This week advocates in the South received yet another good reason to push for expanding Medicaid in their states. A new poll from the Joint Center for Political and Economic Studies found that residents in five of the most conservative states in the nation strongly support expanding Medicaid and implementing the core pieces of the Affordable Care Act. Residents in the deep Southern states of Alabama, Georgia, Louisiana, Mississippi, and South Carolina not only support expansion overall, but the support spans across racial lines.  This evidence of strong support among the very people they serve should be a clarion call for Southern state lawmakers to expand Medicaid.

The Joint Center conducted a poll of 2,500 Southern residents between March and April of this year to examine how the public in conservative states view key parts of the Affordable Care Act generally and the Medicaid expansion specifically. Among the findings:

  • 62 percent support Medicaid expansion
  • 75 percent support the creation of health insurance Exchanges
  • Nearly 69 percent support financial help (premium subsidies) for low-income individuals
  • Expansion draws support across all ethnic groups

There are nearly 15 million uninsured people in the South – the highest number and proportion of any region of the country. Expanding state Medicaid programs will provide insurance coverage to 7 million people, greatly improving the health and productivity of Southern residents. This dramatic increase in health care coverage through Medicaid will also address health disparities in reducing death and disease among nonelderly adults, racial and ethnic minorities, and residents of low-income areas. With the federal government covering the full cost of expansion for the first three years, expanding Medicaid will also be a great economic benefit to states. This should be a no brainer for the South.

But even with these clear cut health and economic benefits, nine Southern governors stand in opposition to accepting federal funding for expansion – with only, Arkansas, Kentucky, and Florida in favor. And even in Southern states with a supportive governor, challenges remain, especially when it comes to persuading state legislators.

The voices of their constituents should serve as a powerful motivator for policymakers who say they are representing the will of the people. The case for expanding Medicaid is clear. And advocates in the South will add this strong evidence of support to their efforts to mobilize and engage key constituencies. State policymakers have a responsibility to not just speak into their own megaphones but to listen to the voices in the crowd. These poll findings clearly show that the will of the people is to expand Medicaid in states across the Deep South.

Ongoing debates during the 2013 legislative sessions showed signs that even within the most conservative states expanding Medicaid was not completely off the table. Statements from Governor Bentley (AL) that Medicaid will not be expanded “as it exists under the current structure,” suggest that expansion remains possible. In addition, a number of governors and legislators are considering alternative models such as Arkansas’ premium assistance model to expand Medicaid.

As these poll results show, and to borrow from Mark Twain, reports of the demise of Medicaid expansion in the South have been greatly exaggerated. For economic, political, and moral reasons, expanding Medicaid is a top priority for advocates in the Southern states. At Community Catalyst, we will continue to lift up and promote all the reasons why Southern states should move forward with expanding Medicaid and implementing the Affordable Care Act. Advocates will discuss their Medicaid expansion campaign strategies at the 6th Annual Southern Health Partnersconvening in Atlanta, Georgia this July. There is no doubt the findings of this report will be an integral part of the conversation.