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.
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.
Private health plans, both on-exchange and off-exchange, are normally only available during the annual open enrollment period or a special enrollment period triggered by a qualifying event. But to address the ongoing pandemic, a six-month COVID-related enrollment window is available in 2021.
During this window, which continues through August 15, 2021, Mississippi residents can enroll in a plan or make a change to their existing coverage. No qualifying event is necessary, even though this is outside of the normal open enrollment period.
The extended enrollment window allows people an opportunity to access the enhanced premium subsidies that are available as a result of the American Rescue Plan. The additional subsidies are retroactive to January 1 for people who are already enrolled in a plan through the marketplace.
After August 15, Mississippi residents will need a qualifying event in order to enroll in a health plan before the start of open enrollment. Open enrollment will begin again on November 1, 2021, for coverage effective January 1, 2022. This applies both on-exchange and outside the exchange.
Magnolia/Ambetter/Centene offers plans statewide in the Mississippi exchange, and Molina joined the exchange in 19 counties for 2020, giving residents in those counties a choice of two health plans.
But for 2021, Molina expanded its coverage area statewide, so all marketplace enrollees in Mississippi can choose from among plans offered by both insurers.
Mississippi’s exchange insurers implemented the following average rate changes for 2021:
- Molina: 3.5% average decrease.
- Ambetter/Magnolia: 6.4% average increase
Blue Cross Blue Shield of Mississippi implemented a slight average rate decrease (0.45%) for its individual-market plans, all of which are sold only outside the exchange.
Read more about health insurance rate changes in Mississippi.
By the end of the open enrollment period for 2021 coverage, nearly 111,000 people had signed up for private individual market plans through the Mississippi health insurance marketplace. This was the third year in a row with increasing enrollment, and it brought Mississippi’s marketplace enrollment to a record high.
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 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 dozen holdout states (including Mississippi) might move forward with Medicaid expansion as a result of that legislation.
And Mississippi residents may have an opportunity to vote on this issue in the 2022 election. Initiative 76 was filed with the Mississippi Secretary of State in April 2021, and advocates began gathering signatures in May 2021. A total of at least 106,190 valid signatures will be needed, and must be gathered before the start of the 2022 legislative session.
If Initiative 76 reaches the ballot and is approved by voters, Mississippi would join several other states (Maine, Idaho, Utah, Nebraska, Oklahoma, and Missouri) where Medicaid has been expanded as a direct result of ballot measures.
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 just over $5,000 in total annual income for a family of three in 2021. 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.
Due to the state’s decision not to expand, average monthly Medicaid enrollment was only 9% higher in the fall of 2020 than it had been in 2013, despite the ongoing COVID pandemic (nationwide, average Medicaid/CHIP enrollment has increased by 38% 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 2020, 98% of Mississippi health insurance marketplace enrollees qualified for premium subsidies, and 87% were receiving cost-sharing reductions (CSR), which is the highest percentage in the nation (nationwide, 86% of enrollees receive premium subsidies and 50% 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 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.
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 610,455 people as of January 2021. This included about 435,099 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 chose 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.