Mississippi Medicaid receives nation’s first 10 year federal waiver

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Fred Anklam Jr., Mississippi Today

Mississippi State Capitol

The federal government has granted its first ever 10-year waiver to Mississippi’s Division of Medicaid. The waiver, which is for family planning services, is one in a series of anticipated moves by the federal agency to increase the autonomy of state Medicaid programs.

The decision, announced Friday by the federal Centers for Medicare and Medicaid Services, will allow Mississippi Medicaid to continue providing family planning services such as birth control and emergency contraception to residents with incomes up to 194% of the federal poverty level. Previous federal waivers in this state and others had maxed out at five years.

“We are extremely pleased to have received the 10-year extension of the Family Planning Waiver by the Centers for Medicare and Medicaid Services. The primary objective of this waiver is to reduce the number of unplanned pregnancies and subsequent births by providing eligible individuals access to family planning services,” said the Division of Medicaid in a statement to Mississippi Today. “This 10-year demonstration extension will help ease the administrative burden on our agency allowing us to focus on providing these needed services to our beneficiaries.”

In their announcement Friday, the federal Centers for Medicare and Medicaid Services said that extending the length of the waiver was a strategic move towards giving states more authority over how to run their programs.

“This is the first ten-year demonstration extension in the history of CMS, and allows Mississippi to administer its Medicaid program without the inconvenience of obtaining routine approvals from CMS,” said administrator Seema Verma. “This action shows our continuing commitment to giving states the flexibility they deserve to meet the unique needs of their people.”

Giving states more leeway in how they run their Medicaid programs has been an oft- expressed goal for the Trump administration. Block grants, in which states receive only a set allotment for Medicaid in exchange for greater flexibility in how they design their program, have been a frequently discussed topic, in both the state’s and nation’s capitals.

This could be a popular result for Mississippi’s elected officials who have previously tried and failed to change aspects of the program. In 2015, the Legislature tried to curb the ability of Planned Parenthood to deliver family planning and other women’s health services by passing a law barring that organization from receiving Medicaid funds. A federal appeals court blocked that law last year. Although Planned Parenthood does provide abortions in several states, it does not in Mississippi.

Over the next several months, Verma and CMS are also expected to grant several controversial Medicaid waivers to Republican-led states. These waivers could allow states to require certain beneficiaries to participate in cost sharing programs or work before becoming eligible for the program. Healthcare advocates and some states, however, have projected that these moves would reduce the number of people enrolled in Medicaid.

In November, Mississippi’s Division of Medicaid held two hearings on proposed work requirements. If granted, Mississippi adults who receive Medicaid would have to work at least 20 hours a week.

Ironically, working 20 hours a week at minimum wage would make potential beneficiaries ineligible for Medicaid in the state. In order to qualify for Medicaid in Mississippi, an adult with one dependent cannot receive more than $306 dollars a month in income. A minimum wage of $7.25 an hour equals $580 a month.

In contrast, the federal waiver allows Medicaid to provide family planning services, alone, to Mississippians who earn more than 194 percent of federal poverty level, or just under $24,000 a year for an individual, or approximately double that for a family of four. Normally these people would earn too much money to qualify for Medicaid in this state.