Health Insurance Coverage and the ACA: Results of the 2014-15 Survey of Mississippi Adults

Friday, August 7th, 2015

The Center for Mississippi Health Policy commissioned researchers at the Social Science Research Center (SSRC) at Mississippi State University to survey non-elderly Mississippi adults to assess their knowledge, attitudes, and behaviors related to health insurance and the Affordable Care Act (ACA). This survey serves as a follow-up to a similar study conducted in the fall of 2013 and contains additional analysis by geographic area of the state.  The Center has prepared an Issue Brief that summarizes the results of this survey, which was conducted in 2014-2015.  A copy of the full SSRC Report containing all survey responses, as well as the survey methodology, is also available under Related Links.

KEY Findings

As found in the 2013 survey, respondents report little knowledge of the ACA or the Health Insurance Marketplace (formerly known as the “Exchange”). Three out of five (59%) say they know nothing or only a little about the ACA, and 69 percent know little or nothing about the Health Insurance Marketplace. Similarly, less than half (46%) say they have enough information about the health reform law to understand how it will affect them or their families. The rates of the uninsured reporting no knowledge of the ACA, the Health Insurance Marketplace, or the open enrollment period, as well as not having enough information to understand the impact of the ACA, are significantly higher for the uninsured than the insured. Approximately 15 percent of survey respondents reported not being currently covered by health insurance, a drop from 23 percent in 2013. Most (51%) had been uninsured for over two years.

MS Knowledge of ACA by HI 2014 Test 7

Mississippi adults indicated a slightly more positive opinion of the ACA in 2014, with 43 percent stating they do not support the law (46% in 2013), 41 percent expressing support (38% in 2013), and the remainder (16% in 2013 and 2014) were not sure. While 40 percent anticipated in 2013 that they would be worse off as a result of the ACA, only 25 percent in 2014 said they were worse off due to the Act. Almost half said they were unaffected by the law. As in the previous survey, respondents showed support for many of the components of the ACA, with the notable exception of the individual mandate penalty.

Mississippi Opinions Health Reform Fig2 from Issue Brief


Geographic Variations

A second larger sample of Mississippi adults, equally distributed by public health district, was surveyed to determine if there were any significant differences in attitudes and opinions by geographic area of the state. Considerable geographic variation was found in the responses to several questions:

  • Support for the ACA
  • Thought they were better/worse off due to the ACA
  • Agreed people should be required to have health insurance
  • Planned to buy health insurance through the Marketplace

There were several areas of consistent agreement statewide:

  • Health insurance is necessary
  • Health insurance is worth the cost
  • Subsidies should be available to low-income individuals
  • Medicaid should be expanded to all below the federal poverty level


The findings of this survey illustrate the changes in the attitudes, opinions, and behaviors of Mississippi adults since the initial survey in 2013 and describe geographic variations across the state. There continue to be low levels of knowledge about the Affordable Care Act, the Health Insurance Marketplace, and the open enrollment period, particularly among uninsured adults in Mississippi. While there remains little support for the Affordable Care Act in general, and specifically for the individual mandate penalty, Mississippians strongly support many of the health reform components in the law, including subsidies for low-income individuals and Medicaid expansion.

The percentage of Mississippi adults who report being uninsured has dropped since 2013, but cost is still the greatest barrier to their obtaining health insurance coverage. The uninsured overwhelmingly perceive value in health insurance coverage, although not to the extent of the insured, and are more likely to state that health insurance is not worth the cost.  More uninsured, however, expressed intent to purchase coverage through the Health Insurance Marketplace than in 2013.

For More Information

Copies of the Issue Brief can be downloaded HERE. Copies of the complete SSRC Report can be downloaded HERE.  Printed copies of the Issue Brief are available by contacting the Center for Mississippi Health Policy at 601-709-2133 or by e-mail at