Failure to Expand Medicaid Keeping Health Coverage Out of Reach for Many Struggling Mississippians

September 16th, 2015

Mississippi’s improvement in health coverage was not what it could have been in 2014, because the state has not expanded Medicaid coverage to more residents who cannot otherwise afford health insurance.

The Census Bureau today released the country’s official data on health insurance rates, which shows that 14.5 percent of Mississippians were uninsured in 2014, only a small decrease from 2013 (2.6 percentage points). This decrease would have been much larger had the state expanded Medicaid coverage.

States that have expanded Medicaid coverage collectively had a lower share of people without insurance (9.8%) than states that did not expand Medicaid (13.5%) (See Chart). Moreover, the effect of Medicaid expansion is particularly clear when you look at the uninsured rates among persons living below the poverty level. In 2014, in Medicaid expansion states the rate of uninsured among persons living at or below poverty fell to 25 percent while in “non-expansion states” the rate of uninsured among those in poverty was almost 40 percent.
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Although Mississippi has not expanded Medicaid coverage, other provisions of the Affordable Care Act are helping reduce the number of Mississippians without health insurance, which is why Mississippi did have a small decrease in people without health insurance. People have gained health coverage through the state’s new health insurance marketplace, which allows people to easily compare prices and benefits of health care plans. Through the marketplace, some people who do not make enough to afford private insurance receive federal subsidies to help pay their premiums and reduce their out-of-pocket health costs, but a family of four who makes less than $23,550 does not qualify for this help because they should be receiving Medicaid instead.

Mississippi has so far passed up a big opportunity to make more progress through the Affordable Care Act, leaving thousands of Mississippians without the health care they need. In order to strengthen state-run Medicaid programs, the federal government agreed to pay all the costs of providing Medicaid to people making up to just $32,500 per year for a family of four (138 percent of the federal poverty rate) through 2016, and then no less than 90 percent of the costs thereafter. But the Supreme Court left it up to the state to decide whether to extend their benefits to these people and accept the federal funding to do so, and unfortunately Mississippi has not yet done so.

Making matters worse, residents of states that have chosen not to expand Medicaid like Mississippi had higher uninsured rates than those in Medicaid expansion states to begin with. In other words, the hole was deeper at the start, and we have done less to dig ourselves out.

Jessica Shappley