This image shows last year’s HealthCare.gov web site home page.

More Mississippians signed up for health insurance this year through the Affordable Care Act’s marketplace than last year.

Nationally, sign-ups were down by 5 percent at the close of the six-week open enrollment period; however, Mississippi is one of just five states that increased total marketplace enrollment over last year. Uncertainty surrounded the ACA as federal dollars aimed at aiding enrollment — advertising budget, navigator funds — were hit with deep cuts. Meanwhile, the nixed mandate penalty worried insurers —Ambetter was the only marketplace provider in Mississippi this year — and potential consumers.

While experts say the uncertainty from those changes likely kept both healthy young people and those without insurance — two of the ACA’s target — out of the marketplace, 4,658 more Mississippians signed up this year compared to last year, a 6 percent gain according to Centers for Medicare and Medicaid Services enrollment numbers.

Only Oklahoma had a larger percent change in enrollment. Florida, Hawaii and Wyoming also increased marketplace enrollment over last year.

Insurance Commissioner Mike Chaney’s office announced last week that over 88,000 people enrolled in the federal marketplace. “It is likely that consumers will continue to access individual coverage through the Exchange so long as tax subsidies remain available,” Chaney said in a news release.

Automatic renewals — those who enrolled in coverage last year and did not actively renew their plan through Healthcare.gov — are accounted for in the state’s 88,371 enrollees.

Last year, automatic renewals accounted for a quarter of all enrollment. Average premium costs were steady this year over last, when more than 90 percent of Mississippians who enrolled in coverage received a tax credit to help pay their monthly premiums that averaged under $100.

Mississippi enrollment numbers increased even as a federal judge’s decision earlier this month struck the entire health law down, a case which Gov. Phil Bryant was a plaintiff to. Health advocates say the proof of the law’s — and particularly the marketplace’s — impact are clear, and politicians should steer away from rhetoric that adds confusion about health care options. Work is needed to reach the 350,000 Mississippians who are still uninsured, says Roy Mitchell, executive director of Mississippi Health Advocacy Program.

“Through word of mouth, people now know what the marketplace represents a good value,” Mitchell said. “Imagine where we’d be with [Health and Human Services] support and funding instead of constant sabotage. Even with the odds against us, the value and peace of mind that the marketplace represents has sustained enrollment.”

While overall understanding of the law is still low, polls show more Mississippians support the marketplace and the consumer protections, such as requiring insurers to cover pre-existing conditions and blocking lifetime and yearly limits of coverage, built into the ACA law. Research echoes the negative impact that stripping the ACA would have on Mississippians, citing 229,000 more would lose access to coverage if the law falls.

“In regard to Mississippi’s participation in the lawsuit, politically it doesn’t make any sense. I think Mississippians are tired of these efforts to take their health care away,” Mitchell said. “There is disconnect between public opinion that supports health coverage expansions and (politicians) current policy of denying people coverage.”

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Erica Hensley, a native of Atlanta, has been working as an investigative reporter focusing on public health for Mississippi Today since May 2018. She is a Knight Foundation fellow for our newsroom’s collaboration with local TV station WLBT and curates The Inform[H]er, our monthly women and girls’ newsletter. She is the 2019 recipient of the Doris O'Donnell Innovations in Investigative Journalism Fellowship. Erica received a bachelor’s in print journalism and political science from the University of Southern California Annenberg School for Communication and Journalism and a master’s in health and medical journalism from the University of Georgia Grady College for Journalism and Mass Communication.