Cathy Puckett went to Mendenhall Elementary School one day in 2023 to pick up her granddaughter’s report card. The pair noticed booths set up at the school as part of a health-care fair, so they decided to look around.
The grandmother, now 55, had been struggling to obtain steady and affordable health care for her four young grandkids. She and her husband, David Puckett, became guardians of the children after the State removed their mother’s custody rights in 2022, she told the Mississippi Free Press on Jan. 14.
That day in 2023, Cathy Puckett asked a woman working at a Medicaid-assistance booth about getting her grandchildren added to the program’s roster. The grandmother had yet to gain custody of her grandkids at that time.
“I had figured it’s going to be the same thing,” Puckett told the Mississippi Free Press on Jan. 14. “It’d probably be a waste of time because I wasn’t getting no help trying to fill out applications, trying to explain to them, ‘Here’s my custody papers, but I still don’t have full custody because I’m going to juvenile court hearings.’”
The woman at the Medicaid-assistance booth promised to look into the grandmother’s case. Two weeks later, Cathy Puckett’s four grandchildren were enrolled in the TrueCare Children’s Health Insurance Program—something she had been fighting for for over a year.
“That is the best feeling in the world—to know that you do exist, you are being heard,” the grandmother said.
Cathy Puckett is unable to work a steady job because she has to care for her grandkids, making TrueCare essential for the Puckett family.
All four of their grandchildren are between the ages of 4 and 8. Cathy and David Puckett now have full custody of all of them and receive no support from the children’s mother or fathers. They are unable to get food stamps because David Puckett makes slightly too much money to qualify for the Special Supplemental Nutrition Assistance Program.
Her youngest grandchild is a 4-year-old boy with autism, emotional developmental delays, as well as asthma and allergies that require four daily prescription medications. She has to drive him to pre-K each weekday at 8 a.m. and bring him home at 11 a.m.
Thousands of Mississippians like the Puckett family are at risk of losing their Medicaid and Children’s Health Insurance Program coverage under Trump’s One Big Beautiful Bill Act, which experts say could cause detrimental effects to the federally dependent Magnolia State.
“We (can) cut corners and cut corners, but it’s going to hurt us. It is truly going to hurt us,” Cathy Puckett said. “Me and my husband, we worked hard our whole life. We got our whole place paid for by the time we were 50. Yeah, we had savings. We spent that savings taking care of babies. When they came here, they had nothing. All four of them were in diapers.”
The Changes Mississippi’s Medicaid Program Face
The federal Medicaid program and CHIP could lose $1.02 trillion from the federal spending budget approved under House Resolution 1, removing between 9.9 million and 14.9 million Americans from the programs by 2034, the Center on Budget and Policy Priorities estimated. The nonpartisan office calculated that H.R. 1, which President Donald Trump signed into law on July 4, 2025, cuts the Supplemental Nutrition Assistance Program’s federal funding by $186 billion through 2034, which will affect Mississippi’s food assistance programs
“The very same households that are being impacted by SNAP cuts, so their food budgets are likely to go up, (and) are also going to be affected by Medicaid cuts, which means their health care costs are going to be going up at the same,” University of California San Francisco professor Dr. Hilary Seligman, an expert on food insecurity and how it impacts a person’s livelihood, told the Mississippi Free Press on July 14, 2025. “And there’s simply not enough money in many low-income households’ budgets to deal with both of those at the same time.”
Across the U.S. and in Mississippi, the professor said, federal programs that provide food and food banks that receive federal funding are being reduced under H.R. 1.
Medicaid covers 57% of births in Mississippi, KFF data from 2023 show, and about 50,000 Mississippi children are enrolled in CHIP, Mississippi Division of Medicaid data from 2024 show. Of those who receive Medicaid coverage, KFF statistics show 58% of people are employed part-time or full-time. Medicaid insures 38% of working-age adults with disabilities and 74% of nursing home residents, KFF reported.
KFF estimates that the federal government’s funding cuts could reduce Mississippi’s Medicaid funding between $2 billion and $4 billion by 2034. H.R. 1 also requires states to cover anywhere between 5% to 25% of SNAP funding by 2028 based on administrative error rates for the states, while also cutting administrative funding in half. Mississippi’s nearly 400,000 SNAP recipients collectively received a total of $843 million in benefits in 2024, Center on Budget and Policy Priorities data show.
About 115,000 Mississippians could lose Medicaid benefits under the bill, the Center for American Policy predicts. The Center on Budget and Policy Priorities estimates that between 9.9 million and 14.9 million Americans could be at risk of losing Medicaid coverage by 2034 due to H.R. 1.
But Children’s Defense Fund Southern Regional Director Oleta Fitzgerald predicts “thousands, if not millions” of children in the U.S. will lose Medicaid coverage under H.R. 1. She said people won’t feel the effects of the cuts until late 2026, though.
“This upcoming Mississippi Legislative session is going to be really interesting—not only in Mississippi but across the country—because there are so many things that this federal legislation wrought that’s going to require the State to make some changes … either for the good or for the worse,” she told the Mississippi Free Press on July 16, 2025.
