The budget reconciliation bill approved over the weekend by Democrats in the US Senate and now awaiting a vote in the House does not provide assistance to poor Mississippians trying to get health insurance.
Despite generally praising the bill, Sharon Parrott, president of the Washington DC-based Center for Budget and Policy Priorities, said, “However, the current funding does not support the more than 2 million low-income people living in poverty.” line the uninsured because their states refused to adapt to Medicaid expansion. The majority of Medicaid beneficiaries live in the South and three out of five are of color.
A previous version of the bill, which was considered last fall, provided a way for people living below the federal poverty level (about $13,550 a year) to get health insurance. The proposal was designed specifically to provide health care to the poor in 12 states, including Mississippi, that did not expand Medicaid. But at the time, the Senate Democratic leadership could not get the 50 votes needed to pass what is known as a reconciliation bill. Democratic senators Joe Manchin of West Virginia and Kyrsten Sinema of Arizona rejected the $3.5 trillion bill for various reasons, not least related to health care.
Over the weekend, Sinema and Manchin stepped up to help pass a $669 billion reconciliation bill — known as the Inflation Reduction Act — that provided a number of things, including:
- Various tax credits and other incentives for electric vehicles and other green energy technologies.
- A lower tax rate of 15% for large companies.
- Insulin cartridges for Medicare recipients.
- A policy that allows Medicare to negotiate the cost of drugs.
- Continuing to help people buy private insurance on the health market exchanges.
The health care provision that was originally part of the bill but was removed from last week’s proposal would allow those who fall below the federal poverty level to receive special health care provided by the state through health exchanges.
Under current law, people who earn less than the federal poverty level are not eligible for market policies.
Two million Americans could get health care through the plan, with most of them in Texas, Florida, Georgia and North Carolina, according to an analysis by Judith Solomon, a health expert with the Center for Budget and Policy Priorities. Southern Republicans in particular have opposed Medicaid expansion.
In Mississippi, studies estimate that between 200,000 and 300,000 working Mississippians could be eligible for benefits if the state expands Medicaid.
If Mississippi expands Medicaid under current law, the state will pay 90% of health care costs while the state pays the rest. Gov. Tate Reeves, Speaker of the House Philip Gunn and others have argued that Mississippi cannot afford to pay for the increase in Medicaid, although many studies have found that the increase, including the infusion of billions of dollars in federal funds, would increase the amount that the state provides.
Of course, the waiting list in non-Medicaid states is a strong incentive to expand Medicaid. The federal American Rescue Plan, proposed in early 2021 as a response to the COVID-19 pandemic, provides additional incentives for states to expand Medicaid. The initiative in Mississippi to expand Medicaid by more than $600 million over two years.
The Deficit Reduction Act will likely pass the House in the coming days and be sent to President Joe Biden, who is expected to sign it into law.