A recent analysis highlights the potential for Mississippi to experience a significant decline in health insurance coverage if Congress does not take action to extend temporary healthcare coverage subsidies by the end of the upcoming year.

According to projections from The Urban Institute, over 100,000 residents in Mississippi could find themselves without health insurance, leading to a 43% rise in the state’s already considerable uninsured population.

Jessica Banthin, a senior fellow at The Urban Institute, emphasized that the expiration of enhanced premium tax credits could have severe consequences on coverage rates, with the impact varying based on geographic, racial, and economic factors. She noted, “Our analysis indicates that some communities could face more significant losses in coverage, rendering healthcare unaffordable and out of reach for many.”

The enhanced subsidies were introduced by Congress in 2021 as a response to the COVID-19 pandemic, enabling more Americans to purchase health insurance through the Affordable Care Act Marketplace at reduced prices. These adjustments also raised income eligibility limits for premium tax credits and allowed low-income households to obtain insurance without premium costs.

With the extensions set to expire in December 2025 without Congressional intervention, concerns are mounting. Each enrolled individual through the Marketplace has reached an all-time high, with 21.3 million people benefiting nationwide because of the enhancements.

Dr. Daniel Edney, the State Health Officer, expressed concerns about the future, commenting that if premium tax credits are removed next year, it could revert the Marketplace policies back to being primarily catastrophic plans. These plans primarily cover major medical emergencies rather than routine healthcare needs.

According to estimates, if the tax credits disappear, average premium payments could increase by over 75%. For instance, a 40-year-old resident in Jackson earning $30,000 per year might see their monthly premium for a silver plan rise by $93—from $49 to $143—as reported by KFF.

The Marketplace serves as a platform where individuals can explore health insurance options and enroll in plans, with financial assistance available according to their income levels. Since 2021, the enhanced tax credits have greatly improved health coverage in Mississippi.

In 2020, the uninsured rate stood at 12.9%, a figure that decreased to 10.5% by 2023. Dr. Edney referred to the changes as a “gamechanger,” noting that health coverage through the Marketplace in Mississippi nearly doubled, marking the second-largest growth in the nation, trailing only Texas.

Interestingly, Mississippi is among the ten states that have not expanded Medicaid, increasing its reliance on the Marketplace for accessible healthcare coverage. Trends indicate that enrollment has surged in states with high uninsured rates that also remain unexpanded regarding Medicaid.

According to the Urban Institute’s data tool, the potential expiration of enhanced tax credits could lead to 143,000 Mississippians losing their subsidized Marketplace plans. While some may have access to employer-sponsored insurance or may be able to afford alternative plans, many are expected to lose coverage altogether.

While Mississippi is currently using the federal exchange, the state legislature has already approved the development of a state-based Marketplace. This shift could motivate insurance companies to offer lower-cost policies. However, implementation is pending as federal officials await a letter of approval from Governor Tate Reeves.