Mississippi Heavily Depends on Federal Medicaid Funding
Mississippi is one of the states that is most dependent on federal funding, and it requires significant funding each year for the state-run Medicaid and CHIP programs. The Mississippi Division of Medicaid has an $8.4 billion budget for the 2026 fiscal year, with $969.9 million—or about 11%—coming from the state and the remaining amount contributed by the federal government. But Congress is still drawing up the federal government’s budget for the 2026 fiscal year, and Congress could give Mississippi’s DOM less funding than its leaders requested.
Hundreds of thousands of Mississippians could feel negative effects from Medicaid cuts under H.R. 1, especially since half of the state’s population lives in rural areas, said Health Justice Director Linda Dixon of the Mississippi Center for Justice. More than 10% of Mississippians do not have health insurance, the Kaiser Family Foundation reported in 2023; that number could go up due to the changes H.R. 1 makes to the Medicaid program, Dixon predicted.
“We have one of the highest uninsured rates in the nation in comparison to nationally, and this is according to Kaiser,” she told the Mississippi Free Press on July 16, 2025. “And, of course, those rates will increase with expansive cuts to Medicaid with detrimental consequences because it’s really about the health and overall well-being of Mississippi’s children, pregnant women, vulnerable adults and seniors because those are the people who qualify for the current Medicaid program.”
H.R. 1 adds new work requirements for adults who receive Medicaid. People between the ages of 19 to 64 who are childless or parents whose youngest child is 14 or older must complete 80 hours per month of some kind of work to receive benefits. The maximum age of SNAP work requirements for able-bodied adults without dependents has been increased from 54 to 64. Work requirements have been expanded to those whose youngest child is 14 or older. SNAP beneficiaries must meet the same 80-hour monthly work requirement as Medicaid beneficiaries.
“People (on Medicaid and SNAP) generally are either sick, or they have children under age, or they are caregivers. Not to mention the fact that there are no jobs,” Fitzgerald said. “This work requirement situation is going to be the same for Medicaid and for SNAP, and it is one of the reasons that we are seeing such low numbers and participation in TANF. So, while the rules and the budgets may not cut people, the process is going to be what kicks people off.”
How Should Mississippi Lawmakers React to Federal Cuts?
In Mississippi, where the minimum wage is $7.25 and the median household income is $54,203, Oleta Fitzgerald said low-income people could go hungry and stop visiting the doctor without support from SNAP and Medicaid.
“Not having access to food assistance and health care in a state that has the lowest wages in the nation means that folk just cannot afford the high cost of health care and food, so people go without, which just makes the situations they’re in more difficult to work out of and makes their conditions worse,” she said.
Mississippi is one of 10 states that has not expanded its Medicaid program to cover uninsured adults between 19 to 64 who make low wages and fall in the coverage gap, where they make too much to qualify for Medicaid but not enough to afford private insurance. Linda Dixon said the Mississippi Legislature could make a fiscally responsible decision to benefit working Mississippians and hospitals by passing legislation to expand Medicaid.
“When you expand Medicaid, you also look at the benefits it’ll have for the state: (Preventing) rural hospital closures, job creation and, of course, coverage … addressing the overall health and wellbeing of Mississippians,” she said.
Measures to expand Medicaid in the 2024 legislative session failed after the House and Senate could not come to an agreement on monthly work requirements, a feature included in both chambers’ versions of expansion. Because the Biden administration was seen as unlikely to approve Mississippi’s Medicaid expansion as long as it included a work requirement, the effort died and Senate President Lt. Gov. Delbert Hosemann said expansion would have to wait for Donald Trump to become president.
But during the 2025 legislative session, the U.S. Senate had yet to confirm Mehmet Oz as the director of the U.S. Centers for Medicare and Medicaid. Because of this, Mississippi House Medicaid Committee Chairwoman Rep. Missy McGee, R-Hattiesburg, and Mississippi Senate Medicaid Committee Chairman Sen. Kevin Blackwell, R-Southaven, both said Medicaid expansion would likely not happen that year. Once again, Medicaid expansion did not become law.
If the Legislature wanted to help Mississippians at risk of losing Medicaid and SNAP coverage under H.R. 1, Oleta Fitzgerald said the governing body could remove “punitive work requirements” and “invest more in childcare” to allow parents to go to work and boost workforce training.
“This has been the question forever: Does Mississippi want to move off the bottom or does it want to be as punitive as possible to people who struggle in this state?” she asked.
Fitzgerald said many Mississippians who receive government assistance live in rural areas where jobs are scarce, and they may lack childcare or transportation to commute and find available work. Mississippi leaders need to invest more in community programs that make it easier for people to work, she added.
“Poverty affects everything. Poverty affects health care, it affects food access, it affects education, it affects the ability to have safe and affordable housing. If you don’t make enough money, it affects everything,” Fitzgerald said.
This coverage is supported by a grant from Press Forward Mississippi, part of a nationwide philanthropic effort to strengthen local news so communities stay informed, connected and engaged.