Mississippi

Mississippi has the highest poverty rate in the nation (18.8%) and the lowest median household income ($44,966). It is one of 10 states that still refuse Medicaid expansion. Its voters have not been able to put anything on the ballot since the state Supreme Court killed the initiative process in 2021. And the case that overturned Roe v. Wade started here.

Sen. Cindy Hyde-Smith faces Democrat Scott Colom on November 3, 2026. Everything else on this page runs through who holds that seat.

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Healthcare and Benefits

Mississippi has refused Medicaid expansion every year since 2014, leaving 74,000 to 100,000 residents in the coverage gap. They earn too much for traditional Medicaid but too little for marketplace subsidies. The federal government would pay 90% of the cost. Multiple expansion bills died in the 2026 session without a floor vote because Republican leadership never called them up.

$2 billion+ in federal Medicaid funding rejected annually since 2014. The federal government covers 90%, so Mississippi would pay 10 cents on the dollar.

More than half of Mississippi’s rural hospitals are at risk of closing, with 25 facing immediate threat. Rural maternity wards are shutting down, leaving entire communities without obstetric care. Trump’s proposed Medicaid cuts put 8 more rural hospitals at risk.

Governor Reeves vetoed a bill that would have required quarterly reports and competitive procurement for federal rural health funds, saying it could jeopardize up to $1 billion over five years. The legislature failed to override.

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Ballot Power

Mississippi is the only state that had a functioning ballot initiative process, lost it through a court ruling, and has gone five consecutive years without the legislature restoring it.

In 2021, the state Supreme Court overturned voter-approved medical marijuana Initiative 65. The ruling was based on a technicality: the state constitution required signatures from five congressional districts, but Mississippi dropped to four districts after the 2000 census. The court declared the entire initiative process “unworkable and inoperative.”

Every session since then, the legislature has failed to fix it. In 2026, the Senate tabled a restoration bill that had been advancing. If the measure had passed both chambers, voters would still have needed to ratify it statewide. They never got the chance.

Without ballot initiative, Mississippi voters have no way to work around the legislature on Medicaid, marijuana, redistricting, or any other issue. The only tool left is elections.

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Public Schools

The House passed HB 2, an omnibus school-choice bill that would have directed taxpayer funds to private schools, by a vote of 61-59. The Senate refused to pass broad vouchers. The session ended with a $2,000 teacher raise and no voucher agreement.

Despite ranking near the bottom in per-pupil spending (43rd), Mississippi has made real education gains. Per-pupil expenditures rose 73% between 2016-17 and 2025-26. The state’s overall education ranking climbed to 16th nationally by 2025. The $2,000 teacher raise helps, but it does not close the gap with neighboring states competing for the same teachers.

DOGE federal cuts halted more than $137 million in federal education funds, pandemic-era grants that schools expected to last through 2026. The Mississippi Food Network lost over $1 billion in USDA cuts affecting food banks statewide.

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Jackson Water

In August 2022, intake pumps failed at the O.B. Curtis Water Treatment Plant, and flooding made the breakdown worse. The system, which serves about 160,000 people, lost pressure, and many users went without running water for more than a week. It had more than 7,300 distribution line breaks from 2017 through 2021, and more than 320 boil-water notices were issued from May 2020 until the federal complaint in November 2022.

Jackson is approximately 83% Black. An EPA Inspector General report found that state officials saw the crisis coming and did nothing. The EPA sued Jackson for violating the Safe Drinking Water Act. A court-appointed manager now runs the water system.

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2026 Elections in Mississippi

Cindy Hyde-Smith is running for reelection. District Attorney Scott Colom won the Democratic primary.

The race is personal. Biden nominated Colom for a federal judgeship in October 2022. Hyde-Smith blocked it. Colom entered the Senate race against her. He outraised her in Q4 2025 ($420,327 to $357,995), though she held far more cash on hand ($2.49 million to $698,749).

In February 2026, Hyde-Smith said in a WLOX interview that Americans who cannot afford beef have “so many proteins to choose from.” In the poorest state in the country, that answer is the race in one sentence.

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What You Can Do in Mississippi

1. Check your voter registration. Mississippi has strict photo ID requirements. Verify your status and confirm your polling place at the Secretary of State’s office.

2. Call your state legislators about ballot initiative. Five years is long enough. Ask your senator and representative why they keep blocking restoration. Find your legislator at legislature.ms.gov.

3. Ask both Senate candidates about Medicaid expansion. Mississippi has rejected $2 billion per year in federal funding while half its rural hospitals are at risk. Make Hyde-Smith and Colom answer for that on the record.

4. Track the Jackson water repairs. If you live in Jackson, monitor boil water notices through the city’s public works page. If you do not live in Jackson, understand that infrastructure neglect in a majority-Black city is a civil rights issue.

5. Show up for school board meetings. The $2,000 teacher raise and the voucher fight will land on local desks. Ask your school board where the money is going and whether your district is losing students to private schools.