Mississippi lawmakers delay efforts to create state-run health insurance marketplace
Mississippi has not advanced in creating a state-run health insurance marketplace, despite legislative efforts over the past two years, according to state officials. The Mississippi Senate on March 3 rejected a House proposal that would have made establishing the exchange mandatory by changing the law’s wording from “may” to “shall,” effectively killing the bill.
Insurance Commissioner Mike Chaney has repeatedly stated he does not plan to develop a state exchange without the approval of Gov. Tate Reeves. Chaney told Mississippi Today that the bill would not have changed his stance, as he already has the authority to set up the marketplace but has not pursued it.
The effort to create a state exchange faced opposition from former Gov. Phil Bryant and remains stalled. State Rep. Hank Zuber, who authored the House bill, said lawmakers are still studying the idea but have not committed to moving forward. He noted that the state would likely not offer additional subsidies beyond federal support.
Experts say the success of a state-based marketplace largely depends on the level of investment. Sabrina Corlette, a research professor at Georgetown University, noted that states with their own exchanges tend to have lower uninsurance rates, often because they supplement federal subsidies and improve enrollment assistance and infrastructure.
Chaney pointed out that federal subsidies expired at the end of last year, making it less feasible to launch or sustain a state exchange now. Early data shows a decline in Mississippi Marketplace enrollment for 2026, with about 25,000 fewer residents enrolled compared to last year. Experts anticipate enrollment will fall further as higher premiums take effect.
Currently, Mississippi operates its health insurance marketplace on the federal platform, like 27 other states. The operation is funded by user fees paid by insurance companies, which are passed on to consumers. Chaney said a state-run exchange would cost between $15 million and $20 million to launch and would likely generate limited revenue due to enrollment numbers.
Jason Levitis of the Urban Institute noted that federal proposals could make transitioning to a state exchange easier, including allowing private web brokers and removing mandatory transition periods. However, some advocates, like Khaylah Scott of Mississippi Health Advocacy Program, suggest waiting for federal policy clarity before proceeding. She emphasized that a successful state exchange could tailor programs to Mississippians’ needs and potentially lower costs.
Chaney said the state has about $20 million in reserve funds from the former high-risk insurance plan, which could be used to establish a marketplace. He estimated that it would take about $15 million to $20 million to set up the exchange, with user fees eventually covering operational costs. However, he acknowledged that revenue from fees would be limited given current enrollment levels.
Overall, officials and experts agree that a clear vision and sufficient funding are essential before Mississippi pursues a state-run health exchange. As federal policies evolve, the state continues to evaluate whether such a move is feasible or beneficial at this time.
Source: Original Article
