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Mississippi Medicaid Expansion: Don’t Lose a Friend Over This

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Mississippi Medicaid Expansion: Don’t Lose a Friend Over This


  • Pepper Crutcher discusses the complexities of Medicaid expansion.

“From thirty feet away she looked like a lot of class. From ten feet away she looked like something made up to be seen from thirty feet away.” – Raymond Chandler, The High Window

That’s typically true of legislation that seeks to solve complex problems. How you see the House-passed Medicaid Expansion bill probably depends on your pre-existing point of view. The Mississippi House passed HB 1725 with a vote of 98-20 on February 28, advancing it to the Mississippi Senate.

Everyone would like to see reliable, relevant data about a truly comparable, prior State expansion, but no such data is available. Since we have little more than confirmation bias to inform us, none should question the character or motives of those who see this differently. Here’s a short, over-simplified explanation of why this topic confounds so many who sincerely want to get it right.

Who would be eligible for expanded Mississippi Medicaid coverage?

There are 15 coverage categories; low Modified Adjusted Gross Income (MAGI) alone won’t suffice. To qualify under the most restrictive category, non-disabled adults with dependents, your MAGI must be very low indeed. Typically, these are households with reported income from part-time or sporadic employment at or just above the minimum wage. Mississippi has the option to raise this limit to 138% of the Federal Poverty Limit (FPL), thereby drawing a more generous federal Medicaid match – currently up to 95% of qualifying expenditures.

HB 1725 goes all-in. Even if CMS (the federal Centers for Medicare and Medicaid Services) disapproves the bill’s work requirement, full expansion will happen; so says section 1(f) of HB 1725. Mississippi Medicaid would no longer cover only the abjectly impoverished; it would cover many people with full-time jobs that pay more than the minimum wage.

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When would Mississippi Medicaid expansion become effective?

Even if CMS denies Mississippi’s work requirement request, the enrolled expansion population would be covered beginning January 1, 2025, based on HB 1725 as passed by the House.

What is the difference between Medicaid and “Obamacare”?

Medicaid is a federal/state health insurance program administered mostly by states but funded, in the poorest states, almost entirely with federal dollars. Payments to providers are, in most situations, lower than private insurance or Medicare payments.

Currently, there is a gap between the upper MAGI limit for adult Mississippi Medicaid and the lower limit of “Obamacare” subsidy eligibility. Mississippi households with income 100% to 400% of the Federal Poverty Level are eligible to buy federally subsidized, privately issued health insurance plans through Healthcare.gov – the “Obamacare” web site. See for yourself. Go there, enter single member household, minimum wage, full-time job numbers (amounting to $14,720 annually) and the site’s calculator will tell you that your income is too high for Mississippi Medicaid but that you are eligible for Obamacare subsidies.

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Through “Advance Premium Tax Credits,” the Feds pay all Obamacare premiums for households with incomes between 100% and 150% of the FPL. There also are “Cost Sharing Reduction” subsidies, but, even with them, beneficiaries may have to bear several thousand dollars annually of “out-of-pocket” (OOP) costs that they would not bear if Medicaid had covered the same medical expenses.

What’s the problem?

Lest this article become a book, let’s just scratch the surface. Should HB 1725 become law as passed by the House, the upper Medicaid adult MAGI limit will substantially overlap the lower limit of Obamacare subsidies. Healthcare.gov will redirect Mississippi applicants to Medicaid if they enter Medicaid-qualifying MAGI numbers, reducing federal expense for that household’s coverage (100% of premiums plus cost sharing reduction subsidies), while increasing State expense (5% of covered costs of care for the expansion population). The added Mississippi Medicaid burden of the newly enrolled would be known in percentage terms but unknown in absolute dollar – i.e., budgetary – terms. The State’s cost could be raised further by small employer decisions to drop their plans. Some people now working full time for their employer-sponsored insurance might quit or go part time, and Mississippi already has the nation’s lowest workforce participation rate. HB 1725 anticipates this and directs the Division of Medicaid to make coverage hoppers wait a year to enroll in Medicaid. Just like the work requirement, this would require CMS approval.

Plus, enforcement mechanisms and capacities are unclear. If the people dropping from employer insurance plans tend to be younger and healthier than average, those plan terms and premiums may get worse as claim experience trends badly. Some small employers might become uninsurable, effectively. In the worst-case scenario, expansion might solve much of the Obamacare OOP problem for current uninsureds while creating a new group of uninsureds who would be less likely to qualify for full Obamacare subsidies. A similar expansion consequence could wreck Mississippi Obamacare. About 286,000 Mississippians are enrolled in a 2024 Healthcare.gov plan.

