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HB 546

Medicaid; require Governor and Division of Medicaid to negotiate to obtain federal waiver to expand Medicaid coverage.

2025 Regular Session Introduced by Bryant Clark

Requires Mississippi to seek federal Medicaid expansion waiver, potentially covering 180,000+ low-income residents with 90% federal funding; died in committee.

Died In Committee
#appropriationsa #medicaid
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Bill Summary · HB 546

Legislative bill overview

HB 546 would have required Mississippi's Governor and Division of Medicaid to negotiate with the federal government to obtain a waiver allowing the state to expand Medicaid coverage beyond current eligibility limits. The bill died in committee on February 4, 2025, and did not advance to a floor vote.

Why is this important

Medicaid expansion would extend healthcare coverage to approximately 180,000-200,000 additional low-income Mississippians who currently fall into the "coverage gap"—earning too much for current Medicaid but too little to afford private insurance. The federal government covers 90% of expansion costs, potentially bringing hundreds of millions in federal dollars to the state while reducing uncompensated hospital care costs.

Potential points of contention

  • State budget concerns: Even with 90% federal funding, Mississippi would bear approximately 10% of costs ($30-50 million annually), raising concerns about long-term state budget obligations if federal matching rates decline
  • Conservative ideology: Mississippi leadership has historically resisted Medicaid expansion on principle, viewing it as federal overreach; mandatory negotiation language may be seen as circumventing executive discretion
  • Implementation complexity: Negotiating federal waivers requires significant administrative resources and time, with uncertain outcomes depending on federal administration priorities

Compiled from official sources — confirm details with the bill’s official record.

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