In Mississippi, a two-parent working family of four earning $10,000 to $23,500 would not be eligible for assistance either through Medicaid or the exchange because the state did not expand Medicaid.
Twenty percent of Mississippi’s nearly 3 million residents are on the Medicaid rolls. Twelve percent are on Medicare, and 20 percent are uninsured, according to the Kaiser Family Foundation.
In rejecting the Medicaid expansion, Republican Governor Phil Bryant is turning down an estimated $426 million in federal funds for next year. He has argued that the administrative costs borne by the state would be too high. A report by the Mississippi Institutions of Higher Learning estimated the cost of Medicaid expansion for the state at $8.5 million in 2014, rising to $159 million in 2025 as more people enroll in the program and federal subsidies step down from 100 percent initially to 90 percent.
Mississippi is also among the states that may get the least benefit from healthcare reform in other ways. Only two health insurers are offering coverage in the state on the federally run subsidized exchange for private insurance, with premiums for a benchmark plan costing more than the national average.
It was the sole state to apply to run its own exchanges and be turned down by the federal government because of concerns Bryant would not provide enough support to launch it. Instead, the federal government is running Mississippi’s exchange.
State House Minority Leader Bobby Moak, a Democrat whose coalition has fought hard for health reform in Mississippi, says Bryant’s arguments are a cover for rejecting anything President Obama supports.
“We like to say that the healthcare act was written for Mississippi, but our folks had the ‘good sense’ to turn it down,” he said.
In late June, state House Democrats staged a showdown to force a vote on Medicaid expansion, holding up reauthorization of the state’s current Medicaid program, which serves one in five Mississippi residents. A last-minute legislative deal reached on June 28 saved the program but failed to expand it.
Bryant declined requests to speak to Reuters, but spokesman Mick Bullock said in an email the governor will not reconsider his position on Medicaid expansion, which he said was “bad policy” and “fiscally unsustainable.”