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House panel holds hearing on previously taboo topic: benefits of Mississippi Medicaid expansion

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House panel holds hearing on previously taboo topic: benefits of Mississippi Medicaid expansion

Feb 20, 2024 | 8:36 pm ET
By Sophia Paffenroth
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House panel holds hearing on previously taboo topic: benefits of Mississippi Medicaid expansion
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Photo courtesy of Mississippi Today

Experts told a panel of lawmakers Tuesday that expanding Mississippi Medicaid would bring a large influx of federal dollars — costing the state nothing for the first two years and little in the years after.

In providing health coverage to poor, working uninsured Mississippians, it would also boost the economy, generate thousands of jobs and help struggling hospitals.

It’s nothing that experts, health providers and economists haven’t been saying for years — but it’s the first time in recent years House Republicans have offered them a platform to speak.

The House Medicaid Committee heard from speakers from the Hilltop Institute, a nonpartisan research group that partnered with the Center for Mississippi Health Policy on several Medicaid economics reports. 

“I thought it was an excellent presentation by the Hilltop Institute … We are seeking information right now to make the best policy decisions that we can,” Medicaid Chairwoman Missy McGee, R-Hattiesburg, said. 

The hearing marks a sea change for the Mississippi Legislature.

Republican legislative leaders are for the first time in a decade at least considering Medicaid expansion. Mississippi remains one of only 10 states not to expand the federal-state program to cover hundreds of thousands of Mississippians who cannot afford private insurance. The issue has been a political third rail for Republicans in Mississippi. GOP state leaders, including former House Speaker Philip Gunn, blocked even serious discussion or hearings on the issue in recent years.

Republican Gov. Tate Reeves has remained steadfast in opposition to what he calls “Obamacare” and “Welfare” even as polls show a wide majority of people in Mississippi support expansion.

Reeves on Tuesday in a social media post criticized Republican lawmakers for considering the program, and said “for those wondering how I feel, I offer you the words of President Trump” — with a screenshot of a Trump post saying “Obamacare Sucks!!!”.

New Republican House Speaker Jason White – who replaced Gunn this year – has been outspoken about the state’s health care crisis and has authored a soon to be made public expansion bill. Republican Lt. Gov. Delbert Hosemann said the Senate has drafted its own Medicaid expansion plan, which would likely also include people paying premiums through a private care option and a work requirement.

During Tuesday’s hearing, Data scientist Morgan Henderson outlined the results of a 2021 study on the economic effects of a hypothetical expansion program in Mississippi. He covered three sets of impact: cost to the state, impact on the state economy, and impact on state hospitals. 

The study estimated:

  • There would be about 210,000 new enrollees from expansion.
  • Of these, 95% are expected to be newly eligible. And about 65% would be previously uninsured — despite critics predicting that expansion would incentivize people to get off private insurance and move to Medicaid.
  • The first two years of adopting the program would cost the state nothing. That’s because in the first two years, the state would earn roughly $676 million in federally matched dollars through the ARP enhanced FMAP.
  • The third year would cost the state roughly $3 million, after a majority of the $190 million of the state’s match was offset by increased tax revenue, reduced uncompensated care costs to hospitals, and other program cost offsets.
  • For state- and locally-owned hospitals, which make up about 40% of Mississippi hospitals, there would be a reduction in uncompensated care costs by about 60% each year.
  • Expansion would stimulate the economy, putting about $1.2 billion into circulation that the state would not otherwise see.
  • Expansion would create an additional 11,000 new jobs. 
  • Expansion would improve hospital aggregate performance by up to 2.4%

The study was based on a traditional expansion model, as opposed to one including a private care option – first modeled in Arkansas and which has gained traction as conservative lawmakers consider expanding Medicaid in several Southern states. 

House Democrats, in the minority, recently unveiled an expansion proposal, which includes a private insurance option for people making up to double the federal poverty level. It’s often touted as a more pragmatic approach, since it involves more people partially paying premiums in a tiered system, based on income.

The House Republican bill authored by White, and the Senate expansion bill both had yet to be assigned to committee or publicly posted late Tuesday, but leaders in both chambers said they were filed before a Monday night deadline.

Correction 2/21/2024: This story has been updated to reflect the percent of newly-eligible Mississippians expected to be previously uninsured.