Frequently asked questions about health insurance
coverage options in Mississippi
Residents who buy their own health insurance in Mississippi enroll through HealthCare.gov, the federally-run exchange/marketplace. People can also enroll in on-exchange coverage through an approved enhanced direct enrollment partner.
Mississippi used to run its own small business health insurance 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 insurance coverage.
In Mississippi, open enrollment for individual/family coverage runs from November 1 through January 15 (enrollments must be completed by December 15 to have coverage effective January 1).
Outside of that open enrollment period, residents need a qualifying event in order to enroll in coverage or make a change to their plan.
In Mississippi, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). More than 90% of consumers who enrolled in 2022 coverage through HealthCare.gov received premium subsidies.
Mississippians may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in Mississippi.
Short-term health insurance is also a lower-cost coverage option in Mississippi, where eight insurers offer short-term plans.
All Mississippi residents have access to plans from at least three insurers for 2023. A total of five insurers offer exchange plans in Mississippi:
- Molina
- Ambetter/Magnolia
- Cigna
- Vantage Health Plan of Mississippi
- UnitedHealthcare (new for 2023, after previously leaving the market at the end of 2016)
According to the federal government’s rate review website, the following average rate changes were approved for Mississippi’s individual/family health plans:
- Ambetter/Magnolia: 3% increase
- Molina: 8.1% increase
- Cigna: 6.9% increase
- Vantage Health Plan of Mississippi: 2.8% increase
- UnitedHealthcare: New for 2023, so no applicable rate change
Read more about health insurance rate changes in Mississippi.
Note that average rate changes apply to full-price plans, but most people do not pay full price. In Mississippi, 98% of exchange enrollees were receiving premium subsidies as of early 2022. The subsidies change from one year to the next to keep pace with the cost of the benchmark health plan (second lowest-cost silver plan) in each area.
As of early 2022, more than 131,000 people were enrolled in private individual market plans through the Mississippi health insurance marketplace.
Under the Affordable Care Act, Medicaid eligibility was extended to adults age 19-64 whose income doesn’t exceed 138% of the poverty level, regardless of their assets or other circumstances. However, Mississippi has continued to reject federal funding to expand Medicaid.
The state’s decision leaves roughly 102,000 individuals in what is known as the coverage gap – ineligible for Medicaid and also ineligible for premium subsidies.
The American Rescue Plan provides two years of additional federal funding for any states that newly expand Medicaid, so it’s possible that some of the remaining holdout states (including Mississippi) might move forward with Medicaid expansion as a result of that legislation.
Medicaid expansion advocates in Mississippi were gathering signatures to get Initiative 76 on the 2022 ballot, in order to give the state’s voters a chance to decide whether Medicaid should be expanded (in every other state where voters have been given this choice, the ballot measures have passed). But Initiative 76 was suspended in mid-2021, after the state Supreme Court essentially made the entire ballot initiative process unworkable in Mississippi.
Without Mississippi Medicaid expansion, non-elderly, non-disabled adults without children are not eligible for Medicaid coverage. Adults with dependent children qualify for Medicaid coverage only if the family’s income is 23% or less of the federal poverty level (FPL), which works out to under $5,300 in total annual income for a family of three in 2022. Pregnant women are eligible for Medicaid coverage with a household income up to 194% of the poverty level. Medicaid eligibility for Mississippi children varies by age and ranges from 133% to 194% 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% or less of FPL.
Due to the state’s decision not to expand, average monthly Medicaid enrollment was only 22% higher in September 2022 than it had been in 2013, despite the ongoing COVID pandemic (nationwide, average Medicaid/CHIP enrollment had increased by 59% in that same time period). Under the Trump administration, Mississippi was working towards a Medicaid work requirement for the existing Medicaid population, although the Biden administration has told states that this type of waiver proposal will no longer be approved.
Most states, including Mississippi, contract with health plans to operate their Medicaid programs. Enrollment for Medicaid plans 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 coverage.
In 2022, 98% of Mississippi health insurance marketplace enrollees qualified for premium subsidies, and 82% were receiving cost-sharing reductions (CSR), which is the highest percentage in the nation (nationwide, 90% of enrollees receive premium subsidies and 49% 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% under the ACA, falling from 17.1% in 2013 to 12.1% in 2018. But it increased to 13% in 2019, following the same general upward trend in the uninsured rate that many other states experienced under the Trump administration. Although it’s lower than it was in 2013, the state’s uninsured rate remains higher than the national average. It would be considerably lower if Mississippi were to expand Medicaid as called for in the Affordable Care Act.
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 coverage. Hyde-Smith believes the ACA should be repealed, and Wicker has voted numerous times 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. For a decade, they have continued to reject Medicaid expansion, despite the fact that it would bring considerable federal funds into the state.
Mississippi defaults to the current federal rules for short-term health insurance 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 coverage in Mississippi.
Medicare enrollment in Mississippi stood at 621,549 people as of September 2022. This included more than 400,000 people covered under Original Medicare, with the rest enrolled in Medicare plans through the Medicare Advantage program (the number of people with Original Medicare has been decreasing as the number with Medicare Advantage has been increasing).
Read more about Medicare enrollment in Mississippi. This page includes information about traditional Medicare (the federal government pays directly for services you receive) Medicare Advantage (you can choose from one of several private health plans in your state, and the federal government pays the plan for the services you receive) and Medicare Part D (prescription drug coverage), as well as state rules for Medigap plans.
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.
