An extensive report from the Commonwealth Fund has found deep-seated racial health disparities in all 50 states — with many more pronounced in Mississippi than anywhere else in the nation.

Across 24 measures graded in a Health Equity Scorecard, Mississippi ranked near the bottom or last when measuring health outcomes, health care access and health care quality for both its Black and white populations. Only one state, Oklahoma, had a lower overall health care rating for its Black population. 

The number of deaths in Mississippi from potentially preventable diseases, like diabetes, that are given effective and timely health care are much higher than the national average for both racial groups. However, in nearly all categories where disparities were measured, they were more pronounced for Mississippi’s Black population.

READ MORE: The full report from the Commonwealth Fund.

For example, Mississippi’s health system scores in the 8th percentile for Black residents, but much higher for white residents, in the 38th percentile. Compared to 38 states with large Black populations, Mississippi’s health system ranks 37th overall. 

Mississippi also performed poorly for insured and uninsured patients, showing that there are issues in health care delivery for those who have access on paper. There is one specific policy issue, however, that is partly responsible for the sheer breadth of the disparities in the state’s health care system: Medicaid expansion. 

“Improving people’s health care requires people to have health insurance coverage, and you’re not going to see a narrowing of disparities in states like Mississippi unless you provide health insurance coverage for everyone in the state,” said Sarah Collins, vice president for health care coverage and access at Commonwealth. “We’ve seen in other states that the disparities narrow in coverage once they expand Medicaid. So this would be a critical first step for Mississippi. It’s not the last step, but would be a critical first one.”

Mississippi is one of 12 states that haven’t expanded Medicaid under the Affordable Care Act. Doing so would allow thousands of low-income Mississippians eligible for tax credits through the ACA marketplace. Without these tax credits, the few plans that are available on the state’s marketplace are too expensive for those that fall in this “coverage gap.”

The state’s top elected officials, most notably Gov. Tate Reeves and Speaker of the House Philip Gunn, oppose Medicaid expansion, and have long maintained that the state cannot afford the costs.

If Medicaid were expanded, the federal government would cover 90% of the health care costs related to expansion, while Mississippi would have to cover the remaining 10%. In September, one of Mississippi’s top economists released a study showing that the 10% state match would be more than covered by health care-related savings to the state and new tax revenue generated.

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