Hundreds of thousands of Mississippians rely on Medicaid.

But Mississippi’s traditional Medicaid program does not cover everyone simply because they need healthcare.

Today, thousands of low-income adults are left without coverage.

That fact has helped Democratic Senate nominee Scott Colom make healthcare a major campaign issue.

Colom has repeatedly warned about Mississippi’s healthcare system and the financial pressure facing hospitals.

But he has also focused on the human cost.

People who cannot afford regular care do not stop getting sick.

Treatment may instead be delayed until illness becomes more serious. But that can also make treatment more expensive.

Poor health can make it harder to work, making healthcare an economic issue as well.

Despite those problems, Mississippi remains one of just 10 states that have not expanded Medicaid.

Republicans have controlled state government throughout the period when expansion has been available.

Efforts came close in 2024, but lawmakers failed to reach an agreement. Multiple expansion bills were introduced again in 2026, but died after Republican legislative leaders did not bring them forward for consideration.

Now the issue is moving into the midterm elections.

Colom is challenging Republican Cindy Hyde-Smith, whose campaign has portrayed him as too ideologically liberal for Mississippi.

But Colom has responded with a heavy focus on economic issues that directly affect Mississippi households.

His campaign is also drawing increased national attention as Democrats look for opportunities in states they have struggled to win in recent elections.

Turnout is another major part of the Democratic strategy.

Colom and Congressman Bennie Thompson have recently urged Mississippians to participate in November’s election, with Thompson describing grassroots voter-engagement efforts as a blueprint for increasing turnout.

Thompson has also long advocated for greater healthcare access and Medicaid expansion in Mississippi.

The larger question now belongs to Mississippi voters.

The state has voted reliably Republican in recent federal elections. But Mississippi’s healthcare problems will loom large as voters head to the polls this fall.

Mississippi has spent more than a decade declining Medicaid expansion. That has given Democrats a concrete issue to put before voters in 2026.

On November 3, Mississippians will decide what they want to do about it.