Hospitals in Mississippi " already strained under the costs of caring for a high rate of patients without health insurance and with low-reimbursement plans, such as Medicaid " are expected to lose $1 billion over the course of the next decade as a result of President Donald Trump's sweeping tax and spending bill signed into law in July. To complicate matters further, federal enhanced premium tax credits for Affordable Care Act Marketplace insurance expired late last year. That happened after Congress did not extend them, making health care less affordable for hundreds of thousands of Mississippians.