Senate Medicaid Chairman says without a work requirement waiver, Medicaid expansion “probably over”

• A Senate Medicaid bill, unlike the House version, will be fully contingent on a work requirement approved by CMS before expansion to any level.  

On committee deadline day, the Mississippi Senate Medicaid Committee passed a bill to open code sections that will allow them to address potential expansion of the Medicaid rolls to low-income families in the Magnolia State.

SB 2735 in its current form is what lawmakers consider a “dummy bill.” A dummy bill refers to legislation that only contains code sections, typically because a proposal is not complete but a deadline requires movement on that issue.

State Senator Kevin Blackwell (R), Chairman of Medicaid, said that the proposal from the chamber on the topic of potential Medicaid expansion is expected by this time next week.

The Senate bill is in response to the House Medicaid expansion bill that was passed 98 to 20 in the chamber last week. The House legislation requested a work requirement waiver for individuals up to 138 percent of the Federal Poverty Level (FPL) to be eligible for Medicaid. However, Section 2 of the House bill moves forward with the expansion, even if the Centers for Medicare and Medicaid Services (CMS) does not approve the work waiver.

RELATED: Mississippi House Prepared to Vote on Medicaid Expansion

According to Sen. Blackwell, the Senate’s bill will hinge on the approval of a work requirement waiver by CMS. He said if CMS does not approve a work requirement waiver, then “it’s probably over.”

Blackwell told reporters that he would be unable to move a piece of legislation that implemented traditional expansion through the Senate.

“The House bill, the way I look at it, is strictly traditional expansion,” said Senator Blackwell. “You’re going to give CMS the option of us taking work requirements, or not. They’re denying them left and right, so they’re obviously going to deny it which will mean we will automatically go into full expansion.”

Blackwell said one element Senators are considering regarding any expansion is how it could impact the exchange. Currently, individuals within the FPL range that is being addressed in expansion conversations can receive federally subsidized insurance plans through the Affordable Care Act (ACA) exchange.

Blackwell said individuals who are on the exchange do have a work requirement, but no work requirement is currently necessary for Medicaid.

When it comes to crafting the Senate’s plan for an attempt at expansion, Sen. Blackwell said lawmakers have had conversations with multiple agencies including the Division of Medicaid and Department of Insurance to gain as much data as possible before making a decision.

Senator Blackwell did not provide any insight as to what the work requirement threshold would be but indicated Senators have considered the 20 hour a week provision with inclusions for care workers for homebound patients. He also did not clarify if the Senate’s FPL level would reach 138 percent or look different from the House plan.

Blackwell was asked if a change in President in November could impact whether CMS would approve a work waiver requirement for Medicaid enrollment. While he said he would love to see a change in that office come the election, it was still unclear if that would make a difference in the outcome.

The Medicaid Chairman did say Senators are considering implementation time frames to accommodate if there was a change in presidential administrations.