Miss. Medicaid expansion unlikely, GOP leaders say

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Top Republicans in Mississippi say the state can't afford to expand its Medicaid program to cover more people under the federal health care overhaul. Some Democrats, however, say the state should jump at the chance to provide coverage for its more than half million uninsured residents. 

The U.S. Supreme Court upheld most of the federal Affordable Care Act on Thursday. But justices said the federal government can't withhold Medicaid money from states that choose not to expand Medicaid coverage to more low-income adults. 

Medicaid is a health insurance program for the needy, paid by federal and state governments. Because Mississippi is one of the poorest states in the nation, it has a high percentage of its residents already on Medicaid and receives one of the most generous federal contribution rates. 

The federal health care law says that starting in 2014, states should expand Medicaid coverage to people whose income whose income is up to 133 percent of the federal poverty level, now about $30,650 for a family of four. The federal government will pay most of the tab in the early years of the expansion. Mississippi currently allows Medicaid enrollment for people whose income is up to 100 percent of the federal poverty level, about $23,050 for a family of four. 

Republican Gov. Phil Bryant said Thursday that Mississippi would have to make deep cuts to education and transportation to cover expenses for an estimated 400,000 new people on Medicaid, the federal-state health insurance program for the needy. 

"I understand there is some leeway in the decision to not penalize states for not complying with Medicaid requirements, and we're going to look at that," Bryant said in a brief interview. 

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