Rejecting Medicaid Expansion would Create Coverage Gap for Mississippi’s Most Vulnerable Working Families

July 13th, 2012

One of the main purposes of the Affordable Care Act is to limit the number of uninsured Americans. Those without insurance often cannot afford regular medical treatment (including preventative care) and are forced to turn to costly emergency care when it cannot be avoided. This care is paid for by taxpayers through state Uncompensated Care funds and by consumers through increases in medical costs by providers to fund the balance of these costs. If everyone has health insurance, these costs are lowered and care costs less for everyone.

The ACA is designed to provide insurance to the uninsured through two basic measures:

An expansion of Medicaid for the lowest income Americans
A health insurance exchange to allow uninsured persons to buy insurance more easily and to provide subsidies for those at low income levels

Mississippi has engaged in considerable work to set up a health insurance exchange, and the mandate to purchase health insurance was upheld by the recent Supreme Court ruling. However, the same ruling allows states to opt out of participation in Medicaid expansion. Since the ruling, some Mississippi state leaders have been contemplating denying Medicaid coverage for the low income Mississippians who would be eligible under the ACA expansion.

According to estimates from the Urban Institute, the ACA Medicaid expansion would allow coverage for over 60% of the uninsured in Mississippi. The table below provides estimates of the number of uninsured below certain income thresholds.

That’s over 300,000 Mississippians. Those working families who would be newly eligible for Medicaid would be families whose earnings are between 44% and the 138% of the federal poverty guidelines, or between about $10,000 and $30,000 for a family of four. That would include families with two workers in minimum wage full time employment. Without expanding Medicaid, these families would be left out, and Mississippi taxpayers and consumers will still be paying for the higher health care costs through uncompensated care.

If the state does provide Medicaid coverage for these families, the federal government will provide 100% of the costs of the expansion up front and 90% when the expansion is fully implemented. Furthermore, the Act is a huge economic opportunity – bringing in over $10 billion from 2014 to 2019 that will support job creation in the health care sector.