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House agrees to work requirement, Senate concedes covering more people in Medicaid expansion deal

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mississippitoday.org – Taylor Vance – 2024-04-29 22:34:12

With minutes to spare before a Monday-night deadline, House negotiators conceded a Senate demand that expansion would include a strict work requirement for those covered — a requirement not likely to be approved by the federal .

The Senate had already backed off its initial proposal that would only the poorest of the poor, would still leave tens of thousands of poor working uninsured and would have turned down billions in federal money to cover the costs. 

House and Senate negotiators agreed to a deal that would expand Medicaid to about 200,000 people who make up to 138% of the federal poverty level, roughly $20,000 for an individual. It would require recipients to prove they work for at least 25 hours a .  

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The plan will be a “hybrid,” as first proposed by the House. People up to 99% of the federal poverty level would be covered by traditional Medicaid. Those making 100% to 138% of FPL would be covered with subsidized private insurance plans from the federal exchange.

Neither House Medicaid Chair Missy McGee, a Republican from Hattiesburg, nor Senate Medicaid Chair Kevin Blackwell, a Republican from Southaven, answered questions from reporters at the Capitol about the agreement on Monday night. 

“A compromise requires concessions between the chambers,” Republican Lt. Gov. Delbert Hosemann said in an earlier statement. “The Senate requires a real work requirement, but our plan now covers individuals up to 138 percent of the federal poverty level.” 

The Affordable Care Act, the federal legislation that allows states to expand Medicaid coverage, does not authorize work requirements. However, states can seek a federal waiver from the Centers for Medicare and Medicaid Services to implement them. 

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CMS under the Trump administration did sign off on some states using work requirements, but under the Biden administration, the federal agency has not approved requests and rescinded the ones that had been approved. 

The House's original plan directed officials to seek a waiver for work requirements, but would have expanded Medicaid even if the federal agency denied it. House previously pointed out that people with income above the federal poverty level are likely working.

The Senate, however, drew a hard line that it would only agree to an expansion plan that contained work requirements — a stance that could at the least delay expanded coverage, perhaps for years, or prevent it from ever happening.

READ MORE: House, Senate leaders swap Medicaid expansion proposals as Monday night deadline nears

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If CMS denies Mississippi's waiver for a work requirement, the compromise proposal directs the state Division of Medicaid to apply for a work requirement waiver each year the first denial. 

It also directs state officials to immediately apply for a waiver if CMS starts approving work requirements in other states.   

Senate leaders have expressed optimism that the Biden administration will be so pleased with longtime Medicaid expansion holdout Mississippi making an effort that it would approve a work requirement, or that the conservative federal 5th Circuit Court would approve it if litigated.

Work requirements in states that previously had them proved to be costly and ineffective, with a large amount of costs going into administration of the work requirements instead of medical services.

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The agreed proposal will likely bring an end to several days of House and Senate negotiators trading proposals back and forth with one another behind closed doors. 

Right up to the 8 p.m. Monday deadline, it was unclear if legislative leaders would reach a compromise. They signed the agreement with only minutes to spare.

Reporters, lobbyists and advocates gathered at the Capitol waiting to see if lawmakers could broker a deal to establish what many believe could be the most transformative state policy since Gov. William Winter's Education Reform Act of 1982.

But despite earlier vows by House and Senate leaders to negotiate Medicaid expansion in public, the final details were worked out behind closed doors and negotiators declined comment Monday night.

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Now that the negotiators have signed off on an agreement, the Capitol's two chambers have until Wednesday to either approve the proposal, reject it or send it back to negotiators for further work. The 2024 legislative session is expected to end within days, although lawmakers have already had to push back deadlines for agreeing to a state budget.

The Medicaid expansion proposal places a 3% tax on managed care organizations to cover the state's costs, and the 's rules require a three-fifths majority of the lawmakers in both chambers to approve bills that enact taxes. 

But the actual threshold the two chambers likely need to achieve is a two-thirds majority, needed to override a potential veto from Republican Gov. Tate Reeves, a longtime opponent of expansion. 

Passage of the compromise, particularly by a wide margin, may be difficult in both chambers. House Democrats, who Medicaid expansion, have threatened to oppose any bill with a work requirement. Any expansion measure is a tough sell in the Senate, and its earlier more austere plan barely garnered a two-thirds vote.

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Senate Minority Leader Derrick Simmons, D-Greenville, on Monday night said he was glad the two chambers came to an agreement and he looks forward to seeing more details.

“I am grateful we are finally at a point where we are working to access to health care to Mississippians who desperately need it and have been waiting for it for a long time,” Simmons said.

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

Mississippi Today

Podcast: The controversial day that Robert Kennedy came to the University of Mississippi

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Retired U.S. Bankruptcy Judge Edward Ellington talks with Mississippi 's Bobby Harrison and Geoff Pender about former U.S. Robert Kennedy's speech at the University of Mississippi less than four years after the riots that occurred after the integration of the school. Ellington, who at the time headed the Speaker's as a school student, recalls the controversy leading up to the speech. 


