MISSISSIPPI LEGISLATURE 2025 Regular Session To: Medicaid By: Senator(s) Hickman Senate Bill 2888 AN ACT TO AUTHORIZE AND DIRECT THE MISSISSIPPI DIVISION OF MEDICAID (MDOM) TO CONDUCT A STUDY EXAMINING THE EFFECTIVENESS AND FISCAL RESPONSIBILITY OF WORK REPORTING REQUIREMENTS IN MEDICAID EXPANSION LEGISLATION, IN THE EVENT A MEDICAID EXPANSION BILL EXPANDS COVERAGE TO CREATE A PLAN TO ALLOW MEDICAID COVERAGE IN MISSISSIPPI FOR INDIVIDUALS DESCRIBED IN THE FEDERAL AFFORDABLE CARE ACT, TO PROVIDE THAT THE COVERAGE GROUP FOR ELIGIBILITY MUST BE INDIVIDUALS 19-64 OF AGE WHOSE INCOME IS NOT MORE THAN 138% OF THE FPL; TO PROVIDE FOR A STUDY OF THE EFFECTS OF MANDATORY MONTHLY AND/OR QUARTERLY WORK REPORTING REQUIREMENTS ON THE NEWLY ELIGIBLE COVERAGE GROUP; TO PROVIDE THAT UPON THE COMPLETION OF THE STUDY CYCLE CONDUCTED BY JULY 1, 2028, A REVIEW OF THE STUDY MUST BE CONDUCTED BY THE MEDICAID COMMITTEES OF BOTH HOUSES OF THE LEGISLATURE; TO AUTHORIZE THE DIVISION TO RECOMMEND METHODOLOGY TO AMEND MEDICAID EXPANSION WORK REQUIREMENT LEGISLATION UPON REVIEW OF THE REPORT DISPLAYING DETRIMENTAL IMPACTS TO THE COVERAGE GROUP, IMPLICATIONS OF MEDICAID COVERAGE LOSS FOR HEALTH CARE PROVIDERS AND HEALTH PLANS; TO PROVIDE THAT THE PROVISIONS OF THIS ACT SHALL STAND REPEALED ON JANUARY 31, 2032; AND FOR RELATED PURPOSES. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: SECTION 1. (1) The Mississippi Division of Medicaid (MDOM) shall collect, evaluate and report upon the following data in connection with the Medicaid expansion program as federal law may require: (a) In addition to and on the same schedule as the data collection required by federal law, the division shall collect, evaluate and report on further information with respect to any mandatory work reporting requirements of the Medicaid expansion legislation. (b) With respect to all terminations of Medicaid benefits to the coverage group, all of the same information as required under the federal law, plus the specific reason or reasons for the termination must be recorded and provided for the study upon request. (c) The division shall, in conjunction with the Mississippi Institutions of Higher Learning (IHL) in addition to the foregoing data collection and reporting activities, conduct a study on the implementation of Medicaid expansion and work reporting requirements. The study shall select subgroups representing important sectors of the coverage group, including type of area of residence (city, suburban, small town, rural), English proficiency, level of education, literacy, work experience, number of adults in the home, number of children in the home, teen parentage, parents before and after the age of eighteen (18), and other such subgroups. For each subgroup, the study shall assemble a statistically valid sample of cases entering the Medicaid expansion and work reporting requirements programs at least six (6) months after its implementation date and prior to July 1, 2026. The study shall continue until July 1, 2031. The division shall report to the Medicaid committees of the House and Senate and Governor by March 1 of each year, beginning July 1, 2027, the interim findings of the study with respect to each subgroup, and by August 1, 2031, the final findings of the study with respect to each subgroup. The reports shall be available to the public upon request. No later than November 1, 2031, the division, in consultation with an advisory panel of specialists in welfare policy, social science, and other relevant fields shall devise the study and identify the factors to be studied. The study shall, however, at least include the following features: (i) Demographic breakdowns including, but not limited to, race, gender, and number of children in the household at the beginning of division services. Study participants must meet the following criteria to participate: 1. Age nineteen (19) through sixty-four (64); 2. Received Medicaid coverage in the past year and have been subject to new Medicaid work requirements as a condition of eligibility; 3. Lost Medicaid eligibility in the past six (6) months by not meeting Mississippi Division of Medicaid work requirement rules and reporting procedures; or regained Medicaid coverage by reporting work activities; or received employment assistance. (ii) The division shall obtain permission to conduct the study from the subjects of the study and guarantee their privacy according to the federal law, Health Insurance Portability and Accountability Act (HIPPA). To facilitate this permission, the study may be designed to refer to subject by pseudonyms or codes and shall in any event guarantee anonymity to the subject without limiting access by outsiders to the data (other than identities) generated by the study. (iii) The subjects of the study shall be studied upon enrollment and potential disenrollment based on compliance