Medicaid has existed for over 50 years in one form or another, but it’s always been a complicated topic with major political and sociocultural implications. Beyond that, expansion based on federal standards is largely dependent on individual state decisions. Over 30 states and Washington, D.C. have opted to expand Medicaid coverage, but many states still have not. Among the states that have not is Mississippi.
Current State of Medicaid in Mississippi
As of December 2019, Mississippi continues to walk its own path where healthcare is concerned. It has not adopted major policies from the Affordable Care Act (ACA), and is one of a handful of states that is doing little to keep ACA regulations from expiring or being overturned. Most citizens of Mississippi who need healthcare coverage do so through the Marketplace, assuming they can afford it.
Mississippi’s choice to forego the policies of the ACA has left more than 100,000 people in the coverage gap. In fact, Mississippi’s enrollment in Medicaid has hardly changed since 2013 as a result of this choice. The way regulations currently stand, adults with dependent children are only eligible for Medicaid if the family’s income is 23 percent or less of the federal poverty level (FPL). That’s approximately $4,419 annually for a family of three. On the other hand, pregnant women are eligible for Medicaid in a household at 194 percent of the FPL. Not-elderly, non-disabled, childless adults are not eligible for Medicaid at all.
Children up to age 19 may be eligible for Medicaid, but the percentage of the FPL that they must be beneath is dependent on their age, ranging from 133 percent to 194 percent. If ineligible for Medicaid, they may be eligible for CHIP if their household income is less than 209 percent of the FPL.
At the end of 2019, almost 99,000 people in Mississippi were signed up for plans through HealthCare.gov due to a lack of other options.
Mississippi is attempting to establish Medicaid work requirements in a similar manner to Alabama. The work requirement, if approved (it is currently pending), would require low-income individuals to work 20 hours/week to maintain their Medicaid status. However, that would mean 5,000 people would actually lose coverage from Medicaid, as they would then make more money than the required percentage of the FPL.
Many people would be exempt from this waiver. These populations include individuals with disabilities, those who are physically or mentally unable to work, caregivers, pregnant women, children and Native Americans. The state proposed a 12-month transitional period for the nonexempt in which they could figure out their finances, but this would realistically do little to help this population.
How DECO Can Help
At DECO, our job is to help patients get eligible for healthcare coverage and help healthcare organizations get reimbursed for the care they provide. Our staff are highly trained experts at revenue cycle management and advocating for eligibility. We also make it a priority to stay up-to-date on the latest healthcare news, and to pass that information on to you. In addition, we have a free state-by-state Medicaid regulation guide that you can use to help determine eligibility. Contact us today with any questions! We’re happy to help.