Mississippi insurance commissioner pushes short-term plans as healthcare costs climb

As more Mississippians struggle to afford healthcare, Insurance Commissioner Mike Chaney is working to make short-term health plans more accessible as a lower-cost alternative to traditional health insurance, even though they could deny coverage to people with preexisting conditions.

The Mississippi Comprehensive Health Insurance Risk Pool Association, the state's long-dormant insurer of last resort, is on track to serve as a customer portal for short-term, limited-duration plans with basic health benefits offered by UnitedHealthcare in 2027, Chaney told Mississippi Today on Tuesday. He said he expects the company to offer two or three plan options similar to those it already offers in Mississippi. However, details have not been finalized, and premiums will be roughly "a couple of hundred dollars a month," Chaney said. People can enroll or cancel at any time.

These plans are designed to bridge a temporary gap in coverage, such as when people are in between jobs. They do not meet federal requirements for comprehensive health insurance under the Affordable Care Act. They are not required to cover essential benefits, including maternity, mental health or prescription drug coverage, or meet federal requirements barring discrimination based on health status.

"It's just like the plans we had before the ACA came along," Chaney said.

The Affordable Care Act, enacted in 2010, significantly reformed the U.S. healthcare system. It established protections for people with pre-existing conditions, created online insurance marketplaces with financial subsidies, expanded Medicaid eligibility for low-income adults and allowed young adults to remain on their parents' plans until age 26. Most major provisions went into effect in 2014, and for over a decade, Mississippi lawmakers have chosen not to expand Medicaid.

Health policy experts say short-term plans could provide limited coverage to people who will otherwise go without health insurance after the enhanced federal tax credits that made health insurance more affordable for over 300,000 Mississippians expired in December. But they also present potential risks for consumers, who could be saddled with costly medical bills due to the plans' limitations or be excluded entirely due to a preexisting condition. Experts warn that more young and healthy people enrolling in short-term plans could make Affordable Care Act marketplace plans more expensive because the remaining pool of customers will be sicker — and more costly to insure — on average.

Over time, this situation could create an "unlevel playing field" for older adults nearing retirement age or those with chronic health conditions who need robust healthcare coverage, said Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University.

"The emergence of a market around these short-term plans is likely to drive the ACA rates even higher," she said.

Chaney acknowledged the plans will not be a good option for people with more serious health concerns.

"If you need a liver transplant or a knee operation because you haven't taken care of your body very well, you're not going to get coverage out of the plan," Chaney said.

Caroline Landree, a spokesperson for UnitedHealthcare, declined to comment to Mississippi Today.

But he said he hopes the short-term plans will help more than 70,000 Mississippians who disenrolled from ACA marketplace health plans between February 2025 and February 2026 — one of the biggest drops by percentage in the country. Among all states, Mississippi had the lowest share of enrolled people who paid their first premium this year, demonstrating the affordability challenges residents are facing. At the same time, Medicaid enrollment is at one of its lowest numbers in the last decade.

Health policy experts and Chaney expect the number of people without insurance in the state, which fell in 2024 to its lowest rate in over 15 years, to rise.

Congress first authorized the expanded subsidies in 2021 during the COVID-19 pandemic. Mississippi was one of the states that benefitted the most from the increased federal support, in part because state lawmakers have not expanded Medicaid. Between 2020 and 2025, the number of people enrolled in ACA marketplace plans increased by about 240,000. During the same period, the rate of people without insurance — one of the highest in the country — dropped by over 65,000.

With the enhanced subsidies now gone, marketplace premiums for people renewing their coverage more than doubled on average, according to KFF. Marketplace plans primarily insure people who do not have health coverage through their employer, Medicare or Medicaid.

Cathy Peters, senior director of state and local campaigns for the American Cancer Society Cancer Action Network, said her organization is concerned about the expansion of short-term plans. She said their low premium costs can create a "false sense of security," but leave people with costly medical bills or without coverage for serious illness.

"Things happen to people in their life, and the longer you go on this type of product, the more likely it is that you have some kind of serious health incident," Peters said.

Dormant state insurance program expected to host short-term plan options

In 1991, the Legislature created the Mississippi Comprehensive Health Insurance Risk Pool Association to extend healthcare coverage to people who were denied insurance, largely due to pre-existing conditions. The program was financed through mandatory contributions from insurance companies. The plans were more expensive than typical policies in the open market, but for some people, they were the only option for comprehensive coverage.

The association stopped issuing policies after the ACA barred insurance companies from denying coverage to people with pre-existing conditions or charging them more.