with work reporting requirements to the extent feasible. The evaluator shall attempt to maintain personal contact with the subjects of the study, and employ such methods as meetings, telephone contacts, written surveys, and computer matches with other data bases to accomplish this purpose. The intent of this feature of the study is to discover the paths the coverage group takes upon expansion of Medicaid and implementation of work reporting requirements including the factors that may influence these paths and patterns. The study shall include a review and analysis of: 1. Division of Medicaid outreach and education efforts; 3. Division of Medicaid training and employment resources; 4. Division of Medicaid work reporting systems; 5. Division of Medicaid exemptions from work requirements; 6. Division of Medicaid enrollee understanding of work requirements; 7. Implications of Medicaid coverage loss for health care providers and health plans. (iv) The study shall examine the influence of various employability, education, and training programs upon employment, earnings, job tenure, and unemployment through work reporting requirement mandates. (v) The study shall examine the frequency of unplanned occurrences in subjects lives, such as illness or injury, family members' illness or injury, transportation complications, strikes, natural disasters, evictions, loss of other sources of income, domestic violence, and crime, and their impact upon employment, earnings, job tenure, and unemployment through work reporting requirement mandates. (vi) The study shall examine the reasons for subjects benefits loss, the reasons for coverage loss due to administrative requirements, noncompliance of work reporting requirements, the availability of reenrollment services, programs or services utilized by subjects to reenroll, whether the subject suffered a job loss, the characteristics of the subject's next job if applicable, and the relationship of these factors to reenrollment benefits, job tenure, and unemployment through work reporting requirement mandates. (vii) The study shall examine the impact of mandatory work reporting requirements, including the types of work activities, and the links between the requirements and the activities and sanctions, employment, earnings, job tenure, and unemployment through work reporting requirement mandates. (viii) The study shall, in compliance with HIPPA laws, track the subjects' usage of Medicaid benefits over the course of the study, including patterns of usage, preventative visits/screenings, sick visits, surgeries, emergency room visits, and number of cases. (ix) Put an objective, third-party evaluation in place at the start of a Medicaid work requirements demonstration so the implementation and impacts can be rigorously evaluated. (x) The division may recommend methodology to amend any Medicaid expansion work requirements upon review of the study prescribed in this section. (2) This section shall stand repealed on January 31, 2031. SECTION 2. This act shall take effect and be in force from and after July 1, 2025.
MISSISSIPPI LEGISLATURE
2025 Regular Session
To: Medicaid
By: Senator(s) Hickman
# Senate Bill 2888
AN ACT TO AUTHORIZE AND DIRECT THE MISSISSIPPI DIVISION OF MEDICAID (MDOM) TO CONDUCT A STUDY EXAMINING THE EFFECTIVENESS AND FISCAL RESPONSIBILITY OF WORK REPORTING REQUIREMENTS IN MEDICAID EXPANSION LEGISLATION, IN THE EVENT A MEDICAID EXPANSION BILL EXPANDS COVERAGE TO CREATE A PLAN TO ALLOW MEDICAID COVERAGE IN MISSISSIPPI FOR INDIVIDUALS DESCRIBED IN THE FEDERAL AFFORDABLE CARE ACT, TO PROVIDE THAT THE COVERAGE GROUP FOR ELIGIBILITY MUST BE INDIVIDUALS 19-64 OF AGE WHOSE INCOME IS NOT MORE THAN 138% OF THE FPL; TO PROVIDE FOR A STUDY OF THE EFFECTS OF MANDATORY MONTHLY AND/OR QUARTERLY WORK REPORTING REQUIREMENTS ON THE NEWLY ELIGIBLE COVERAGE GROUP; TO PROVIDE THAT UPON THE COMPLETION OF THE STUDY CYCLE CONDUCTED BY JULY 1, 2028, A REVIEW OF THE STUDY MUST BE CONDUCTED BY THE MEDICAID COMMITTEES OF BOTH HOUSES OF THE LEGISLATURE; TO AUTHORIZE THE DIVISION TO RECOMMEND METHODOLOGY TO AMEND MEDICAID EXPANSION WORK REQUIREMENT LEGISLATION UPON REVIEW OF THE REPORT DISPLAYING DETRIMENTAL IMPACTS TO THE COVERAGE GROUP, IMPLICATIONS OF MEDICAID COVERAGE LOSS FOR HEALTH CARE PROVIDERS AND HEALTH PLANS; TO PROVIDE THAT THE PROVISIONS OF THIS ACT SHALL STAND REPEALED ON JANUARY 31, 2032; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) The Mississippi Division of Medicaid (MDOM) shall collect, evaluate and report upon the following data in connection with the Medicaid expansion program as federal law may require:
(a) In addition to and on the same schedule as the data collection required by federal law, the division shall collect, evaluate and report on further information with respect to any mandatory work reporting requirements of the Medicaid expansion legislation.
