Medicaid expansion efforts fizzled and died Thursday in Republican-led Mississippi because top lawmakers could not agree on a final proposal to send to the House and Senate.

This was the first year that expansion has received serious legislative discussion in Mississippi, which is one of the poorest states in the U.S. and has some of the worst health outcomes.

Any plan would have needed to pass with at least a two-thirds vote — a wide enough margin to survive an expected veto from Republican Gov. Tate Reeves, who refers to Medicaid as “welfare” and says he does not want more people to enroll.