Under Chaney's plan, the risk pool association will act as a portal for consumers to purchase short-term plans. The portal is built and ready to go, he said.

In the future, he added, the association's board could decide to use its remaining funds to partially subsidize the plans. The association has over $22 million in assets, according to 2024 tax filings.

But the available funds may not be enough to make the plans significantly more affordable for customers, Corlette said.

"$20 million is just not going to get you very far," she said.

In 2025, Mississippians received roughly $2.2 billion from the federal government in advanced premium tax credits, according to an estimate from KFF based on the number of active enrollees and average credit amount.

Chaney has previously pitched the idea of using the remaining funds from the association to create a state-run health insurance marketplace or a reinsurance program to protect insurers on the marketplace from high medical claims for beneficiaries with costly medical needs.

Chaney's interest in short-term limited-duration plans follows federal efforts to loosen restrictions on them. In 2018, during President Donald Trump's first term in office, the plans' allowable duration was extended to up to 36 months.

The current federal rules, passed under the Biden administration, limit the plans to up to three months plus renewals. But the Trump administration announced in August 2025 it would not enforce the three-month cap and planned to consider rule changes that could roll back those regulations.

Chaney said the policies offered through the Comprehensive Risk Pool Association are expected to have terms of at least 364 days.

Some states, including Oklahoma, have indicated they will permit coverage periods that extend beyond the length allowed under the current federal rule. Other states prohibit the sale of short-term limited-duration insurance, such as California, Massachusetts and New York.

A 2025 study from ACSCAN found that after the restrictions were loosened during the first Trump administration, states without their own restrictions on the plans saw increases in late-stage cancer diagnoses. States with no regulations, like Mississippi, saw an average net increase of .84%.

States can strengthen these plans by setting minimum standards, such as forcing them to have more robust benefits or to not discriminate based on health status, Corlette said.

"But it's a tradeoff," she added. "The more regulations, the more expensive they can become."

Richard Roberson, president and CEO of the Mississippi Hospital Association, said short-term plans could help address the state's health insurance affordability challenges. But he said proposals should consider not only premiums, but also the out-of-pocket and deductible costs consumers may face. These costs can affect hospitals, too, because when patients cannot pay their medical bills, hospitals often absorb the cost.

"The devil's in the details," Roberson said.

Chaney said he does not regulate the short-term limited duration plans that are already sold in Mississippi and does not plan to set minimum requirements for the plans advertised through the Comprehensive Risk Pool Association's portal.

"We do not want to regulate them," Chaney said. "It should be a free market."

Changes coming to Mississippi's marketplace

Several companies will be leaving the ACA marketplace in Mississippi in 2027, and the remaining plans have proposed double-digit rate increases.

Cigna Healthcare announced in April it would be leaving the marketplace in all 11 states where it currently offers plans. The decision stemmed from Cigna's inability to scale the business, which has been shrinking in recent years, a spokesperson said in an email to Mississippi Today.

Chaney said Molina Healthcare will also leave the state's marketplace. Molina announced in July it will reduce the number of states where it offers marketplace plans next year as a result of a sicker and more costly insurance pool after the expiration of the enhanced subsidies. Molina did not respond to a request for comment from Mississippi Today.

The remaining three insurers on Mississippi's marketplace have all requested rate increases ranging from roughly 14% to 40% for 2027, depending on a customer's plan, according to federal rate review submissions made in May and June.

"It's not good news," Chaney said of the proposed rates.

The companies' suggested rate increases are higher than the national average. Marketplace insurers across the country are proposing a median premium increase of 15%, according to an analysis from KFF. This comes after last year's median finalized rate change of 20%, representing two years of significant increases.

In rate filings, insurers pointed to higher healthcare costs, general economic inflation, labor shortages, the expiration of the enhanced tax credits in 2025 and a subsequent increase in the risk pool's morbidity, according to the health policy research organization's analysis.

Other insurance-like products have also attempted to shore up gaps in coverage, but carry some of the same risks as short-term plans. Farm Bureau in 2026 began offering basic health coverage plans in Mississippi that can deny people with preexisting conditions and deny certain coverage, including maternity care. In 2024, the state Legislature passed a bill to exempt the plans from standard health insurance regulations.

Corlette said it is disappointing that millions of Americans are facing health affordability challenges after enhanced premium tax credits made ACA marketplace plans more affordable between 2021 and 2025, and the uninsured rate decreased.

"It's sad to see the clock turn back," she said.

This article was originally published on Mississippi Today.