An effort in the Mississippi Legislature to accept billions of dollars in federal money to expand Medicaid coverage to the working poor – a policy which medical experts, clergy and business leaders advocated – was expected to die on a Thursday night deadline, according to House leaders.  

House Medicaid Chair Missy McGee, R-Hattiesburg, told reporters that she delivered a proposal to Senate negotiators on Thursday morning that would have allowed voters to have the final say on a statewide referendum in November whether the state should expand Medicaid. 

But the Forrest County lawmaker said she had not heard a response from the Senate at all on Thursday, leading her to believe expansion is certain to die by an 8 p.m. Thursday deadline. 

“It’s disappointing,” McGee said. “We worked really hard on it, and we fought to the bitter end.” 

The bill’s death would mark an end to months of intense debate at the Capitol and scores of rallies urging legislators to adopt expansion under the federal Affordable Care Act. 

For a brief moment on Wednesday, it appeared both chambers at the Capitol might adopt a compromise, but expansion under that proposal contained stipulations the federal government is not likely to approve and could have held expansion here in limbo for years.

House and Senate negotiators on Tuesday night agreed on a compromise that would have expanded Medicaid coverage to individuals who make roughly $20,000 but only if the federal government signed off on a work proposal for recipients – something the federal government was almost certain to reject. 

But the deal fell apart after rumors circulated in the Capitol that the Senate did not have enough votes to support the plan and after a large portion of Democrats in the House objected to the work requirement. 

House Speaker Jason White, R-West, said he would have had the votes Wednesday in the House to pass the compromise, even with the loss of a significant number of Democratic votes.

But the speaker opted to send the proposal back to negotiations after being told by Senate leaders that the Senate only had 28 votes – not enough to pass it by a needed three-fifths majority. 

White said his negotiators offered the referendum option as a compromise that he hoped more Senate Republicans could support. He said he knew it was a long shot that the Senate would accept the proposal, but he thought it was worth a try.

“I am not casting blame,” White said when asked about what he said was the lack of votes in the Senate. “… But I had to act on that information.”

White said he was disappointed that Medicaid expansion did not pass this session, but he said he is glad it was debated and discussed during the session.

“It was a good first step,” he said. “Whether we will look at it next year or the next, I don’t know. We will have to reassess.”

White, in his first year as speaker, was the first Republican legislative leader to bring up legislation to enact Medicaid expansion. That original proposal passed by an overwhelming bipartisan vote in the House.

When asked about whether the Senate had the votes to pass the compromise on Wednesday, a spokesperson for Lt. Gov. Delbert Hosemann said, “The Senate was working to secure the votes, but that effort stalled when House Democrats indicated they did not support the bill.”

Democratic leaders in a statement said they have been “crystal clear” about what they were willing to accept in a Medicaid expansion compromise, but whether House Republicans wanted to listen to is “beyond our control.”

“Unfortunately, neither House nor Senate leadership chose to act on the language we proposed,” the statement read. “Instead, we will leave Jackson without a plan to solve our state’s increasingly dangerous healthcare crisis.”

If the expansion legislation dies as expected, lawmakers will have to wait until next year during the 2025 session to reconsider the policy that 40 other states have adopted. 

Bishop Ronnie Crudup, Sr., the Mid-South Diocese of the Fellowship of International Church who has been advocating for expansion for months at the Capitol, told Mississippi Today he was still hoping the two chambers could reach a “dramatic” last minute compromise. 

“But we will continue to advocate for Medicaid expansion,” Cruddup said. “If something dramatic doesn’t happen, we will be looking for other routes to make this happen.”

Lawmakers on Thursday said they expect to end the 2024 legislative session early Saturday.

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