A Medicaid expansion surprise in Mississippi, as negotiations will be held in public

House Speaker Jason White and Lt. Gov. Delbert Hosemann have both agreed to negotiate final details of a bill to expand Medicaid coverage to the working poor in public meetings, an increasingly rare occurrence at the state Capitol.

The House last week voted to “invite conference” with the Senate to try and work out a compromise on a bill to expand Medicaid coverage to more Mississippians. In recent years the vast majority of conference committee negotiations don’t take place in public.

White, a Republican from West, first called for the negotiations to be public in a recent interview with Mississippi Today. The new speaker said he doesn’t believe it’s realistic for lawmakers to have public conference committee meetings on every relevant bill but believes Medicaid expansion rises to the level of holding such a public meeting.

“I think the public on this issue is probably going to demand it to some degree, is going to want to see where people are on it,” White said.

Hosemann, a Republican who leads the Senate, also said in a statement that he believes major issues should be “conducted in public and not behind closed doors,” including conference committees.

“Such conversations create a better end product,” Hosemann said. “The Senate has demonstrated its own commitment to transparency by holding public conference committees in the past, equipping committee rooms with webcasting and archiving abilities, and robustly debating issues on the floor.”

A conference committee is formed when the House and the Senate pass different versions of the same bill, such as the case with Medicaid expansion. When this occurs, the speaker of the House and the lieutenant governor each appoint three lawmakers from the chamber they lead to work out the differences in a conference committee.

Different proposals

For the first time since the federal Affordable Care Act became law, the two legislative chambers have each passed plans to expand Medicaid coverage. But each has proposed vastly different proposals, making the conference process extremely important on a measure that could provide health insurance to poor Mississippians.

The House’s expansion plan aims to expand health care coverage to upwards of 200,000 Mississippians, and accept $1 billion a year in federal money to cover it, as most other states have done.

The Senate, on the other hand, wants a more restrictive program, to expand Medicaid to cover around 40,000 people, turn down the federal money, and require proof that recipients are working roughly 30 hours a week.

If the lawmakers, called conferees, cannot reach an agreement, the bill would die. But if they do reach an accord, the revised bill, called a conference report, gets brought back to the full Senate and House again for consideration.

The joint rules of the Legislature, which the vast majority of lawmakers voted in favor of this year, state that all official conference committee meetings “shall be open to the public at all times.”

The reality, though, is conference committees often involve lawmakers simply talking over the phone or exchanging text messages. Other times, lawmakers may skip an actual meeting and just email proposals back and forth.

The practice often leaves the public and rank-and-file lawmakers in the dark about what happens in these meetings and how the reports are drafted.

Not the first time

Hosemann and Senate leaders upended these norms in 2022 by calling for a public conference committee meeting for the House and Senate to haggle over the final details of a proposal to increase public K-12 teacher salaries.

“I’ve encouraged all of my chairmen to meet with all of their chairmen and to do it in a public forum,” Hosemann said at the time.

Hosemann’s push for a public process that year resulted in several committee leaders having public meetings.

Former House Speaker Philip Gunn, R-Clinton, at the time was less encouraged to deviate from the conference process norms and asserted that “the overwhelming majority of bills don’t require a show.”

“We don’t have to get in a room with everybody sitting around the table and negotiate,” Gunn said. “They can talk on the phone. They can just send written letters back and forth.”

It appears White, currently in his first term as speaker, is willing to have more public conference meetings than his predecessor, though he has continued the practice of holding private Republican caucus meetings at the Capitol, which effectively gives the supermajority House GOP a chance to formulate and debate policy outside public view.

Under Hosemann, the Republican-majority Senate does not conduct any formal, closed-door GOP caucus meetings.

The Senate also since 2020 has live-streamed its committee meetings, open to the public online, while the House has not.