If insurers expect most of them to shift to 2025 Medicaid, will those insurers compete for the shrunken 2025 Healthcare.gov business? How much would the remaining insurer(s) raise premiums in response to what they may see as increased risk? If rates spike or if insurers bail out, many new uninsureds could fall in a new gap between expanded Medicaid and employer-provided coverage.

What could go right?

“Only two people know the future: God and a fool,” says the Lebanese proverb. Medicaid expansion worries may turn out to have been excessive. Expansion might cost the State little, solve the Obamacare OOP problem, throw a lifeline to struggling providers, increase workforce participation, and not wreck the Obamacare exchange program. An old joke, told by Milton Berle, is an apt one: “Two Irishmen are leaving a bar …. What? It could happen!” This, too, could happen. In hindsight, expansion proponents might seem to have been prescient.

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But everyone is guessing. If your friend’s guess doesn’t match yours, he or she should remain your friend. Let it be so, please.





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Mississippi

Mississippi Power plans to strengthen power delivery system

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Mississippi Power plans to strengthen power delivery system


MERIDIAN, Miss. (WTOK) -Mississippi Power is starting a pair of power pole upgrade projects in Gulfport as part of its storm hardening program.

This is to strengthen the power delivery system for customers in the company’s most storm-prone areas.

Their mission is to replace wooden transmission poles with steel ones, beginning in Gulfport and heading east toward Biloxi.

During these two projects, more than 250 power poles will be upgraded to make the equipment more resistant to storms.

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“When you think about a major storm restoration effort, one of the most time-consuming tasks is replacing damaged or broken wooden poles, so with more robust structures like the ones we are going to be installing, we expect a far less outage time that our customers are going to face, for example, last summer in moss point we had tornadoes that had rolled through we ended up having to replace about 75 broken wooden poles, that took a lot of time if we’d had more robust poles in place we wouldn’t have anticipated in seeing a fraction of that kind of damage,” says Mark Loughman, Coast Division Manager.

The projects are expected to be completed by the end of 2024, as similar system upgrades will be performed in and around Meridian in the future.

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Northeast Park Tennis Center hosts USTA Mississippi’s 65 and over State Championships

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Northeast Park Tennis Center hosts USTA Mississippi’s 65 and over State Championships


MERIDIAN, Miss. (WTOK) – The United States Tennis Association of Mississippi (USTA) brought their 65 and over Tennis State Championships to the Queen City over the weekend.

Over 300 participants from all over the state came to Northeast Park Tennis Center to compete. With just 12 total participants from Meridian, most of the competitors had to travel for the event, which benefits the city.

“It’s a great economic impact,” said Pete Mazzella, the director of Northeast Park Tennis Center. “The rest are all eating out here and spending the night at hotels,” Mazzella said.

Besides economic growth for the city, events like this grow the sport in the community. Meridian has a lively tennis community that has grown a lot over the past few years, which USTA Mississippi has noticed.

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“One of the reasons we were awarded this tournament was because of the growth we’ve had. It shines a spotlight. A lot of people have talked about how beautiful this facility is, and we love hearing that because we work hard to keep it up,” said Mazzella.

The tournament took place over a three-day span, featuring eight total flights up for grabs. State Championship winners of the 3.5 Women’s flight mentioned that competing in these events keeps them feeling young.

“It’s the comradery of friends is what it’s all about- is friendship. It makes our health better, the exercise. My doctors tell me to keep playing tennis.” said Tina Roberts and Cynthia Rhaly, members of the team.

For a full list of results, visit this link to the USTA Mississippi website.

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Local dispensaries showcase products, educate people about medical cannabis during Mississippi Cannabis Festival

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Local dispensaries showcase products, educate people about medical cannabis during Mississippi Cannabis Festival


BILOXI, Miss. (WLOX) – Biloxi Town Green was flooded with local dispensaries, food trucks, and live entertainment for the Mississippi Cannabis Festival.

Local dispensaries came out to showcase their products as well as educate people on the benefits of medical marijuana.

One local dispensary says it’s important to educate people on medical cannabis to help provide another avenue of treatment.

“I believe that without this there will be a lot of things happening that shouldn’t happen and it gives people a better outlet to be healthy, especially if they’re old and skeptical of doing other things,” one woman said.

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If you would like to attempt to receive a medical marijuana card, you can visit the state’s health department website.

See a spelling or grammar error in this story? Report it to our team HERE.



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