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Senate Medicaid Expansion Plan Could Cost State More to Cover Fewer People

Medicaid expansion plans that could cover tens or hundreds of thousands more Mississippians have now passed both the state Senate and House, but with key differences that could affect who is eligible—and whether expanded Medicaid becomes available to anyone.

Unlike the House version, the Senate’s proposal requires the federal government to approve a work-requirement waiver before anyone could benefit and would likely cover fewer than half as many people.

Senate Medicaid Committee Chairman Sen. Kevin Blackwell, R-Southaven, sought to distance his chamber’s expansion plan from former President Barack Obama’s 2010 Patient Protection and Affordable Care Act—the federal law that makes Medicaid expansion possible.

“This bill is not Obamacare expansion. This bill is a very responsible and conservative bill geared toward the working poor,” the senator said before his chamber passed its version of Medicaid expansion on Thursday.

The Senate used the original House bill as the vehicle to pass its Medicaid expansion plan by adopting a strike-all amendment that removed the House bill’s original language and replaced it with the Senate’s plan.

Fewer Qualify Under Senate Bill

Sen. Kevin Blackwell estimates that 80,000 Mississippians would qualify for Medicaid coverage under the Senate’s plan, but said he expects as few as 40,000 may actually enroll—significantly lower than the House’s estimation of up to 200,000 for its version.

One key difference is that the House plan includes full Medicaid expansion under the ACA, allowing residents who make up to 138% of the federal poverty level ($20,120 annually for an individual or $40,056 for a family of four) to qualify. 

Mississippi State House Medicaid Committee Chairman Rep. Missy McGee, R-Hattiesburg (seated left), Rep. Jansen Owen, R-Poplarville (seated right), and Rep. Rodney Hall, R-Southaven (back right), join Sen. Bradford Blackmon, D-Canton (back left), as they listen to the debate over a proposed Medicaid expansion bill in the Senate Chamber at the Mississippi Capitol in Jackson, Miss., on Thursday, March 28, 2024. AP Photo/Rogelio V. Solis

The Senate plan would only allow people to qualify if they make up to 100% of the federal poverty level ($15,060 per year for a single person or $31,200

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