Health insurance in Mississippi
Mississippi did not expand Medicaid, so adults below $15,960 can fall through the gap entirely. 12.1% of under-65 residents are uninsured.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release. Figures cover the under-65 population.
Where you enroll
Mississippi uses the federally facilitated marketplace, so you enroll at HealthCare.gov on the federal calendar — the dates are here.
Mississippi has a coverage gap
Mississippi has not adopted the Medicaid expansion. That creates a specific and badly-known problem: the premium tax credit was written on the assumption that everyone below 100% of the poverty guideline would be covered by an expanded Medicaid, so the credit does not start until 100%. In a state that did not expand, an adult below that line qualifies for neither.
In practice that means an adult in Mississippi earning under $15,960 a year — roughly $1,330 a month — may be offered no help at all, while someone earning slightly more gets a substantial subsidy. It is the one part of this system where earning less can leave you worse off.
Mississippi's uninsured rate is 12.1% of under-65 residents, or 264,216 people. Some of them are in this gap.
If your income is near the line, it is worth getting the number right before you assume you do not qualify. Projected annual income is what counts, not last month's pay.
How much choice Mississippi counties get
Counties in Mississippi carry between 3 and 5 insurers, so competition is fairly even across the state without being uniform.
No county in Mississippi is down to a single insurer. Since the previous plan year, 75 counties in Mississippi gained an insurer and none lost one.
Heavy marketplace use
299,716 Mississippi residents selected a marketplace plan for 2026. Against the state's under-65 population that is 137 per thousand, well above the 26-state median of 79, and 4th highest of the 26 states on this site.
Of those, 60,444 — 20% — were new rather than renewing, which is an unusually high share of first-time buyers (1st of 26).
The spread inside Mississippi
Harrison County is the largest county we publish here, with 171,375 under-65 residents; Madison County is the smallest, with 93,552. Harrison County has 4 insurers offering 41 plans, and Madison County has 5 offering 48.
The widest choice in Mississippi is in DeSoto County — 5 insurers, 48 plans. The narrowest is Harrison County, with 4 insurers and 41 plans. Same state, same rules, 7 more plans to choose from.
Uninsured rates range from 9.1% in DeSoto County to 13.3% in Hinds County — 1.5 times as high, within one state.
The 6 largest counties in Mississippi
By under-65 population, covering 38% of the state's under-65 residents. Mississippi has 75 counties with complete federal data; we publish pages for the largest.
| County | Under 65 | Uninsured | Insurers | Plans | Per 1,000 |
|---|---|---|---|---|---|
| Harrison County | 171,375 | 12.7% | 4 | 41 | 128 |
| DeSoto County | 166,554 | 9.1% | 5 | 48 | 89 |
| Hinds County | 161,566 | 13.3% | 5 | 48 | 165 |
| Rankin County | 128,750 | 9.9% | 5 | 48 | 212 |
| Jackson County | 119,161 | 11.3% | 4 | 41 | 117 |
| Madison County | 93,552 | 10.1% | 5 | 48 | 84 |
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release. "Per 1,000" is marketplace plan selections per thousand under-65 residents.
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