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Mississippi health insurance

Two insurers offer 2020 health plans through the state exchange; short-term coverage is available with plan terms up to 364 days.

Health insurance in Mississippi

Mississippi’s health marketplace

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

Mississippi is the state that has done the least to preserve the Affordable Care Act’s gains.

Mississippi uses the federally run exchange for individual-market plans, so residents who buy their own health insurance enroll through HealthCare.gov.

Open enrollment for 2020 health plans has ended, although Mississippi residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.

Mississippi used to run its own small business exchange, dubbed One Mississippi, but had abandoned that by 2018, in favor of having the federal government run the small business exchange. The federal government, in turn, had opted to have small businesses enroll directly through insurers by 2018, and is no longer operating a portal for small businesses to enroll in health coverage.

Molina joined Magnolia/Ambetter in Mississippi’s exchange for 2020.

By the end of the open enrollment period for 2020 coverage, 98,892 people had signed up for private individual market plans through Mississippi’s health insurance exchange.

Read our guide to Mississippi’s health insurance marketplace.

Mississippi Medicaid and CHIP eligibility

Mississippi did not expand Medicaid through the Affordable Care Act. The state’s decision leaves roughly 100,000 individuals in what is known as the coverage gap.

Without Mississippi Medicaid expansion, non-elderly, non-disabled adults without children are not eligible for Medicaid. Adults with dependent children qualify for Medicaid only if the family’s income is 23 percent or less of the federal poverty level (FPL), which works out to under $5,000 in total annual income for a family of three in 2020. Pregnant women are eligible for Medicaid with a household income up to 194 percent of the poverty level. Medicaid eligibility for Mississippi children varies by age and ranges from 133 percent to 194 percent of FPL.

Children in Mississippi up to age 19 qualify for the Children’s Health Insurance Program if not eligible for Medicaid and the family income level is 209 percent or less of FPL.

Due to the state’s decision not to expand, average monthly Medicaid enrollment is virtually unchanged since 2013. It has actually dropped slightly, whereas nationwide average enrollment in Medicaid/CHIP had increased by 26 percent from 2013 to 2019. And Mississippi wants to impose a Medicaid work requirement on the existing Medicaid population, although similar waivers in other states have been overturned by judges.

Enrollment for Medicaid and CHIP is open throughout the year. Visit the Mississippi Division of Medicaid to learn how to apply for Medicaid or CHIP.

Read more about Mississippi and Medicaid.

Short-term health insurance in Mississippi

Mississippi defaults to the new federal rules for short-term plans. That means plans sold in the state can have initial terms of up to 364 days, and total duration, including renewals, of up to 36 months.

Read more about short-term health insurance in Mississippi.

Mississippi health ratings

The Commonwealth Fund’s Scorecard on State Health System Performance ranks the 50 states and DC in terms of overall health. Again in 2019, Mississippi maintained its bottom of the barrel, 51st place ranking.

Mississippi is also ranked the least-healthy state by America’s Health Rankings.

To learn more about Mississippi’s health as a state, see Key Health Data About Mississippi from the Trust for America’s Health. Data from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin allow you to compare the health of counties within Mississippi.

Has Obamacare helped Mississippi?

98 percent of Mississippi exchange enrollees qualified for premium subsidies in 2020, and 89 percent are receiving cost-sharing reductions (CSR), which is the highest percentage in the nation (nationwide, 87 percent of enrollees receive premium subsidies and 52 percent receive CSR benefits; both are based on income, but Mississippi has a lower-than-average per-capita income). These ACA benefits serve to make individual health insurance and health care more affordable and accessible for Mississippi residents than they would be without the ACA.

Mississippi’s uninsured rate dropped by about 29 percent under the ACA, falling from 17.1 percent in 2013 to 12.1 percent in 2018. But the state’s uninsured rate remains higher than the national average. Mississippi has not accepted the ACA’s federal funding to expand Medicaid. The uninsured rate would be considerably lower if they had.

Mississippi lawmakers and the ACA

Mississippi’s Senators are both Republican: Roger Wicker and Cindy Hyde-Smith. Both are opposed to the ACA, and support Mississippi’s decision to reject federal funding to expand Medicaid. Hyde-Smith believes the ACA should be repealed, and Wicker proudly touts his record that includes numerous votes to repeal or defund the ACA.

Mississippi’s US House delegation includes three Republican representatives and one Democrat.

In the Mississippi state legislature, Republicans have a strong majority in both chambers.

Does Mississippi have a high-risk pool?

Before the ACA’s reforms to the individual health insurance market, eligibility for private coverage was contingent on medical history.  People with pre-existing conditions were often unable to purchase private plans, or could only buy policies that excluded their pre-existing conditions.

The Mississippi Comprehensive Health Insurance Risk Pool (the “Association” or MCHIRPA) was established in 1992 as a means of providing coverage for people who were unable to purchase comprehensive plans in the private market because of pre-existing conditions.

Now that the ACA has brought guaranteed issue coverage to the private individual market, high-risk pools are largely obsolete. Mississippi’s Association remained operational through 2016. But by 2017, the website simply said “these policies are no longer being offered.” People with pre-existing conditions can instead obtain coverage in the individual market in Mississippi, since medical history is no longer a factor in determining premiums or eligibility for coverage.

In 2018, Mississippi enacted HB1196, which states that “upon the cessation of operations” by MCHIRPA, the distribution of any remaining funds held by the association would have to be approved by the Commissioner of Insurance.

Medicare enrollment in the state of Mississippi

605,478 Mississippi residents were enrolled in Medicare as of late 2019.

Read more about Medicare in Mississippi, including details about Medicare Advantage and Medicare Part D, as well as state rules for Medigap plans.

State-based health reform legislation

Scroll to the bottom of the page for s a summary of recent Mississippi legislation related to healthcare reform.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.