HB 1725 Summary

• Directs the Division of Medicaid to negotiate a Section 1115 waiver with the federal government to create the Healthy Mississippi Works (HMW) program covering individuals aged 19-64 with income at or below 138% of federal poverty level, with approval deadline of September 30, 2024.

• Establishes HMW coverage requirements including enrollment through managed care organizations, a $10 copayment for nonemergency emergency room use (waived if nurse hotline is called first), and workforce training and financial literacy services provided by health plans.

• Provides fallback provision: if the federal waiver is not approved by September 30, 2024, or is subsequently terminated, the Division shall submit state plan amendments to provide the same HMW coverage beginning January 1, 2025.

• Implements a 4% assessment on capitated payments to managed care organizations, coordinated care organizations, and provider-sponsored health plans to fund state matching funds for the program, with additional funding from hospital assessments and potential legislative appropriations.

• Sunsets all provisions of the act on January 31, 2029, with automatic discontinuation of coverage if federal matching funds fall below 90% at any time.