Many Mississippians face healthcare uncertainty
As Mississippi stares down the barrel of significant federal funding reductions and cuts to Medicaid and Medicare as a result of the One Big Beautiful Bill Act (OBBBA), access to healthcare coverage is uncertain for a significant portion of the state’s population. The OBBBA passed the Senate on July 1, 2025, and the House of Representatives on July 3 before being passed to and signed by President Donald Trump on July 4.
According to the 2024 Annual Report by Mississippi Department of Medicaid, more than 740,000 Mississippians were enrolled in Medicaid in 2024, which equates to little more than 25% of the population. Included in those numbers were nearly half of the children in the state along with approximately 74% of the state’s nursing home residents according to the Mississippi Health Advocacy Program.
The cuts outlined in the OBBBA end continuous coverage, reinstate deadlines that if missed by even one day due to internet connectivity issues or mail delays could result in a drop in coverage and prohibit renewals without full reverification. Eligibility determination must now take place every six months, regardless of whether or not there were any changes to income or circumstances.
Under the OBBBA, states were stripped of the ability to offer Medicaid to legally present immigrants, retroactive coverage was reduced- placing the cost of unexpected medical bills directly onto the citizens and federal funding for specialized care such as cancer screenings, birth control and sexually transmitted infection testing is blocked.
Fortunately, Mississippi hospitals are temporarily shielded from reductions in funding until the federal fiscal year 2029 thanks to a freeze on the commercial rate used in the Mississippi Hospital Access Program (MHAP). MHAP is a supplemental payment program which allows the state to access federal dollars with a state match- paid for by a hospital provider tax.
With strict budgetary restraints on healthcare providers, Mississippians on Medicare and/or Medicaid can expect more red tape and paperwork, longer wait times, staffing shortages and reduced quality of care.
Nursing Facilities
Some of the most vulnerable to the changes in policy are those in the care of nursing facilities. The OBBBA rolled back rules from the Biden era- one calling for increased staffing of nursing facilities and the other which streamlined the process of enrollment and renewal of Medicare, Medicaid to cover the costs not covered by Medicare and to prevent lapses in coverage. The streamlining of these processes simplified applications and mandated automatic enrollment for those receiving Social Security income, such as low-income seniors and the disabled.
The policies put into place by the OBBBA will require eligibility determinations every six months, even for those with no changes to their circumstances or on fixed income. If these deadlines are missed by even one day due to mail delays or internet connectivity issues, patients risk losing their coverage. With estimated out-of-pocket costs of $5,000 - $6,000 monthly for care in a nursing facility, many patients may face eviction due to unpaid bills.
The OBBBA also reduced the retroactive coverage period from three months to two months. Not all patients are able to plan the transition into the care of a nursing facility. Many are released from the hospital after a debilitating diagnosis or injury and are not yet enrolled in Medicare and/or Medicaid. With reductions in staff for facilities and increased workload of state agencies, patients could face the realities of paying out-of-pocket costs or not getting the care they need.
“Honestly, I think it could be devastating for a lot of our residents and their families,” said a Forrest County nursing facility healthcare provider, who wished to remain anonymous. “Many of the families I work with are already juggling jobs, kids and life while also trying to make sure their loved one is cared for appropriately. If a resident temporarily loses coverage, that bill doesn’t disappear, and most families cannot afford the out-of-pocket cost of care.”
The provider went on to voice particular concern for patients in cognitive care, such as patients with dementia or Alzheimer’s, who may not be able to understand what is happening to them or why.
“They don’t understand why their care is changing or why staff hours may be reduced,” they said. “They just know their routine is off- which is extremely upsetting to those patients, familiar faces are disappearing, and they no longer have access to services they relied on.”
Children in low-income families
With nearly half of the children in the state relying on Medicaid for access to healthcare, children in low-income families are also at risk of losing coverage. Among the changes to Medicaid are stricter guidelines for eligibility to include a minimum of working or volunteering 80 hours per month to able-bodied adults between the ages of 19 and 64, stricter guidelines for eligibility and more documentation and in-person meetings being required.
With the reduction in retroactive coverage, families could also face devastating medical expenses in the event of an unforeseen accident or illness. With more requirements for eligibility and decreased funding resulting in the loss of manpower, the process of applying for and obtaining coverage may take longer than the period the retroactive coverage allows for.
“[My child] barely qualified for Medicaid the last time we applied, and that took a few months," said a Lamar County mother. "We make right at the limit of income to get it [Medicaid coverage]. My husband’s job doesn’t offer insurance, and we can’t afford it.”
The anonymous mother voiced concerns of many Mississippians- those whose income is too high for Medicaid coverage but too low to afford private insurance. Living paycheck to paycheck is a reality for the majority of families, so one illness or injury could result in financial ruin.
“I’ve tried to find a job with health insurance but even if I could find one, we’d have to pay for childcare, too,” she said. “That costs more than what I could make, especially after paying for the insurance. It’s like the deck is stacked against you, no matter what. You’re stuck.”
The stark reality that many Mississippi families face is being forced to choose between seeking treatment or not- a decision that could potentially have permanent consequences.
A note from the reporter:
While several attempts were made to contact healthcare providers and citizens with stories relevant to this topic, most responses were left unanswered. Those who did respond either declined to interview or wished to remain anonymous given the “political climate” and nature of the subject.
This coverage is supported by a grant from Press Forward Mississippi, part of a nationwide philanthropic effort to reinvigorate local news.
