Several dozen doctors and health care leaders gathered at the Capitol Thursday to advocate for Medicaid expansion and call on Senate leaders – who have remained quiet on the House expansion bill that sits in their chamber – to close the state’s health care coverage gap. 

“I’m calling on the Senate to do right and to come up with a mechanism by which these people can have coverage,” Dr. Randy Easterling, former president of the Mississippi State Medical Association, said. 

Easterling recounted the story of one working Mississippian named Jimmy who delayed seeking treatment and was diagnosed with multiple myeloma, a type of cancer. He is now on hospice and “probably has two to three weeks to live,” Easterling said. 

Easterling’s relative, an insured Tennessean, was diagnosed with the same condition as Jimmy. He received state of the art care in Nashville for his condition, which is treatable in most cases.

“I wish I could tell you that my story about Jimmy was an exception, but it’s not,” Easterling said. “Everybody behind me can tell their own stories about the hundreds and hundreds of people that we’ve seen over our practice time that this has happened to … What makes my relative more deserving than Jimmy? We need to do better.”

Since the Senate let its own Medicaid bill — which was a “dummy” with no details — die, the House measure is the only expansion bill still alive this session. The House bill would increase Medicaid eligibility to Mississippians making up to 138% of the federal poverty level, about $20,000 annually for an individual. The bill, authored by Missy McGee, R-Hattiesburg, and Speaker Jason White, R-West, contains a work requirement for enrollees, but states that the expansion would go into effect even if the federal government does not approve the work requirement.

The Senate is expected to scratch the House’s plan and replace it with its own proposal, a draft of which was leaked to Mississippi Today on Wednesday.

It would expand Medicaid only to working Mississippians making up to 99% of the federal poverty level, about $15,000 annually for an individual. The plan, which Medicaid Chair Kevin Blackwell, R-Southaven, has referred to as “expansion light,” would be entirely contingent on a work requirement being approved by the federal Centers for Medicare and Medicaid Services. 

That’s unlikely to happen under the Biden administration, which has rescinded work requirements previously approved for other states during the Trump administration and has not approved new ones. If the federal government denies the waiver, Mississippi would have to wait until a new administration took office, or sue the Biden administration. Georgia remains in litigation with the federal government over the work requirement issue, and has suffered low enrollment and missed out on millions in federal funds by not fully expanding coverage.

The Senate proposal has not been released to the public yet. Blackwell declined to comment on the substance of the plan, but stressed to Mississippi Today that he and Senate leaders are still tweaking parts of the legislation.

The Senate has until April 2 to pass the bill through Blackwell’s Medicaid committee and until April 10 to bring it to a floor vote. 

It’s estimated that traditional Medicaid expansion would insure roughly 123,000 uninsured Mississippians. Currently, a Mississippian must have children and be making less than 28% of the federal poverty level to qualify for Medicaid coverage. For a family of two, such as a single mother and her child, 28% of the federal poverty level would be about $5,700 a year.

Tens of thousands of working Mississippians fall into the “coverage gap,” making more than 28% of the federal poverty level, but not enough to receive subsidies that would make private health insurance affordable.

In addition to insuring more Mississippians, expansion would also reduce the risk of rural hospital closure by 62%, according to a report by The Chartis Center for Rural Health. 

Right now, Mississippi hospitals lose hundreds of millions of dollars a year in uncompensated care costs, or money spent treating uninsured patients. That directly impacts the financial health of hospitals, with one report putting almost half of Mississippi’s rural hospitals at risk of closure. 

“It’s a tremendous burden on the health system,” said Dr. Claude Brunson, an anesthesiologist and the association’s executive director. “The whole system depends on us being able to take care of people, and we fund that through people on insurance. And when you go out to the rural areas of our state, there are a lot of people with no insurance but they need care. And they could have insurance, and that would help stabilize those hospitals there, those practices there, so that we can keep them open. If we can keep the hospitals open, we can actually see those patients in their hometowns, in their communities, and that’ll give us the ability to improve the health of Mississippi.”