Holdout states consider expanding Medicaid -- with work requirements

But last month, the state Senate approved an amended version with expansion only up to 100% of the federal poverty level, and a provision that Mississippi would only implement the limited expansion following federal approval of a work requirement.

Now Mississippi lawmakers are trying to find middle ground, knowing that they need a bill that can garner a veto-proof majority.

In Belzoni, Walton, who is a Democrat, wants the state to expand Medicaid to its fullest without any work requirements. But he said people in Humphreys County could live with the flexible requirements in the House expansion bill.

“I could go along with that,” he said. “And I think that will be more acceptable in these rural areas.”

Resistance in Kansas

In Kansas, another holdout state, Democratic Gov. Laura Kelly is pushing a full-fledged Medicaid expansion bill that includes work requirements, designed to win the approval of the Republican-dominated legislature. It would cover an estimated 152,000 Kansans.

At a news conference last month, Kelly emphasized that expansion would help Kansas hospitals in danger of closing.

“At this point, any legislator standing in the way of Medicaid expansion is going against a commonsense, fiscally responsible proposal that benefits their constituents, their hospitals, their businesses, their community and our entire state,” Kelly said.

“I don’t know how many more hospitals, health clinics and emergency rooms must close before we expand Medicaid in Kansas,” she added. “The answer should be zero.”

But Kansas House Speaker Dan Hawkins, a Republican, remains fiercely opposed. At a town hall meeting last week, Hawkins called Kelly’s plan “smoke and mirrors,” according to the Kansas Reflector.

“We don’t want to make a huge mistake,” Hawkins said. “Medicaid expansion is a huge mistake.”

And in Wyoming, Republican state Sen. Cale Case, who supports expansion, said in an interview that he doesn’t think work requirements are enough to win approval — even with the possibility of another Trump administration. Case represents Fremont County, which is about to get a new hospital. He also represents much of the Wind River Indian Reservation, which has a poverty rate of 22.6%, twice the statewide rate.

“My colleagues refuse to accept the basic proposition that this would benefit our rural health care system,” Case said. “They actually think it would hurt our rural health care system and they are wrong. They’re blatantly wrong.”