Percentage of uninsured Americans by state. Credit: U.S. Census Bureau

The rate of uninsured Mississippians dropped for the second year in a row as a result of the Affordable Care Act, according to data released by the United States Census Bureau on Tuesday.

The uninsured rate fell from 14.5 percent in 2014 to 12.7 percent last year. This follows a drop of 2.6 percent between 2013 and 2014, the first year the Affordable Care Act was implemented.

Despite these declines, Mississippi still ranks sixth for uninsured residents, behind only Texas, Alaska, Oklahoma, Georgia and Florida. Like these states, Mississippi declined the Medicaid expansion.

Advocates have argued that the Medicaid expansion would have extended coverage to more 300,000 of the poorest Mississippians, or 10 percent of the state’s population. But opponents of this optional provision of the federal health law have argued that the long-term costs outweigh any benefits of insuring such a large part of the population.

“It doesn’t pay for itself in part because you have all this infusion of more and more people going on the Medicaid rolls,” state economist Darren Webb said in a conversation with Mississippi Today in July. “It pays for itself the first few years because the federal government would be picking up the tab, but then once the state has to start putting in their portion it ends up being more costly.”

The Affordable Care Act lets states expand Medicaid to people earning up to 138 percent of the federal poverty level, or about $15,000 a year for one person. In Mississippi now, the income cutoff is about $5,500 for one person, about one-third of the federal poverty rate, so many adults are not eligible for Medicaid coverage regardless of how little they earn.

The uninsured rate in states that expanded Medicaid eligibility was lower than in states that did not expand eligibility, according to the Census Bureau’s report. In 2015, the uninsured rate was 7.2 percent in states that expanded Medicaid, compared with 12.3 percent in states that did not opt for the expansion.

Mississippi’s decline in uninsured is part of a national trend. Since 2013, the rate of uninsured Americans has fallen over a third, from 14.5 percent to 9.4 percent. Although Mississippi’s rate of uninsured has fallen 4.4 percent, less than the national average of 5.1 percent, it still has declined faster than 27 other states, including 11 which opted to expand Medicaid.

However, all of those 11 states had an uninsured rate under 10.7 percent in 2013, nearly four percentage points under the national average that year.

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Larrison Campbell is a Greenville native who reports on politics with an emphasis on public health. She received a bachelor’s from Wesleyan University and a master’s from Columbia University's Graduate School of Journalism.Larrison is a 2018 National Press Foundation fellow in public health, a 2019 Blue Cross Blue Shield Foundation of Massachusetts fellow in health care reporting and a 2019 Center for Health Journalism National Fellow.