Mississippi’s First Serious Bid to Expand Medicaid Collapses

State lawmakers failed to reach a compromise, dashing hopes of extending largely free health care to most low-income residents and supporting struggling rural hospitals.

Mississippi’s first serious attempt to expand Medicaid under the Affordable Care Act collapsed Thursday night, after an agreement reached by state lawmakers earlier in the week disintegrated and last-minute scrambling for a compromise failed.

The outcome dashed any hope of movement this year to unlock a torrent of federal funds that could have provided largely free health care to as many as 200,000 low-income residents, and possibly resuscitated financially strapped rural hospitals.

The main point of contention was the insistence by Republicans in the State Senate that people could not qualify for the coverage unless they were working.

“I’m disappointed that we couldn’t close the deal,” State Representative Missy McGee, a Republican who was one of the most vocal proponents of expansion, said in a statement. “I’m disappointed that for many, winning an ideological debate was more important than helping Mississippians.”

The push for Medicaid expansion, steered by Republicans in a State Legislature where the party has a supermajority, illustrated the degree to which attitudes about the Affordable Care Act have evolved. The law — which many Republicans around the country reviled and attacked for years as a signature achievement of the Obama administration — has found grudging acceptance. All but 10 states have expanded their Medicaid programs to cover most poor adults in the decade since that option became available under the law.

“The country is not going back,” Jason White, the Mississippi House speaker, said in a recent radio interview.