Mississippi Today

Senate Medicaid ‘expansion light’ would insure fewer than House plan, turn down federal money

Published

2 months ago

March 21, 2024

mississippitoday.org – Taylor Vance and Sophia Paffenroth – 2024-03-20 18:24:28

Senate leaders this week are trying to drum up votes for a Medicaid “expansion light” proposal that would cover far fewer uninsured Mississippians — about 49,000 less — than a House-passed bill and would leave hundreds of millions of federal dollars on the table.

Joan Alker, executive director of Georgetown University's Center for Children and Families and a Medicaid expert, told Mississippi Today that the Senate's approach would do little to address Mississippi's need for a healthy workforce and very few people who need health insurance coverage to protect them from high medical bills would get it.

“It is also a very fiscally irresponsible approach for Mississippi's taxpayers as the state would be turning down $690 million that the federal government has put on the table for Mississippi's health care system,” Alker said.

A draft of the Senate proposal was provided to Mississippi Today on Wednesday. Senate leaders have said for weeks they had a Medicaid plan forthcoming, but it has yet to be made public or presented for a committee vote. The House passed its HB1725 expansion bill in February.

The Senate draft proposal would:

Cover working Mississippians up to 99% of the federal poverty level. For an individual that would be an annual income up to $15,060. For a family of four that would be an annual income up to $31,200.
Not cover those making between 100% and 138% of the FPL — not even through a private-care option. A plan that doesn't cover people making up to 138% is not considered “expansion” under the Affordable Care Act, meaning Mississippi wouldn't qualify for the 90% federal match rate that the ACA grants to new expansion states, nor the additional, two-year 5% increase in match rate the federal government provides to newly-expanded states under pandemic relief spending passed by Congress. Instead, as was the case with Georgia, Mississippi would only get its regular federal Medicaid rate of about 77%.
Leave the health insurance exchange, the online marketplace that offers federally subsidized plans to people who make between 100% and 138% of the FPL, intact. The Senate plan, unlike Arkansas' Medicaid expansion, would not provide extra subsidies from the state's federal Medicaid money available from the ACA.
Include a work requirement mandating at least 120 hours of employment a month in a position for which health insurance is not paid for by the employer. That's more stringent than Georgia's plan, which mandates 80 hours a month. There are several exemptions, such as for full-time students or parents who are the primary caregiver of a child 6-years-old or younger.
Go into effect 30 days after CMS approves a waiver necessary for the work requirement. That's unlikely to happen under the Biden administration, which has rescinded work requirements previously approved for other states during the Trump administration and has not approved new ones. If CMS denies the waiver, Mississippi would have to wait until a new administration took office, or sue the Biden administration. Georgia remains in litigation with the federal government over the work requirement issue, and has suffered low enrollment and missed out on millions in federal funds by not fully expanding coverage.
Require anyone who voluntarily dropped private insurance to wait 12 months before applying for Medicaid coverage.

Senate Medicaid Committee Chairman Kevin Blackwell, a Republican from Southaven who authored the proposal, declined to comment on the substance of the proposal, but he stressed to Mississippi Today that he and Senate leaders are still tweaking parts of the legislation.

Since the Senate let its own Medicaid bill — which was a “dummy” with no details — die, the House measure is the only expansion still alive this session. The Senate Medicaid Committee is expected to insert the Senate proposal as a “strike-all” amendment.”

While House Bill 1725 – which overwhelmingly passed the House – also has a work requirement, it is only a “best-case scenario.” The bill has a provision that if federal authorities do not approve the waiver necessary to allow a Mississippi work requirement by Sept. 30, 2024, Medicaid would still be fully expanded to people up to 138% of the federal poverty level, starting in January 2025. That means under the House plan, Mississippi would receive the 90% federal match, as well as an additional nearly $700 million that would make expansion free to the state in the first two years of its adoption.

Since the Senate plan is drastically different than the House proposal, a final version would almost certainly be hammered out later in the session in a conference committee.

Blackwell's proposal would insure less people, but his plan could be a way to convince more Republican senators, who have been more skeptical about expansion than their House counterparts, to vote in favor of the legislation.

The realpolitik is any final plan would have to pass the House and Senate by a two-thirds majority to show it has the potential to override a potential veto from Republican Gov. Tate Reeves.

Reeves has privately told senators that he plans to veto a Medicaid expansion bill if it reaches his desk and has been a vocal opponent of expanding Medicaid coverage.

The deadline for the bill to pass Senate committee is April 2, with an April 10 deadline to pass the Senate floor.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

EPA absolves MDEQ, Health Department of discrimination in funding Jackson water

Published

10 hours ago

May 8, 2024

Staff Editor

mississippitoday.org – Alex Rozier – 2024-05-08 15:42:36

About a year and half ago, on the heels of Jackson's infamous water system failure, advocates and politicians from Mississippi began publicly questioning the funding mechanisms that are supposed to support such systems.

In October 2022, U.S. Reps. Bennie Thompson and Carolyn Maloney wrote Gov. Tate Reeves, grilling him over an apparent disparity in how federal infrastructure funds were allocated to Jackson versus other parts of the state.

