...

11:19 - No we won't be the first since the work requirement will fly about as far as a penguin can.

Anonymous said...

"...oh, by the way, what about the people below 100% of federal poverty level?"

I'm trying to figure out how one can be 'below 100% of poverty level'. The poverty level is a figure chosen by government experts. If you don't make more than that figure, you're one of the poors and you are mired in poverty.

Red Neck said...

Randy Newman said if best in his song "Rednecks".

Anonymous said...

Response to commenter at 9:06am on March 4:

You couldn't figure out how anyone could be below 100% of poverty level.

This is how. Anybody earning less than $1000-ish a month could qualify. The numbers come from the Federal Government.

100% of Federal Poverty Level for a single person in 2023 was $14.580.
This was an increase from the same category in 2022 of $13,590.

The ACA was originally crafted, and indeed implemented in some states, to cover the people who made less than these amounts. Mississippi is pretending they don't exist, when they are the neediest of us all.


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