- Enrollment numbers in the program are on a decline in the Magnolia State.
The Mississippi Division of Medicaid is anticipated to operate off a total budget of $8.4 billion for the new fiscal year which begins July 1. Of that total, the state’s total support sits at about $969.9 million, Senate Medicaid Committee Chair Kevin Blackwell (R) told his colleagues during the recent special session.
“In this bill, we allowed for a deficit of $60 million. Actually, the department thinks it’s going to be about … $120 [million] for next year, but all we could get was the $60 [million] out of the House,” Blackwell described.
For the previous fiscal year, the Legislature set the state support at about $911 million, meaning the new state budget will provide a $58 million increase to the division.
As with all bills this session, Blackwell said, health insurance increases for employees of the Mississippi Division of Medicaid were included in the increase.
Mississippi is one of a handful of states that has not expanded its Medicaid program for able-bodied adults as part of the Affordable Care Act.
According to reports shared by the Mississippi Division of Medicaid, there were 718,028 Mississippians enrolled in June 2024. That number is a decrease from the 904,590 reported in June 2023. According to the state department’s enrollment report from April 2025, 705,097 residents were enrolled in the program, which includes CHIP participants.
Bills to expand Medicaid were considered during the 2024 session, but none made it to the governor’s desk. No bill with that purpose was discussed on the floor of either chamber of the Mississippi Legislature this session.
However, given the proposed changes at the federal level in the Trump Administration’s “big, beautiful bill” making its way through Congress, that could change as a sticking point in Mississippi centered on work requirements. The federal legislation under consideration seeks to make work requirements a key component of the program going forward.
While Mississippi has not expanded its Medicaid program, it does receive one of the highest, if not the highest, Federal Medicaid Assistance Percentage (FMAP) match rates. The state division’s 2024 report shows the program was at 78.42 percent for fiscal year 2024.
Jeremy Pittari