(b) With respect to all terminations of Medicaid benefits to the coverage group, all of the same information as required under the federal law, plus the specific reason or reasons for the termination must be recorded and provided for the study upon request.
(c) The division shall, in conjunction with the Mississippi Institutions of Higher Learning (IHL) in addition to the foregoing data collection and reporting activities, conduct a study on the implementation of Medicaid expansion and work reporting requirements. The study shall select subgroups representing important sectors of the coverage group, including type of area of residence (city, suburban, small town, rural), English proficiency, level of education, literacy, work experience, number of adults in the home, number of children in the home, teen parentage, parents before and after the age of eighteen (18), and other such subgroups. For each subgroup, the study shall assemble a statistically valid sample of cases entering the Medicaid expansion and work reporting requirements programs at least six (6) months after its implementation date and prior to July 1, 2026. The study shall continue until July 1, 2031. The division shall report to the Medicaid committees of the House and Senate and Governor by March 1 of each year, beginning July 1, 2027, the interim findings of the study with respect to each subgroup, and by August 1, 2031, the final findings of the study with respect to each subgroup. The reports shall be available to the public upon request. No later than November 1, 2031, the division, in consultation with an advisory panel of specialists in welfare policy, social science, and other relevant fields shall devise the study and identify the factors to be studied. The study shall, however, at least include the following features:
(i) Demographic breakdowns including, but not limited to, race, gender, and number of children in the household at the beginning of division services. Study participants must meet the following criteria to participate:
1. Age nineteen (19) through sixty-four (64);
2. Received Medicaid coverage in the past year and have been subject to new Medicaid work requirements as a condition of eligibility;
3. Lost Medicaid eligibility in the past six (6) months by not meeting Mississippi Division of Medicaid work requirement rules and reporting procedures; or regained Medicaid coverage by reporting work activities; or received employment assistance.
(ii) The division shall obtain permission to conduct the study from the subjects of the study and guarantee their privacy according to the federal law, Health Insurance Portability and Accountability Act (HIPPA). To facilitate this permission, the study may be designed to refer to subject by pseudonyms or codes and shall in any event guarantee anonymity to the subject without limiting access by outsiders to the data (other than identities) generated by the study.
(iii) The subjects of the study shall be studied upon enrollment and potential disenrollment based on compliance with work reporting requirements to the extent feasible. The evaluator shall attempt to maintain personal contact with the subjects of the study, and employ such methods as meetings, telephone contacts, written surveys, and computer matches with other data bases to accomplish this purpose. The intent of this feature of the study is to discover the paths the coverage group takes upon expansion of Medicaid and implementation of work reporting requirements including the factors that may influence these paths and patterns. The study shall include a review and analysis of:
1. Division of Medicaid outreach and education efforts;
3. Division of Medicaid training and employment resources;
4. Division of Medicaid work reporting systems;
5. Division of Medicaid exemptions from work requirements;
6. Division of Medicaid enrollee understanding of work requirements;
7. Implications of Medicaid coverage loss for health care providers and health plans.
(iv) The study shall examine the influence of various employability, education, and training programs upon employment, earnings, job tenure, and unemployment through work reporting requirement mandates.
(v) The study shall examine the frequency of unplanned occurrences in subjects lives, such as illness or injury, family members' illness or injury, transportation complications, strikes, natural disasters, evictions, loss of other sources of income, domestic violence, and crime, and their impact upon employment, earnings, job tenure, and unemployment through work reporting requirement mandates.
(vi) The study shall examine the reasons for subjects benefits loss, the reasons for coverage loss due to administrative requirements, noncompliance of work reporting requirements, the availability of reenrollment services, programs or services utilized by subjects to reenroll, whether the subject suffered a job loss, the characteristics of the subject's next job if applicable, and the relationship of these factors to reenrollment benefits, job tenure, and unemployment through work reporting requirement mandates.
(vii) The study shall examine the impact of mandatory work reporting requirements, including the types of work activities, and the links between the requirements and the activities and sanctions, employment, earnings, job tenure, and unemployment through work reporting requirement mandates.
(viii) The study shall, in compliance with HIPPA laws, track the subjects' usage of Medicaid benefits over the course of the study, including patterns of usage, preventative visits/screenings, sick visits, surgeries, emergency room visits, and number of cases.
(ix) Put an objective, third-party evaluation in place at the start of a Medicaid work requirements demonstration so the implementation and impacts can be rigorously evaluated.
(x) The division may recommend methodology to amend any Medicaid expansion work requirements upon review of the study prescribed in this section.
(2) This section shall stand repealed on January 31, 2031.
SECTION 2. This act shall take effect and be in force from and after July 1, 2025.