Mississippi lawmakers passed a bill on Tuesday, February 12, 2026, that could pave the way for the creation of a state-run health insurance exchange, though its immediate impact remains uncertain. House Bill 605, authored by State Representative Henry Zuber (R), passed the House with a unanimous vote of 116-0.
The bill does not directly establish the exchange, but rather initiates the process by requiring the Mississippi Commissioner of Insurance to begin planning for its implementation. According to Representative Zuber, the goal is to “help our employers provide insurance for our hardworking citizens, bring down medical costs and increase the number of insured in Mississippi.” He cautioned, however, that the actual creation of an exchange could take as long as two years.
The State Affairs Committee is scheduled to meet early next week to discuss the best method for establishing the state-sponsored health insurance exchange. Zuber emphasized that the bill is intended to be a starting point, potentially aligning Mississippi with future requirements from the Centers for Medicare and Medicaid Services.
Zuber clarified that the proposed exchange is designed to facilitate private sector health insurance options and should not result in increased Medicaid costs for the state, nor will it be a state-reimbursed plan. The legislation specifically references Section 1311 of the federal Affordable Care Act in its operation.
During debate, State Representative Omeria Scott (D) questioned whether the Mississippi exchange would mirror the current Affordable Care Act exchange and whether it would receive federal subsidies. Zuber responded that whereas the fresh exchange might share similarities with the ACA program, it would not be subsidized, and would be designed with the interests of Mississippi’s small businesses and taxpayers in mind. “All I’m trying to do, hopefully, we can increase the number of Mississippi citizens that have health insurance and we can help our small businesses provide their employees,” Zuber stated.
An amendment adding a “reverse repealer” was incorporated into the bill before its passage in the House. This provision ensures that the legislation will remain in effect unless explicitly repealed by future legislative action.
