The percentage of uninsured residents in Mississippi has gone up since the passage of the Affordable Care Act,
Politico reported.
The reasons are varied — ranging from strong opposition by tea party-aligned Republican Gov. Phil Bryant and his running dispute with Mike Chaney, the elected state insurance commissioner, to the state's fateful decision not to partner with the federal government to implement the Affordable Care Act and not to take part in Medicaid expansion, the news website reported.
The program in Mississippi was further hobbled by disorganization and misinformation, according to Politico.
Mississippi, with the lowest per capita income— $33,073— in the country, has a 22 percent poverty rate. Some 25 percent of its population lacks health insurance. African-Americans comprise 37 percent of the population and most of the uninsured. The local economy is comprised largely of small businesses that don't offer health insurance, Politico reported.
The deck seems stacked against those who most need coverage.
Wylene Gary of Yazoo City, who works in a low-paying restaurant job, paid a $129 premium as soon as Obamacare became available. Her card arrived with the notification that she would be responsible for a $6,000 deductible and 40 percent co-pay.
"This ain't worth a tooth," she said and canceled her coverage, Gary told Politico.
"The state's low standard of living means many people earn less than the federal poverty limit but too much for Medicaid; under the health law, they can't buy insurance on the exchange, leaving 138,000 Mississippians who fall into what has come to be known as the Medicaid gap," Politico reported.
The governor's decision not to take part in Medicaid expansion left rural hospitals — which had depended on millions of dollars in federal subsidies to cover the uninsured — in a lurch.
"Without the cash infusion that a Medicaid expansion would have brought, Mississippi hospitals are being strained to a near breaking point, with a number of them shuttering entire departments," Politico reported.
Most health insurance companies avoided the state because of the dispute between the governor, who opposed Obamacare, and the insurance commissioner who wanted to make it work. Two companies, Magnolia Health Plan and Humana, stayed but opted not to sell policies in all of the state's counties. When the federal HealthCare.gov site came falteringly online, residents of most counties had only a single choice, according to Politico.
By the end of 2013, just 802 people in Mississippi had signed up under the Affordable Care Act. And by the close of the first full year of enrollment — in which 300,000 could have gained coverage — just 61,494, or some 20 percent of those eligible, did so, Politico reported.
For the second year of Obamacare, United Healthcare will join in selling insurance via HealthCare.gov, presenting at least two choices in almost every Mississippi county.
For most of the state's poorest and sickest, that is unlikely to make much of a difference, according to Politico.
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