Mississippi's recent attempt to expand Medicaid under the Affordable Care Act fell through due to a breakdown in an agreement among state lawmakers. The disagreement primarily revolved around the Republican-driven insistence on implementing a work requirement for Medicaid coverage. Despite the evolving attitudes towards the Affordable Care Act, including grudging acceptance from Republicans, the failure to reach a compromise in Mississippi highlighted lingering divisions. Governor Tate Reeves, a staunch opponent of Medicaid expansion, would likely have vetoed any expansion bill. The collapse of this attempt left supporters of expansion in the state frustrated and disappointed, despite significant public support and efforts from various leaders. The proposed work requirement remained a major point of contention, reflecting the ongoing challenge of finding common ground on this issue. While some lawmakers remained committed to a work requirement as a matter of personal responsibility, others expressed concerns based on the experiences of other states. The failed attempt to expand Medicaid in Mississippi represents a setback for those advocating for improved access to healthcare in the state, with the possibility of future efforts being considered.