(Updated August 3, 2018)
Introduction
Mississippi has joined a handful of states seeking federal permission to require parents and caregivers who qualify for Medicaid to prove they are working at least 20 hours a week or participating in an approved work activity before receiving health coverage. Called the “Mississippi Workforce Training Initiative,” the application for a Section 1115 demonstration waiver pledges to bring more Medicaid beneficiaries into the workforce and move them onto other forms of health insurance. The proposal, however, ignores the fact that only the poorest and most vulnerable parents now receive Medicaid in Mississippi—and that few of them will be able to afford insurance even if they find jobs. A revised version of the proposal does little to address the underlying problems.[note]Mississippi’s revised waiver request can be accessed at https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/
downloads/ms/ms-workforce-training-initiative-pa2.pdf.[/note]
In fact, the state’s own estimates suggest that about 5,000 of these Mississippi parents will lose their Medicaid coverage in the first year if the Centers for Medicare and Medicaid Services (CMS) approves the state’s request.[note]These estimates are based on Georgetown CCF calculations of enrollment assumptions included in the state’s budget neutrality estimates
accompanying the Section 1115 proposal. For simplicity’s sake we have divided the enrollment estimates (which are presented as monthly estimates) by 12 to get an annual estimate of those losing coverage. There may, in fact, be more people who lose coverage for less than 12 months or a smaller number who lose coverage for longer.[/note] The vast majority of these parents are likely to become uninsured.
Approval by the federal government is not certain. While CMS has given approval to four states—Arkansas, Kentucky, Indiana, and New Hampshire—to impose work rules, those states have all expanded Medicaid to adults making up to 138 percent of the federal poverty level. Mississippi, however, has not accepted the Medicaid expansion funding provided under the Affordable Care Act. The only Mississippi families affected by the proposed change would be those living at 27 percent of the poverty level or lower. That works out to $5,610 a year for a family of three or $468 a month—among the most restrictive eligibility limits in the nation
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The Georgetown Center on Children and Families is an independent, nonpartisan policy and research center founded in 2005 with a mission to expand and improve high-quality, affordable health coverage for America’s children and families. Mississippi Health Advocacy Program combines research, analysis and grass-roots organizing to improve health policies, practices and funding. Mississippi Center for Justice is a nonprofit, public interest law firm committed to advancing racial and economic justice.