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White House tells Mississippi, Medicaid expansion is ‘all-or-nothing’ deal

Mississippi and other states reluctant to accept full participation in the Affordable Health Care Act’s expansion of Medicaid learned today they can forget about gaining a full share of Obamacare funding.

Gov. Phil Bryant and Republican leaders in the Legislature have insisted the state won’t join in the expansion of Medicaid to cover more than 300,000 of the state’s uninsured working poor. The health care reform law enacted in 2010 calls for Medicaid to be offered to anyone who earns up to 133 percent of the federal poverty level, which is $14,856 this year. Under the law, the federal government would pay the full cost of enrolling newly eligible people from 2014 to 2016, after which the share would gradually shrink until it reached 90 percent starting in 2022.

Bryant says the state can’t afford the expansion. But the state should not expect any matching dollars for an expansion beyond the full one specified in the law, said Health & Human Services Secretary Kathleen Sebelius in a letter to governors Mondays.


The White House position is seen to mean that Mississippi will not be offered money to make up for the $152 million it receives in federal dollars annually to help hospitals cover the cost of treating the uninsured. This money is phased out with the Medicaid expansion.

Some states had questioned whether they could offer benefits to fewer people by extending eligibility to some level of income below 133 percent of poverty. The answer is no, according to Sebelius, who says the law specifies all or nothing.

Here’s a story from Tuesday’s Huffington Post:




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