Washington, DC – A new poll by the Joint Center for Political and Economic Studies finds solid support across the South from a majority of both African Americans and non-Hispanic whites for the expansion of the Medicaid program as called for in the Affordable Care Act (ACA).

The Deep South and Medicaid Expansion: The View from Alabama, Georgia, Louisiana, Mississippi, and South Carolina was conducted in March and April, 2013. The poll found that 62.3 percent of 2,500 respondents living in Alabama, Georgia, Louisiana, Mississippi, and South Carolina support expanding the Medicaid program to cover more low-income, uninsured adults. There were racial differences on Medicaid expansion but, nonetheless, majorities of both African Americans (85.3 percent) and non-Hispanic whites (53.3 percent) favored it. Self-identified liberals (78.2 percent) and moderates (69.3 percent) solidly favored Medicaid expansion. While a plurality of conservatives opposed expansion (48.9 percent), it should be noted that a substantial 46.9 percent of conservatives supported it. A large majority of Democrats (87.1 percent) and a majority of independents (56.6 percent) supported expansion, while Republican identifiers (37.9 percent) were the subgroup most opposed. 

In addition to support for the Medicaid expansion, residents of the polled states showed strong support for the law’s health coverage tax credit subsidies (68.8 percent in favor) and the creation of statewide insurance marketplaces (75 percent in favor).

The U.S. Supreme Court ruled last year that states cannot be required to expand their Medicaid program, which is a state-federal public health insurance program providing coverage to low-income adults. Most Southern states have highly restrictive Medicaid programs in which only very low-income adults with children or disabilities are eligible. The ACA authorizes the expansion of Medicaid to include low income uninsured adults, including adults with no children and whose incomes are below 138% of the Federal Poverty Level. The federal government will pay the entire cost of the expansion for the first three years and, after that, states will gradually pay no more than 10 percent and the federal government 90 percent. In National Federation of Independent Business v. Sebelius, the Supreme Court ruled that states may choose whether or not to participate in the expansion.

In the Deep South states of Alabama, Georgia, Louisiana, Mississippi, and South Carolina, political opposition to the expansion is strong. The Republican governors of these states—Robert Bentley (AL), Phil Bryant (MS), Nathan Deal (GA), Nikki Haley (SC), and Bobby Jindal (LA)—each opposes the expansion, as do the Republican majorities in the states' legislatures.

“These findings indicate that residents of these Southern states understand the benefits of the ACA’s Medicaid expansion for their communities, and want their elected officials to carefully study the merits of the law before expressing opposition,” said Ralph B. Everett, President and CEO of the Joint Center. “I hope leaders in these states will hear the will of the people when considering this historic opportunity to ensure that more people gain health insurance coverage.”

“There is majority support for Medicaid expansion across all five states,” noted David Bositis, Ph.D., Senior Research Associate at the Joint Center, who conducted the survey. “These southern states are some of the most conservative states in the country, yet both African Americans and whites support Medicaid expansion, and there is pretty solid support for some other elements of the ACA, as well.”

“Medicaid has been an important lifeline to many low-income and disabled adults and children who need access to health care,” said Brian D. Smedley, Ph.D., Vice President and Director of the Joint Center Health Policy Institute.  “Medicaid expansions are associated with a significant reduction in mortality, decreased rates of delayed care because of costs, and improved health. In addition, economic models suggest that states with highly restrictive Medicaid eligibility will enjoy a significant economic stimulus because of the jobs and economic activity associated with Medicaid dollars. Expanding Medicaid will not only save lives and improve health; it will stimulate the economies of states that choose to accept it.”

The Deep South and Medicaid Expansion was supported by a generous grant from the W.K. Kellogg Foundation. The Joint Center for Political and Economic Studies is one of the nation’s leading research and public policy institutions and the only one whose work focuses primarily on issues of particular concern to African Americans and other people of color. To learn more, please visit www.jointcenter.org