Mississippi Faces Healthcare Crisis as ACA Subsidies Near Expiration
A looming expiration of enhanced Affordable Care Act (ACA) subsidies threatens to dramatically increase health insurance costs for hundreds of thousands of Mississippians, potentially reversing gains in coverage and exacerbating existing healthcare challenges in the state.
Mississippi has seen a remarkable increase in residents benefiting from the federal marketplace insurance policies, more so than almost any other state. However, state and federal Republican lawmakers have remained largely silent on addressing the impending loss of these crucial financial protections, set to expire at the end of 2025. The expiration is projected to cause insurance premiums to skyrocket for an estimated 200,000 to 300,000 Mississippians.
Established in 2010 as part of the ACA, the health insurance marketplace allows individuals to purchase coverage, often with federal financial assistance. The original law provided subsidies, or tax credits, to those within specific income brackets. During the Biden administration, these subsidies were expanded, offering increased aid to low-income individuals and, for the first time, extending assistance to those with moderate incomes who lack employer-sponsored health insurance. These enhanced subsidies cap premiums at 8.5% of a person’s earnings.
The fate of these enhanced subsidies now hangs in the balance. While Democrats in Congress are actively seeking to extend them, resistance from President Donald Trump and Republican leadership has stalled progress. Mississippi’s congressional delegation, including U.S. Senators Roger Wicker and Cindy Hyde-Smith, have aligned with this opposition.
The financial impact of the expiring subsidies will be significant. According to data from KFF, reported by Mississippi Today, a 40-year-old resident of Jackson earning $30,000 annually could see their monthly insurance premium jump from $42 to $155 when the enhanced assistance ends.
Mississippi politicians, despite their public silence, appear acutely aware of the potential fallout. A staggering 99% of Mississippians who purchase health insurance through the ACA exchange currently receive federal premium assistance, according to KFF. Furthermore, the number of Mississippians with marketplace health insurance has surged by an astounding 242% between 2020 and 2025 – second only to Texas, which experienced a 256% increase.
Both Mississippi and Texas share the common challenges of financially strained hospitals and comparatively poor health outcomes. The enhanced financial assistance has been a rare positive development for healthcare providers and low-income residents in Mississippi, a state where policymakers have historically attempted to address systemic healthcare deficiencies with limited solutions.
Ironically, the enhanced subsidies were previously cited as a reason against Medicaid expansion. Some Mississippi politicians, including Republican House Speaker Jason White, argued that the availability of affordable private insurance through the ACA marketplace, thanks to the subsidies, diminished the need for Medicaid expansion to provide coverage for low-income working Mississippians.
Now, with those subsidies poised to disappear, rural hospitals and working families – who still lack the safety net of Medicaid expansion – will face substantially higher insurance costs. This creates a precarious situation, potentially undoing recent progress in healthcare access.
As the situation unfolds, Mississippi appears locked in a recurring pattern: one step forward, followed by a significant leap backward when it comes to healthcare.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