Then days later, the Environmental Protection Agency's civil rights office opened an investigation into two state agencies — the Mississippi Department of Environmental Quality and the Mississippi Department of Health — in response to the NAACP's claims of discrimination under Title VI of the Civil Rights Act of 1964. Title VI prohibits discrimination — based on race, color or national origin — in providing federal assistance.

On Monday, though, the EPA announced it had ended the probe after finding no evidence the agencies had short-changed Jackson's water system. In its investigation, the EPA looked at the funding amounts and racial demographics of cities that received water funding from MDEQ and the Health Department and determined there was no correlation between the two factors.

A scatter plot from the EPA's analysis comparing the levels of funding cities received with their percent of Black residents.

“The evidence overwhelmingly shows that the Mississippi Department of Environmental Quality did everything right,” MDEQ Executive Director Chris Wells said in a press release following the EPA's announcement.

The two agencies are in charge of disbursing funds from the EPA called “state revolving loan,” or SRF, funds, which are meant to help cities make infrastructure improvements. MDEQ handles SRF funds related to wastewater infrastructure, while the Health Department handles SRF funds for drinking water.

But the claims against the agencies were only part of the 2022 complaint the NAACP filed with the EPA. The federal agency did not address another complaint: The group also focused on the state Legislature, which has denied attempts in recent years by Jackson to raise money for its water system, such as creating a new 1% tax.

Click here for the EPA's full responses to MDEQ and Health Department.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

MSGOP Chair Bordeaux stepping down. Mike Hurst endorsed as successor

Published

13 hours ago

May 8, 2024

Staff Editor

mississippitoday.org – Taylor Vance and Geoff Pender – 2024-05-08 12:25:40

Mississippi Republican Party Chairman Frank Bordeaux announced on Wednesday that he will not seek reelection to his post and endorsed former U.S. Attorney Mike Hurst to succeed him.

Bordeaux, an insurance executive, wrote on Facebook that he's had a great tenure as the party's chairman, but it was time to “pass the torch” to a “new leader with a fresh perspective.”

“We've seen a lot of success,” Bordeaux said. “We've elected more Republicans in the last few years to local, state, and federal offices than at any point in history. With every election, we've gained seats and put more conservatives in positions to improve the lives of Mississippians.”

Republican Gov. Tate Reeves in September 2020 backed Bordeaux, a longtime Coast resident, to replace former GOP Chairman Lucien Smith, a move that likely proved crucial to the governor transforming the Coast into a political firewall of support during the 2023 statewide election.

It's typical for a sitting Republican governor, as head of the state party, to pick a new chairman. While the executive committee technically elects a GOP chairman, a governor's choice is typically installed by acclamation. There has been no major executive committee challenge to a Republican governor's chairman nomination in recent history.

Reeves did not immediately make a statement after Bordeaux' announcement on social media, but Hurst in a statement on Wednesday indicated he has Reeves' support.

“I want to thank Gov. Tate Reeves for his support, Chairman Frank Bordeaux for his incredible leadership, and the staff of the MSGOP, who have all raised our party to new heights and have achieved so much for our conservative principles over the last number of years,” Hurst said.

Gov. Tate Reeves signs qualifying paperwork to run for reelection, as his wife Elee Reeves, left, and party chairman Frank Bordeaux look on at the Mississippi Republican Headquarters in Jackson, Miss., Tuesday, Jan. 3, 2023. Credit: Eric Shelton/Mississippi Today

“Our future is bright in Mississippi and, if elected chairman, I hope I can play a small role in making our state and our party even better in the future,” Hurst added.

Republican Lt. Gov. Delbert Hosemann in a statement Wednesday said: “Being chairman is a tough, uncompensated job which takes a significant amount of personal time. Frank's leadership through part of the pandemic and the recent statewide election has been pivotal to bringing organization, unity, and success to the Republican Party across the state. We appreciate his service and look forward to continuing his efforts under the guidance of Mike Hurst.”

Hurst has been involved in state and national Republican politics for years. He is currently a partner in the Phelps Dunbar law firm's Jackson office. Hurst served as the U.S. attorney for the Southern District of Mississippi under President Donald Trump's administration from 2017 to 2021, and previously served as an assistant U.S. attorney.

Prior to his presidential appointment, Hurst was the founder and director of the Mississippi Justice Institute, a division of the Mississippi Center for Public Policy. He also previously served as a legislative director and counsel to then-U.S. Rep. Chip Pickering, and served as counsel to the Constitution Subcommittee of the U.S. House Judiciary Committee.

Hurst's wife, Celeste Hurst, was elected last year to the state House District 77 seat, representing Madison, Rankin and Scott counties.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Crooked Letter Sports Podcast

Podcast: It’s crunch time in both college and high school baseball.

Published

13 hours ago

May 8, 2024

Staff Editor

We are into the second week of May, which means the college and high school baseball seasons have reached the point where every pitch matters. At present, Mississippi State is a likely 2-seed, Southern Miss is a 3-seed and Ole Miss is on the outside looking in. The Rebels, however, can change that this weekend when No. 1 ranked Texas A&M comes to Oxford. Also, Tyler gives the lowdown on all the high school baseball playoff action.

Stream all episodes here.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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