Health insurance in Mississippi
- Mississippi utilizes the federally run health insurance marketplace, with residents enrolling through Healthcare.gov.
- A COVID-related enrollment window continues through August 15, 2021 (no need for a qualifying event to use this enrollment period)
- Short-term health insurance plans can be sold in Mississippi with initial plan terms up to 364 days.
- Two insurers offer coverage through the Mississippi health insurance marketplace; Blue Cross Blue Shield of Mississippi only offers plans outside the marketplace.
- Mississippi has refused to accept the ACA’s Medicaid coverage expansion.
- More than 610,000 Mississippi residents were enrolled in Medicare plans as of early 2021.
This page provides consumers in Mississippi with information and resources about their health insurance options. Here, you’ll find information about the various health insurance options available to individuals and families who may not have access to an employer-sponsored or government-run health plan. All of the options cover both medical and prescription drug benefits. You can find the basics of the Mississippi health insurance marketplace and current COVID-related enrollment period; a brief overview of Mississippi’s continued opposition to Medicaid expansion; a quick look at short-term health insurance availability in the state; information about Medicare enrollment and state-specific Medigap rules; as well as a collection of health insurance resources for Mississippi residents.
When can I enroll in health insurance in Mississippi?
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 has been extended 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, and will be available for browsing on HealthCare.gov as of April 1, 2021.
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.
Mississippi’s health insurance marketplace
A health insurance exchange or marketplace is a portal that you can use to sign up for coverage under the Affordable Care Act, which is also called Obamacare. The Affordable Care Act established the benefits that must be covered by plans that are sold in the exchange, but the plans themselves are offered by private health insurance companies.
In very general terms, Obamacare helps people who aren’t eligible for employer-provided insurance coverage, have income too high to qualify for Medicaid, or aren’t old enough for Medicare. Other pages on this site provide more detailed information to help you find the right type of program and specific healthcare plans. You can use the health insurance exchange to enroll in healthcare for yourself or your family and to see if you qualify for premium subsidies or cost-sharing reductions (CSR) to help you pay for monthly premiums and out-of-pocket costs (as a result of the American Rescue Plan, premium subsidies are larger and more widely available for 2021 and 2022; the new subsidy amounts will be available on HealthCare.gov as of April 2021).
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.
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.
Read our guide to the Mississippi health insurance marketplace.
Still no Medicaid expansion in Mississippi
Medicaid is run jointly by state and federal government. The federal government sets broad rules, with each state determining specific eligibility guidelines and operating the program. Historically, eligibility has required a very low income and low asset level, in conjunction with being in one of the various assistance-eligible populations (a child, elderly, pregnant, a parent of a minor child, or disabled).
Under the Affordable Care Act, 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 dozen holdout states (including Mississippi) might move forward with Medicaid expansion as a result of that legislation.
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 7% 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 35% 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.
Short-term health insurance in Mississippi
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.
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. The high percentage of residents without health insurance in Mississippi is one of the factors that play a role in the state’s poor performance.
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% of Mississippi health insurance marketplace enrollees qualified for premium subsidies in 2020, 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 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 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.
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 coverage and enrollment 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.
Health reform legislation in Mississippi
Scroll to the bottom of the page for a summary of recent Mississippi legislation related to healthcare reform and Mississippi health insurance coverage.
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.