Medicaid; require division to conduct study on impacts of any mandatory work requirements in any enacted Medicaid expansion program.

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To: Medicaid
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representative Johnson

HOUSE BILL NO. 50

AN ACT TO REQUIRE THE DIVISION OF MEDICAID TO MONITOR, 1
CONDUCT A STUDY ON AND EVALUATE THE IMPACTS OF ANY MANDATORY WORK 2
REPORTING REQUIREMENTS IN ANY MEDICAID EXPANSION PROGRAM ENACTED 3
BY THE LEGISLATURE; AND FOR RELATED PURPOSES. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 5
SECTION 1. (1) The Division of Medicaid shall collect and 6
report upon all data in connection with any Medicaid expansion 7
program enacted by the Legislature as federal law may require. 8
(2) In addition to and on the same schedule as the data 9
collection required by federal law and subsection (1), the 10
division shall collect and report on further information with 11
respect to any mandatory work reporting requirements in any 12
enacted Medicaid expansion program. 13
(3) With respect to all terminations of Medicaid benefits to 14
the coverage group in any enacted Medicaid expansion program, all 15
of the same information as required under the federal law, plus 16
the specific reason or reasons for the termination must be 17
recorded and provided for the study upon request. 18
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(4) (a) The division shall, in conjunction with the Board 19
of Trustees of State Institutions of Higher Learning (IHL), in 20
addition to the foregoing data collection and reporting 21
activities, conduct a study on the implementation of any enacted 22
Medicaid expansion program and any work reporting requirements. 23
(b) The study shall select subgroups representing 24
important sectors of the coverage group, including type of area of 25
residence (city, suburban, small town, rural), English 26
proficiency, level of education, literacy, work experience, number 27
of adults in the home, number of children in the home, teen 28
parentage, parents before and after the age of eighteen (18) 29
years, and other such subgroups. For each subgroup, the study 30
shall assemble a statistically valid sample of cases entering the 31
Medicaid expansion program and work reporting requirements at 32
least six (6) months after its implementation date and before July 33
1, 2027. 34
(c) The study shall continue until July 1, 2032. The 35
division shall report to the Medicaid Committees of the House and 36
Senate and the Governor by March 1 of each year, beginning July 1, 37
2028, the interim findings of the study with respect to each 38
subgroup, and by August 1, 2032, the final findings of the study 39
with respect to each subgroup. The reports shall be available to 40
the public upon request. 41
(d) No later than November 1, 2032, the division, in 42
consultation with an advisory panel of specialists in welfare 43
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policy, social science, and other relevant fields shall devise the 44
study and identify the factors to be studied. The study shall, 45
however, at least include demographic breakdowns including, but 46
not limited to, race, gender, and number of children in the 47
household at the beginning of Division services. Study 48
participants must meet the following criteria to participate: 49
(i) Be between the ages of nineteen (19) and 50
sixty-four (64) years with income of not more than 138% of the 51
federal poverty level; 52
(ii) Have received Medicaid coverage in the past 53
year and have been subject to new Medicaid work requirements as a 54
condition of eligibility; and 55
(iii) Have lost Medicaid eligibility in the past 56
six (6) months by not meeting division's work requirement rules 57
and reporting procedures; or regained Medicaid coverage by 58
reporting work activities; or received employment assistance. 59
(e) The division shall obtain permission to conduct the 60
study from the subjects of the study and guarantee their privacy 61
according to the federal Health Insurance Portability and 62
Accountability Act (HIPAA). To facilitate this permission, the 63
study may be designed to refer to subject by pseudonyms or codes 64
and shall in any event guarantee anonymity to the subject without 65
limiting access by outsiders to the data (other than identities) 66
generated by the study. 67
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(f) The subjects of the study shall be studied upon 68
enrollment and potential disenrollment based on compliance with 69
work reporting requirements to the extent feasible. The evaluator 70
shall attempt to maintain personal contact with the subjects of 71
the study, and employ such methods as meetings, telephone 72
contacts, written surveys, and computer matches with other data 73
bases to accomplish this purpose. The intent of this feature of 74
the study is to discover the paths the coverage group takes upon 75
expansion of Medicaid and implementation of work reporting 76
requirements including the factors that may influence these paths 77
and patterns. The study shall include a review and analysis of: 78
(i) The division's outreach and education efforts; 79
(ii) The division's training and employment 80
resources; 81
(iii) The division's work reporting systems; 82
(iv) The division's exemptions from work 83
requirements; 84
(v) The division's enrollee understanding of work 85
requirements; and 86
(vi) Implications of Medicaid coverage loss for 87
health care providers and health plans. 88
(g) The study shall examine the influence of various 89
employability, education, and training programs upon employment, 90
earnings, job tenure, and unemployment through work reporting 91
requirement mandates. 92
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(h) The study shall examine the frequency of unplanned 93
occurrences in subjects’ lives, such as illness or injury, family 94
members illness or injury, transportation complications, strikes, 95
natural disasters, evictions, loss of other sources of income, 96
domestic violence, and crime, and their impact upon employment, 97
earnings, job tenure, and unemployment through work reporting 98
requirement mandates. 99
(i) The study shall examine the reasons for subjects’ 100
benefits loss, the reasons for coverage loss due to administrative 101
requirements, noncompliance of work reporting requirements, the 102
availability of reenrollment services, programs or services 103
utilized by subjects to reenroll, whether the subject suffered a 104
job loss, the characteristics of the subjects next job if 105
applicable, and the relationship of these factors to reenrollment 106
benefits, job tenure, and unemployment through work reporting 107
requirement mandates. 108
(j) The study shall examine the impact of mandatory 109
work reporting requirements, including the types of work 110
activities, and the links between the requirements and the 111
activities and sanctions, employment, earnings, job tenure, and 112
unemployment through work reporting requirement mandates. 113
(k) The study shall, in compliance with HIPAA laws and 114
regulations, track the subjects' usage of Medicaid benefits over 115
the course of the study, including patterns of usage, preventative 116
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ST: Medicaid; require division to conduct study
on impacts of any mandatory work requirements in
any enacted Medicaid expansion program.
visits/screenings, sick visits, surgeries, emergency room visits, 117
and number of cases. 118
(l) The study shall put an objective, third-party 119
evaluation in place – ideally, before, but at least at the start 120
of a Medicaid work requirements demonstration – so that the 121
implementation and impacts can be rigorously evaluated. 122
(5) This section shall stand repealed on January 31, 2033. 123
SECTION 2. This act shall take effect and be in force from 124
and after its passage. 125