A Medicaid expansion bill will arrive in the Mississippi Senate by Monday, beginning a process that could provide health care to about 230,000 working Mississippians, Lt. Gov. Delbert Hosemann says.
The Republican Senate leader shared plans to introduce a bill before Monday’s legislative deadline for introducing new legislation in an interview with Mississippi Today reporter Sophia Paffenroth on Thursday. Hosemann, who has in the past expressed a preference for the term “Medicaid reform” over “Medicaid expansion,” said in the interview that the bill would likely include work requirements, as other Republican-led states have done when expanding the program. He also touted it as good for business.
“I have tried to tell everybody this: Stop saying Medicaid expansion,” he said. “What we are looking at is providing health insurance for working people. How you couch that is up to you but the interest I have had for a while is: We need to have a better labor force participation rate. That right now is the lowest in the country. But to get to that point … I’ve got to have healthy people.”
Mississippi is one of just 10 states that have not accepted billions in federal dollars to expand Medicaid eligibility under the 2010 Patient Protection and Affordable Care Act, rejecting over $1 billion annually over the last decade.
The Magnolia State has the worst outcomes and the highest rate of preventable deaths in the country. Mississippi is also facing a health-care services crisis, with dozens of hospitals in danger of closing or reducing services. Health-care leaders have said that Medicaid expansion would help hospitals avert “looming disaster” since fewer uninsured people would be coming in for emergency room visits who could not pay for care that hospitals are obligated to provide anyway.
Medicaid expansion would cover Mississippians who make too much for traditional Medicaid but too little to receive federal subsidies to help afford private health care. For a family of four, Medicaid would be an option for incomes up to $43,000. But in states around the country, many Republicans have refused to accept the ACA’s Medicaid expansion funds, often citing its association with former President Barack Obama.
Hosemann has long backed some form of Medicaid expansion, telling the Jackson Free Press in 2019 that he was looking at Arkansas and Indiana as models for expanding Medicaid with work requirements. But during his first term from 2020 to 2023, Hosemann did not actively pursue expansion, which was dead on arrival in the House under the leadership of then-House Speaker Philip Gunn—a staunch opponent of the policy.
But Gunn retired last year, and new Republican House Speaker Jason White has repeatedly said he’s open to considering Medicaid expansion. So has Rep. Sam Creekmore, the new chairman of the Mississippi House Public Health and Human Services Committee. “I’m close to our hospital administrators in New Albany, in Tupelo,” Creekmore told the Associated Press’ Emily Wagster Pettus last month. “I see the struggles they go through. So I’m hoping to put it all on the table.”
Gov. Tate Reeves’ opposition to Medicaid expansion remains an obstacle for proponents, though. In 2019 and again in 2023, the governor defeated Democratic opponents who made Medicaid expansion centerpieces of their campaigns despite polls showing that a large majority of Mississippians support it. The governor derisively refers to Medicaid expansion as “Obamacare expansion” and “welfare.” During a speech at the Neshoba County Fair last year, Reeves said that Mississippians who lack health care need “better, more higher-paying jobs”—not Medicaid expansion.
He introduced a hospital rescue plan late in his 2023 reelection campaign, which he says is a better remedy than Medicaid expansion. But many health-care leaders have continued to argue that expansion is necessary to keep hospitals afloat and remedy poor health outcomes. A Mississippi State Department of Health report reviewing maternal mortality rates recommended Medicaid expansion in December.
“Medicaid expansion should be incorporated for rural hospitals to remain open and include access to telehealth services,” a Dec. 6 MSDH news release said. “There is a need for rural healthcare facilities to provide higher levels of critical care, recruit and retain adequate providers, and have access to life-saving equipment, especially in the most vulnerable areas of the state.”
If the House and Senate did pass a Medicaid expansion bill, Reeves could veto it. If that happened, both chambers would need two-thirds of its members to vote to override the veto for it to become law.
