According to a recent report by the Urban Institute, Mississippi could experience a significant health insurance crisis if Congress does not extend temporary health coverage subsidies set to expire at the end of 2025. Over 100,000 Mississippians, or a 43% increase in the state’s uninsured population, stand to lose health insurance coverage.
“If the enhanced premium tax credits expire, there will be dramatic declines in Marketplace coverage and increases in uninsurance, but the effects will not be felt equally across states or by race, income, and age,” said Jessica Banthin, senior fellow at the Urban Institute.
Temporary Subsidies Have Boosted Coverage Since 2021
The subsidies, initially introduced by Congress in 2021 in response to the COVID-19 pandemic, have played a critical role in expanding health insurance coverage. They allowed Americans to buy Affordable Care Act (ACA) Marketplace plans at reduced costs by enhancing premium tax credits, raising income eligibility limits, and eliminating premiums for low-income households. This led to a record 21.3 million people insured through the Marketplace nationwide.
Mississippi has seen one of the most dramatic increases, with Marketplace coverage nearly doubling since the subsidies’ implementation. The state’s uninsured rate fell from 12.9% in 2020 to 10.5% in 2023. Despite this progress, Mississippi’s reliance on the Marketplace remains high as one of 10 states that have not expanded Medicaid coverage.
Cost Increases Loom Without Congressional Action
Without an extension, the subsidies will lapse in December 2025, causing average premium payments to soar by over 75%. For instance, a 40-year-old Jackson resident earning $30,000 annually could see monthly premiums for a silver plan jump from $49 to $143, according to KFF.
“If (the premium tax credits) go away next year, I’m afraid it will reset us to where we were five years ago, with the Marketplace policies basically becoming catastrophic plans again,” warned Dr. Daniel Edney, State Health Officer. Catastrophic plans typically cover major medical emergencies but leave routine care out of reach for many.
The Future of Mississippi’s Health Care Marketplace
In anticipation of the subsidies’ expiration, Mississippi’s Legislature authorized the creation of a state-based health insurance Marketplace earlier this year. A state-based system could attract insurers to offer more affordable policies. However, the initiative remains stalled because Governor Tate Reeves has yet to provide the necessary letter of approval to federal officials.
Implications for the Uninsured and Healthcare Accessibility
The Urban Institute estimates that 143,000 Mississippians would lose coverage if subsidies end. While some individuals may transition to employer-sponsored plans or afford insurance without subsidies, most are expected to lose coverage entirely.
“It’s been a gamechanger,” said Edney of the subsidies, emphasizing their role in reducing the uninsured rate and expanding access to care. Without renewed federal support, Mississippi’s progress in healthcare coverage could face a significant setback, leaving many without affordable options.
Unequal Impacts Across Communities
Banthin highlighted that the effects of subsidy expiration would disproportionately affect vulnerable populations. Low-income households, communities of color, and older adults are among those most at risk of losing coverage, exacerbating existing disparities in healthcare access.
Conclusion
Mississippi’s dependence on the ACA Marketplace underscores the urgency of extending the enhanced subsidies. As Congress debates the future of healthcare funding, Mississippi’s health coverage gains—and the well-being of its residents—hang in the balance.