STARKVILLE — Medicaid expansion will likely spend another session as one of the Mississippi Legislature’s central issues, but with a new administration headed for the White House, District 48 Rep. and House Speaker Jason White, R-West, hopes to gain more support for expansion.
If expanding Medicaid coverage was purely a business decision, it would have already been made, White told the Starkville Rotary Club on Monday.
“It is a drag on our business economy. It’s a drag on our health care economy and the delivery of health care,” he said during the club’s meeting at Hilton Garden Inn. “It’s time we had real adult conversations about the best path forward for our state and finding a way to cover these individuals.”
White led the House of Representatives’ push to expand Medicaid during the 2024 session. The proposal, which aimed to cover an additional 200,000 low-income citizens, passed overwhelmingly in the House.
However, the Senate stalled the progress when leaders insisted that any expansion must include a work requirement tied to federal approval. With no compromise on the issue, the possibility of expansion fizzled as the session ended.
But with a second Trump administration on the horizon, White said there’s a chance to “put a little more of a conservative spin” on expansion to rally more support.
“There may be things that we can avail ourselves to as a Republican state that a Trump administration leading Medicaid might be willing to work with us on what the Biden administration did not,” he said, referencing work requirements or caps to limit how many can seek coverage as examples.
Conversations about expansion during the 2025 session will take that under consideration, but there’s no guarantee that any part of the Affordable Care Act will change, White said.
“When President Trump was president in his first four years, he had the House and Senate two of those four years, and they didn’t change the ACA,” he said. “At that time, only about 24 or 25 states were in it. There are 40 now. They may change it or they may tweak it, but it’s not going away.”
Either way, the need for expansion isn’t going away either, he said.
“It’s not the way you would have designed health care. It’s not the way I would have designed health care,” White said. “But it is the product that is there. … We’ve just chosen (to ignore it). Our hospitals and our health care providers continue to not reap the benefits of it in the form of uncompensated care that particularly hurts our rural hospitals.”
Higher education in the 2025 session
Rearranging Mississippi’s higher education system was another hot issue in the 2024 session. From a bill proposing the closure of at least three universities to one calling for the merger of Mississippi University for Women into Mississippi State University.
White said he doesn’t know of any House members who have adopted the task of culling costs in the state’s higher education landscape, but with enrollment cliff looming, he expects it will continue to be a conversation.
“I do think as you see increasing enrollment at places like Mississippi State and Ole Miss, and you see decreasing enrollment at places like The W and others, you’re going to hear conversations,” he told The Dispatch.
With such a large network of public universities and a robust community college system, lawmakers will have to make decisions about where funding is best spent, he said.
“Because resources are so few, you’re going to continue to hear lawmakers … figure out what is the best spend of taxpayers’ money as it relates to supporting universities,” White said. “Maybe because of The W’s proximity to Mississippi State, that’s a natural conversation to have.”
McRae is a general assignment and education reporter for The Dispatch.
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