Four years ago, the Mississippi legislature passed Senate Bill 2441. The law’s intent was to have a provider-sponsored health plan participate in the Medicaid program as a way to improve healthcare delivery in the state. This plan, Mississippi True, has already obtained a license from the Mississippi Department of Insurance.
This proposal will close the coverage gap left by Mississippi’s decision not to expand Medicaid under the Affordable Care Act. In Mississippi
many adults (including all childless adults) fall into a coverage gap of having incomes above Medicaid eligibility limits but below the lower limit for Marketplace premium tax credits. These Mississippians earn too much to qualify for Medicaid, but not enough to be eligible for ACA Marketplace premium tax credits.
Our proposal closes this gap and includes:
Coverage for non-disabled adults age 19-64 earning up to 138% of the federal poverty level ($17,326 for an individual or about $35,000 for a family of four in 2019). This population in Mississippi is estimated to be about 163,000 according to the Kaiser Family Foundation.
Those covered will pay $20/month per enrollee in premium payments. There will be a $100 co-pay for non-emergency use of the hospital emergency department if there is a federally qualified health center, rural health clinic, or urgent care center within 20 miles of the hospital. Co-pays will mirror those found in Mississippi’s traditional fee-for-service Medicaid.
Community Engagement – Non-employeed enrollees must enroll in job-training or educational program. There are exceptions for the community engagement requirements.
Benefits Offered – The plan will mirror the Medicaid plan benefits for adults with the exception of non-emergency transportation services. This will allow for unlimited physician visits with a pharmacy limit of six prescription drugs per month. Dental and vision will be included.