Mississippi voters have a lot of issues to consider when they head to the polls on Nov. 7 – chief among them, perhaps, is the state’s crushing poverty rate.

According to the U.S. Census Bureau's American Community Survey, Mississippi has the highest poverty rate in the nation: 19 percent of its citizens are at or below the poverty line.

The cascading impact of that statistic ranges from the closure of hospitals in the state’s rural communities to the inability of those most in need to access public assistance due to political corruption. These issues have figured prominently in the race between incumbent Republican Gov. Tate Reeves and Democrat Brandon Presley, a member of the state’s Public Service Commission.

The statewide financial crisis impacting Mississippi’s health care system has taken center stage in the general election, said Adam Ganucheau, editor-in-chief of Mississippi Today, a nonprofit news organization that covers statewide issues.

Not being able to find medical care near their home is a major problem for these rural communities, but it’s not the only one.

“Dozens of rural hospitals are on the verge of closure because of financial concerns,” Ganucheau said. “One of the biggest concerns, and hospital leaders have been clear about this, is having to cover the cost of care for uninsured patients.”

“Mississippi is a very rural state and if one hospital closes, the next closest one might be 60 to 80 miles away. If you’ve had to go to a hospital in the last year, you’ve seen firsthand what this crisis is doing. People rely on these hospitals for many things. In many cases, these hospitals are the largest employer in these counties. This is hitting home for a lot of people.”

According to KFF News, a health care research and policy newsletter, Mississippi is one of 10 states that have refused to take the Medicaid expansion money offered through the Affordable Care Act. This money would help provide insurance for those who don’t have it.

Reeves signed a bill that would provide $103 million to hospitals to help with this problem. But because lawmakers wanted to use federal American Rescue Plan funds instead of state funds, many of the hospitals were ineligible to access the money because they’d already received federal funding.

Though she technically dropped out of the race, Gwendolyn Gray, a Black businesswoman who was running in the governor’s race as an independent, remains on the ballot because they’d already been printed with her name on it. Gray may receive some votes but has thrown her support behind Presley.

Because of this, and a change in the law that removed a Jim Crow-era provision that required candidates to win a majority of the votes cast in the majority of counties, the state’s first-ever runoff election could happen. That election would be held on Nov. 28.

Even if Presley were to confound conventional wisdom and become Mississippi’s next governor, he would have to fight through a Republican supermajority. All 174 members of Mississippi’s House and Senate are up for reelection and many of the incumbents are running unopposed.

Considering this, it’s important that everyone’s voice be heard through the ballot box, said Shaughny Rickmon, Central Mississippi field coordinator for Mississippi Votes, a nonprofit organization focused on empowering Mississippi’s residents and teaching young people the importance of voting.

Rickmon and her colleagues have been busy working toward that goal.

“We have a lot of people on the streets canvassing, knocking on doors, and helping people find out who’s on the ballot and what the issues are,” she said. “We have a sample ballot on our website msvotes.org and are doing text banking through [the peer-to-peer text marketing platform] Hustle.”

The text bank is part of Mississippi Votes’ #Up2Us Program, which helps voters create a voting plan for this year’s elections. Among the group’s goals is to send out 1 million texts by Election Day. 

“We’re also looking for people to act as poll monitors just in case voters need help,” Rickmon said. If you would like to volunteer, contact her at shaughnessy@msvotes.com. 

The final day to register to vote in Mississippi’s general election has passed. The last day to request an absentee ballot is Nov. 2. To see the criteria that would allow you to vote absentee and to request a ballot, go to www.vote411.org/mississippi.