Mississippi legislative leaders advocate Medicaid expansion, heading to conflict with the governor

JACKSON, Miss. — Mississippi's Republican legislative leaders said Thursday that they plan to push for Medicaid expansion to cover working people who earn too little to afford private insurance — a position that business groups have advocated but that Republican Gov. Tate Reeves opposes.

House Speaker Jason White and Lt. Gov. Delbert Hosemann spoke about their 2025 policy priorities to hundreds of business people and community leaders at Hobnob, a social gathering hosted by Mississippi Economic Council, the state chamber of commerce.

Medicaid expansion is an option under the health overhaul that then-President Barack Obama signed into law in 2010. Mississippi is one of the poorest states in the U.S., and it’s one of 10 states that have not expanded the program. The vast majority of funding for the expansion would come from the federal government, but the state would have to cover some costs.

Reeves, though, refers to Medicaid as “welfare” and has frequently said he does not want more people to enroll. The governor usually speaks at Hobnob, which is held at the Mississippi Coliseum on the state fairgrounds. But he did not appear at the event this year.

MEC and two other business groups — the Mississippi Manufacturers Association and the Business and Industry Political Education Committee — released a joint statement in April when legislative leaders were negotiating over the possibility of Medicaid expansion. The groups said expanding access to health care would lead to “a healthier population, a healthier workforce, and an improved quality of life, all of which contribute to stronger Mississippi communities.”

The three groups said they trust elected officials and state agencies “to use federal dollars responsibly.”

Reeves is in his second term as governor after two terms as lieutenant governor.

Hosemann said Thursday that Medicaid expansion could help about 75,000 working people who can’t afford insurance, and he noted: “There’s a governor that doesn’t necessarily agree with some of our proposals."

White said he has heard politicians say elected officials should run the state like a business.

“Providing affordable access to health care for low-income workers is a smart investment in our workforce, and it is exactly the business-minded approach that all of you would take in your own individual businesses,” White said.

The three-month legislative session begins in early January.

White said some of his other big goals for the session are phasing out the state income tax, reducing the 7% sales tax on groceries and enacting a plan to let children attend public schools outside the districts where they live.

Hosemann said the Senate will propose a reduction in the grocery tax. He did not list a phase-out of the income tax or a school choice plan among his policy priorities. He mentioned that Mississippi is already in a years-long process of reducing its personal income tax under a law enacted in 2022.