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

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Mississippi Today

On this day in 1961

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mississippitoday.org – Jerry Mitchell – 2024-05-20 07:00:00

MAY 20, 1961

In this 1961 , leader John Lewis, left, stands next to James Zwerg, a Fisk student. Both were attacked during the Rides. Credit: AP

A white mob of more than 300, Klansmen, attacked Freedom Riders at the Greyhound Bus Station in Montgomery, Alabama. Future Congressman John Lewis was among them. 

“An angry mob came out of nowhere, hundreds of people, with bricks and balls, chains,” Lewis recalled. 

After beating on the riders, the mob turned on reporters and then Justice Department official John Seigenthaler, who was beaten unconscious and left in the street after helping two riders. 

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“Then they turned on my colleagues and started beating us and beat us so severely, we were left bloodied and unconscious in the streets of Montgomery,” Lewis recalled. 

As the mob headed his way, Freedom Rider James Zwerg said he asked for God to be with him, and “I felt absolutely surrounded by love. I knew that whether I lived or died, I was going to be OK.” 

The mob beat him so badly that his suit was soaked in blood. 

“There was nothing particularly heroic in what I did,” he said. “If you want to about heroism, consider the Black man who probably saved my . This man in coveralls, just off of work, happened to walk by as my beating was going on and said ‘Stop beating that kid. If you want to beat someone, beat me.' And they did. He was still unconscious when I left the hospital.” 

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To quell the violence, Robert Kennedy sent in 450 federal marshals.

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

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2024 Mississippi legislative session not good for private school voucher supporters

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mississippitoday.org – Bobby Harrison – 2024-05-19 14:11:52

Despite a recent Mississippi Supreme Court ruling allowing $10 million in public money to be spent on private schools, 2024 has not been a good year for those supporting school vouchers.

School-choice supporters were hopeful during the 2024 legislative , with new House Speaker Jason White at times indicating for vouchers.

But the , which recently completed its session, did not pass any new voucher bills. In fact, it placed tighter restrictions on some of the limited laws the state has in place allowing public money to be spent on private schools.

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Notably, the Legislature passed a bill that provides significantly more oversight of a program that provides a limited number of scholarships or vouchers for special-needs children to attend private schools.

Going forward, thanks to the new , to receive the vouchers a parent must certify that their child will be attending a private school that offers the special needs educational services that will help the child. And the school must report information on the academic progress of the child receiving the funds.

Also, efforts to expand another state program that provides tax credits for the benefit of private schools was defeated. Legislation that would have expanded the tax credits offered by the Children's Promise Act from $8 million a year to $24 million to benefit private schools was defeated. Private schools are supposed to educate low income students and students with special needs to receive the benefit of the tax credits. The legislation expanding the Children's Promise Act was defeated after it was reported that no state agency knew how many students who fit into the categories of poverty and other specific needs were being educated in the schools receiving funds through the tax credits.

Interestingly, the Legislature did not expand the Children's Promise Act but also did not place more oversight on the private schools receiving the tax credit funds.

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The bright spot for those supporting vouchers was the early May state Supreme Court ruling. But, in reality, the Supreme Court ruling was not as good for supporters of vouchers as it might appear on the surface.

The Supreme Court did not say in the ruling whether school vouchers are constitutional. Instead, the state's highest court ruled that the group that brought the – Parents for Public Schools – did not have standing to pursue the legal action.

The Supreme Court justices did not give any indication that they were ready to say they were going to ignore the Mississippi Constitution's plain language that prohibits public funds from being provided “to any school that at the time of receiving such appropriation is not conducted as a free school.”

In addition to finding Parents for Public Schools did not have standing to bring the lawsuit, the court said another key reason for its ruling was the fact that the funds the private schools were receiving were federal, not state funds.  The public funds at the center of the lawsuit were federal COVID-19 relief dollars.

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Right or wrong, The court appeared to make a distinction between federal money and state general funds. And in reality, the circumstances are unique in that seldom does the state receive federal money with so few strings attached that it can be awarded to private schools.

The majority opinion written by Northern District Supreme Justice Robert Chamberlin and joined by six justices states, “These specific federal funds were never earmarked by either the federal or the state for educational purposes, have not been commingled with state education funds, are not for educational purposes and therefore cannot be said to have harmed PPS (Parents for Public Schools) by taking finite government educational away from public schools.”

And Southern District Supreme Court Justice Dawn Beam, who joined the majority opinion, wrote separately “ to reiterate that we are not ruling on state funds but American Rescue Plan Act (ARPA) funds … The ARPA funds were given to the state to be used in four possible ways, three of which were directly related to the COVID -19 emergency and one of which was to make necessary investments in , sewer or broadband infrastructure.”

Granted, many public school advocates lamented the , pointing out that federal funds are indeed public or taxpayer money and those federal funds could have been used to help struggling public schools.

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Two justices – James Kitchens and Leslie King, both of the Central District, agreed with that argument.

But, importantly, a decidedly conservative-leaning Mississippi Supreme Court stopped far short – at least for the time being – of circumventing state constitutional language that plainly states that public funds are not to go to private schools.

And a decidedly conservative Mississippi Legislature chose not to expand voucher programs during the 2024 session.

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

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