The 2024 regular session of the Mississippi Legislature ended with a failure to reach consensus between Senate and House conferees on an effort to expand the state’s Medicaid program. That after Senate and House leaders engaged in a good faith debate of Medicaid expansion for the first time since former President Barack Obama’s administration implemented the program.
In 2010, the Patient Protection and Affordable Care Act or “Obamacare” was enacted by Congress – then the biggest public policy overhaul and coverage expansion of public healthcare since the 1965 enactment of the Medicare and Medicaid programs. Today, Mississippi remains one of 10 states that has not adopted some form of Medicaid expansion to draw down additional federal funds to pay for health care for the working poor. The 10 states include Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming. The failed 2024 Mississippi Medicaid expansion effort would have expanded Medicaid coverage to about 200,000 people who earned up to 138% of the federal poverty level, or $20,120 annually for one person. Facing deadlines in the waning hours of the 2024 session, legislative conferees simply could not achieve a compromise on the question of applying a work requirement to Mississippi’s proposed Medicaid expansion plan. During the first administration of President Donald Trump, the federal government authorized work requirements for Medicaid expansion – and in doing so offered red states like Mississippi that had resisted Medicaid expansion a politically palatable means to do so. The work requirements also served as a natural limit to the costs of the program.
When current President Joe Biden was elected, his administration rejected the work requirement changes Trump had put in place and Republican state lawmakers in non-expansion states again faced roadblocks in trying to implement Medicaid changes. The 2024 efforts to expand Medicaid coverage to cover the working poor was ultimately logjammed on that reality. The working poor are those fellow Mississippians with jobs who don’t make enough money to afford health insurance. All of us who pay federal taxes in Mississippi are already paying for expanded Medicaid in 40 other states and providing healthcare opportunities for the citizens of those states. But not here, not for our own people. The Legislature in 2024 saw and heard an effective demonstration of the depth and breadth of public support for an expanded Medicaid program that provides a path to health care for working Mississippians. House Speaker Jason White and Lt. Gov. Delbert Hosemann shared the desire to expand Medicaid to take care of Mississippians who were already members of the workforce but who didn’t make enough money to afford insurance coverage. There was broad-based taxpayer support for some form of work requirement in that expanded program. Both Hosemann and White have in recent months reiterated their desire to expand Medicaid for the working poor in Mississippi. With Trump winning the presidential election and the GOP taking control of both the Senate and the House on Capitol Hill, the incoming Trump administration has several options that could impact Medicaid expansion efforts in Mississippi and across the nation. First, the new Trump administration could restore the work requirements for Medicaid that were in place during his first term. With a solid GOP majority in the Mississippi Legislature, which would clear the expansion logjam from the 2024 session. That seems a likely outcome, but certainly not a sure thing. Second, the Trump administration could decide to launch an effort to dismantle the ACA altogether and replace it with the “something better” that Trump referenced but failed to provide details of in his presidential debate with Vice President Kamala Harris. That outcome is less likely but not without the bounds of possibility. Finally, Trump and the GOP congressional majority could allow the Biden-era ACA subsidies to expire as scheduled in 2025, implement general Medicaid budget cuts during budget reconciliation (including marketing and outreach funds) and place additional restrictions on Medicaid eligibility. Those actions would reduce the Medicaid rolls. Regardless the paths the second Trump administration chooses Mississippi’s Medicaid expansion leaders in Jackson will pay close attention to what Congress and the White House are saying and doing about Medicaid expansion in Washington. Sid Salter is a syndicated columnist. Contact him at sidsalter@sidsalter.com.
23 comments:
I suspect Sid wrote this before Dr. Oz got appointed. The plan supported by Dr. Oz is to get rid of Medicaid and Medicare funding. Instead he wants medicine completely privatized and given to Medicare Advantage which is promoted by Trump and part of Project 2025. The plan will increase your costs and reduce coverage as well as creating more paperwork. He promoted a Covid vaccine alternative that was shown not to be effective. You will discover that bad things happen to civilizations when professions become businesses.
