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Introduction
Mississippi remains one of only ten states in the nation that have not yet accepted enhanced federal Medicaid funding to cover low-income adults with incomes up to $20,783 per year1. In addition to a permanent enhanced federal match of 90% that is available to states to cover this group, the American Rescue Plan Act of 2021 included additional incentives for states that had not yet adopted the expansion, including a five percentage point increase in the state’s federal Medicaid matching rate (FMAP) for 2 years after the state expands for all other Medicaid enrollees.2 Projections from KFF estimate that Mississippi’s budget could see a net gain of $400 million if the state expands its Medicaid program.3 Of those Mississippians that may gain health coverage from the expansion, approximately 61% have full or part time workers in their household and almost 80% are parents.4
Numerous studies find that expanding Medicaid has a beneficial impact on mortality rates, chronic disease, cancer outcomes, and mental and behavioral health. There is also extensive evidence that Medicaid expansion is a crucial support for rural hospitals.5 Many studies also show the financial and economic benefits for families that come from expanded Medicaid such as reductions in catastrophic out-of-pocket health costs, decreases in unpaid medical and non-medical debt, and improved satisfaction in personal financial conditions.6
This fact sheet examines which industries and occupations have the largest share of low-wage workers that are uninsured. The food service, construction, and general merchandise industries employ the largest share of uninsured, low-wage workers, collectively accounting for over a quarter of such workers (see Table 1). Cooks, construction laborers, and cashiers are the most likely to be uninsured (see Table 2).
What are the demographics of Mississippi’s low-wage uninsured workers?
Figure 1 suggests that low-wage working women in particular would benefit from Medicaid expansion. Women are more likely to be employed within industries with high rates of uninsurance such as accommodation and food services and retail.
Which parts of the state have higher proportions of uninsured workers?
Below is a list of counties with the highest proportion of uninsured workers (of all incomes), with shares ranging from nearly one fifth to over one quarter of a county’s employed, non-elderly adult population (See Table 3). Rural counties are more likely to have high rates of uninsurance, and the counties along the Mississippi Delta are hit the hardest (See Figure 2). Eight out of ten counties with the largest share of uninsured workers are rural, a majority of which are in the Delta region.
| Acknowledgements: We would like to thank Linda Dixon and Hannah Green for their contributions to this fact sheet. |
Methodology
This report from the Georgetown University Center for Children and Families (CCF) analyzes data from the U.S. Census Bureau’s American Community Survey (ACS). This report uses two ACS data products:
- 2022 ACS Public Use Microdata Sample (PUMS). Data points in this sample were collected in calendar year 2022. ACS PUMS are used to analyze top occupations and industries based on citizen respondents ages 19-64. (For more information on how the Census Bureau defines and classifies occupation and industry, as well as which occupations fit into each occupational category and industry sector, see “Industry and Occupation Code Lists and Crosswalks.”)
- 2018-2022 ACS 5-Year Estimates Data Profiles. Data points in this sample were collected over the five years and aggregated to produce more reliable estimates for small geographies. These tables are used to estimate county-level uninsured rates for adults ages 19-64 who are in the labor force and employed.
CCF calculates coefficients of variation (CVs, also known as relative standard errors) to measure data reliability for each estimate. CCF suppresses any estimate with a CV larger than 25%.
Endnotes
1 In Mississippi, the current Medicaid income limit for parents and caretaker relatives in a family of four is $587 per month, approximately $7,000 per year. Mississippi Division of Medicaid. (2023). Income Limits for Medicaid and CHIP Programs. Medicaid.ms.gov. https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/income-limits-for-medicaid-and-chip-programs/
2 Park, E., & Corlette, S. (2021, March 11). American Rescue Plan Act: Health Coverage Provisions Explained. Center for Children and Families. https://ccf.georgetown.edu/2021/03/11/american-rescue-plan-act-health-coverage-provisions-explained/
3 Rudowitz, R., Corallo, B., & Garfield, R. (2021, March 17). New Incentive for States to Adopt the ACA Medicaid Expansion: Implications for State Spending. KFF. https://www.kff.org/medicaid/issue-brief/new-incentive-for-states-to-adopt-the-aca-medicaid-expansion-implications-for-state-spending/
4 Drake, P., Tolbert, J., Rudowitz, R., & Damico, A. (2024, February 26). How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All States Adopted the Medicaid Expansion - Appendix - 10118-02. KFF. https://www.kff.org/report-
5 Ammula, M., & Guth, M. (2021, May 6). Building on the Evidence Base: Studies on the Effects of Medicaid Expansion, February 2020 to March 2021. KFF. https://www.kff.org/report-section/building-on-the-evidence-base-studies-on-the-effects-of-medicaid-expansion-february-2020-to-march-2021-report/
6 Sojourner, A., & Golberstein, E. (2017). Medicaid Expansion Reduced Unpaid Medical Debt And Increased Financial Satisfaction. Health Affairs. https://doi.org/10.1377/forefront.20170724.061160