MS HB305

Governor and Division of Medicaid must negotiate with Centers for Medicare and Medicaid Services (CMS) for a Section 1115 waiver to expand Medicaid coverage to adults earning up to 138% of Federal Poverty Level (FPL).

Newly eligible adults will receive private market-based health coverage through at least two Qualified Health Plans (QHPs), with state paying premiums directly to insurers while enrollees pay cost-sharing contributions.

Cost-sharing capped at 2% of income for those earning 50-99% FPL and 5% of income for those earning 100-138% FPL, with contributions made to Mississippi Healthy Living Accounts and reducible through healthy behavior participation.

Plan automatically terminates if federal contribution rate falls below 90%, and parents currently earning up to 22% FPL will be transitioned from traditional Medicaid to the new plan.

Upon obtaining waiver approval, Division of Medicaid shall amend state plan and implement the expansion, with newly eligible individuals added as a covered category under state Medicaid law effective July 1, 2018.