As Congress moves toward potential Medicaid cuts, many in Mississippi could lose benefits

JACKSON, Miss. – by Sophia Paffenroth (Mississippi Today) Hundreds of thousands of poor, disabled or pregnant Mississippians could lose health care coverage if Congress slashes funding for Medicaid. 

Although President Donald Trump has vowed Medicaid won’t be “touched,”  the U.S. House of Representatives passed a budget resolution Tuesday that instructs the committee that oversees Medicaid and Medicare to cut $880 billion over 10 years. The cuts will help pay for Trump’s agenda on tax cuts and border reform.

The talk of such dramatic changes to the federal-state program has Mississippi lawmakers concerned – and hesitant to push expansion this year.

Proposals for Medicaid budget cuts nationwide include lowering the rate at which states are reimbursed for Medicaid services, capping the amount of money states can get per enrollee, and imposing block grants – meaning states would receive a fixed dollar amount for the program, regardless of need. 

Mississippi, the poorest state in the nation, could suffer the most under some of these proposals, according to health policy experts. 

Despite the state having some of the strictest eligibility requirements in the nation, pervasive poverty and poor social health determinants mean that more than 650,000 Mississippians – about half of whom are children – rely on the program for basic health care. More than half of births in Mississippi are funded by Medicaid. 

“Mississippi has a relatively small population, with the lowest per capita annual income in the country, rates of chronic conditions that are consistently higher than the national average, and with around 60% of Mississippians living with multiple chronic conditions,” explained John Dillon Harris, a health care systems and policy consultant at the Center for Mississippi Health Policy. “… The result is a large Medicaid population that is very expensive to treat.” 

Democratic lawmakers are also sounding the alarm about deep cuts to Medicaid. Rep. Omeria Scott, D-Laurel, said it’s something Mississippians “ought to really be afraid of.”  

“If they are talking about cutting $880 billion out of the budget, Mississippi is going to be on its knees,” she said at the Democrats’ legislative press conference Tuesday. 

However, since Mississippi is one of only 10 states not to expand Medicaid and draw down billions in additional federal funds, some proposed cuts wouldn’t directly affect the state’s current budget – though they would affect future enrollment. 

“Mississippi isn’t drawing down as much, so that’s not going to be a direct cut to your current budget, but it’s an opportunity cost,” said Joan Alker, Medicaid expert and executive director of Georgetown University’s Center for Children and Families. 

Threats to slash Medicaid spending have already scared away Mississippi lawmakers from attempting expansion this year – though they have passed “dummy bills,” void of details, to keep the issue alive “should something transpire,” House Speaker Jason White said. 

After a decade of squelching any debate on the issue, Mississippi House GOP leaders in 2024 pushed for legislation that would expand Medicaid to 200,000 low-income adults, as 40 other states have done. While the bills died after a saga of partisan politics, advocates were hopeful that the historic session created enough momentum to get the policy through the finish line in 2025. 

Now, lawmakers fear they may have bigger problems on their hands. 

“Unfortunately, we’re hearing more about what may be cuts or block grants to the Medicaid program in general that we will have to deal with as a state because there’s no denying we have a large Medicaid population – so I don’t know the chances,” White said when asked about the likelihood Medicaid expansion would be brought up this year.

Others are more certain the issue is dead this year.

“In a most practical sense, I’d say we probably won’t be doing anything this year,” Senate Medicaid Chairman Kevin Blackwell told Mississippi Today, though he added that if anything changes, lawmakers could suspend the legislative rules and bring a bill back to life late in the session. 

Lt. Gov. Delbert Hosemann said Mississippi lawmakers have “a leg up” since the state’s former Medicaid director recently landed a spot in Washington leading the federal Medicaid division under Trump. Hosemann has yet to say what, if anything, Snyder has told lawmakers so far, but said he expects to have “a direct commentary into the area of Medicaid” through Snyder.

Regardless of what action the federal government decides to take, cuts of this magnitude would affect millions of low-income people across the country, not just in Mississippi. 

“States will be forced to deeply cut eligibility, benefits and reduce provider rates,” Alker said in a statement published online in response to the House budget resolution outlining Medicaid costs. “These cuts will especially harm rural communities who are more reliant on Medicaid, and where hospitals are already operating on tighter margins.” 

Taylor Vance, Geoff Pender and Michael Goldberg contributed to this report.

Mississippi Today receives grant support from The Bower Foundation, as does the Center for Mississippi Health Policy.  Donors do not in any way influence our newsroom’s editorial decisions. For more on that policy or to view a list of our donors, click here.

Mississippi Today first published this article. The Vicksburg Daily News republishes it here under a Creative Commons license.