MS does not need Medicare nor Medicaid expansion. We need less government, not more.
Received it Sunday
Legislative folks need to couple medicaid expansion with elimination of the certificate of need program. In fact, the Trump admin should encourage states to eliminate certificate of need programs in any way possible. We need to encourage more supply of medical providers not restrict them...
Trump and the Republican Party publicly committed ahead of the election not to cut Social Security or Medicare if Trump won the White House, with the GOP’s platform stating the party will “fight for and protect Social Security and Medicare with no cuts, including no changes to the retirement age.”
Remember, this is the same "columnist" who said Wicker is an expert.
Fake news above from a disgruntled leftie. DJT is not cutting Medicare.
@8:36 we have enough bed capacity to serve MS, just not enough docs, nurses and staff to run them. That has nothing to do with certificate of need. I don't think full abolition will be a good thing, it would create a lot of wasteful and predatory investment from out of state hucksters. However, thoughtful modernization of the CON law will be helpful to promote healthy competition.
@9:18 maybe, maybe not. The fact remains that Medicare is heading for a fiscal cliff - the average beneficiary draws out like 10x more per year than they ever paid in and that's going to continue to grow as now Gen X is aging into Medicare. Complete privatization is a whole other can of worms in terms of getting care denied all the time, not being in network with your doc etc. but it at least keeps the system from bankruptcy
Not only is Trump not cutting Medicare, he will stop taxes on Soc Sec.
Why pay any attention to a work requirement put in place by the Trump administration when the next administration might remove it? Why be bedazzled by the federal money the State would get by expanding when that inducement is temporary, meaning that at some point the State would bear the full cost? Why expand these social programs when their costs are always underestimated and will keep rising as time goes on? After these people in government establish these programs and expand them, there is no politically viable way to end or limit them
People do not realize that when Medicare started more than 50% of workers died before they turned 65years old, so they never received one penny in Medicare payments. This kept the system solvent much longer than anticipated. Eventually improvements in lifestyle, and medications led to a greatly expanded life expectancy which Medicare covered, and improvements in medicine led to greatly expanded costs for the beneficiaries that were not anticipated when the budget estimates were originally made.
@9:38 - anyone that wants to take the risk and invest money in the state to provide health care services should be welcomed. The more supply of service providers = the more choices for patients = higher quality services at lower prices
@11:36 if only. Pricing in for healthcare services in no way work as a free market. What we typically see in non CON states is higher unnecessary utilization that lines investor pockets without passing along any savings to the consumer
9:14 for the win. Deporting 15M will take a lot of pressure off of health services nationwide.
I can’t ever tell if Sid is just a moron or last to know. I think he just pulls stuff out of his ass, throws it against the wall to see if it sticks. The Trump campaign called the Gov. office early this year and asked them to pass a meaaage to the legislature. Anyone supporting Medicaid expansion would get a primary opponent back by DJT. This was relayed to both chambers GOP caucuses. Poor Sid. He so wants to be relevant.
What we typically see in non CON states is higher unnecessary utilization that lines investor pockets without passing along any savings to the consumer
Link? Provide an example.
New Medicaid director won't go for it. Last one didn't either.
Why should my tax dollars pay for feee health care for others and I have to pay for my own insurance. I don’t have any issues with Medicare because all citizens can get Medicare at 65 and elderly people do pay for it. Medicaid is something I can never qualify for. It isn’t my responsibility to bay others health care
Federal money isn’t free money because it comes from some qhere
Biology, Chemistry, Anatomy, Pharmacogy and Medicine are very difficult disciplines to master in college and Medical/Nursing school. Let us reward them adequately for their contributions.
@3:29 PM It comes in the form of loans from European banking families via the Federal Reserve (they own) who then print the bank notes and sell them to our drunken spending government. The loans can never be repaid but collecting the interest (for however long the indebted nation survives) is very lucrative. Whatever cream the elected officials and federal employees can skim off the top is bonus!
Last one is now the new Exec. Dir. of The Mississippi Hospital Association. What does that tell you?
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