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Deep South key test for Medicaid expansion

May 22, 2013 By Tony Pugh, MCT Washington Bureau

While only one in three people in the region has a favorable view of the Patient Protection and Affordable Care Act in general, many more support some of the law's main provisions.

WASHINGTON -- Even though governors and lawmakers in five Deep South states oppose a plan to cover more people through Medicaid under the health care overhaul, 62 percent of the people in Alabama, Georgia, Louisiana, Mississippi and South Carolina support expanding the program, according to a new poll.

The region is considered a crucial test case in gauging nationwide response and implementation of the Affordable Health Care Act, nicknamed "Obamacare."

The level of support for expanding Medicaid --the state and federal health insurance program for the poor and disabled --ranged from a low of 59 percent in Mississippi to a high of 65 percent in South Carolina, according to the poll by the Joint Center for Political and Economic Studies, a leading research and public policy think tank that focuses on African-Americans and other people of color.

Brian Smedley, director of the center's health policy institute, said the findings show that lawmakers who are blocking Medicaid expansion in the five states are "out of step with their constituents."

"A strong majority of respondents in our poll understand that not only will broader Medicaid coverage save lives and end unnecessary suffering, it will also stimulate job growth and the economy in these states," Smedley said.

The health care law extends coverage to people who earn up to 138 percent of the federal poverty level --about $16,000 a year for an individual in 2013, or roughly $32,500 for a family of four. The federal government has pledged to pay all medical costs for the newly eligible enrollees in 2014, 2015 and 2016, and no less than 90 percent of their costs thereafter.

But the five states in the poll, all led by Republican governors, have decided not to participate. Mississippi and Louisiana rank dead last among all states in the overall health of their residents, according to America's Health Ranking, an annual report by the United Health Foundation, a nonprofit arm of the insurer UnitedHealth Group. The other three states in the poll --South Carolina, Alabama and Georgia --rank 46th, 45th and 36th, respectively.

Not surprisingly, the law's least popular provision is the federal tax penalty that will be levied, beginning next year, against people who don't have coverage. Nearly two-thirds of poll respondents, or 64.5 percent, disliked the penalty, while just 31 percent viewed it favorably.

While only one in three people in those states has a favorable view of the Patient Protection and Affordable Care Act in general, many more support some of the law's main provisions, according to the poll.

In phone interviews with 500 people in each state, 69 percent of the 2,500 respondents expressed support of the health law's tax credits to help low-income people buy health coverage, and 75 percent supported the new online insurance marketplaces, or "exchanges," where consumers and small businesses can shop for health coverage beginning in October.

The poll results were notably divided by age and along racial, political and economic lines. Generally, blacks were more supportive of all parts of the law than whites, and younger people were more supportive than older people.

Lower-income people also expressed more support for the law than those with higher incomes, while Democrats and liberals were more supportive than Republicans and conservatives, as well as moderates and independents.

For instance, the poll found 85 percent of blacks and 53.3 percent of non-Hispanic whites support expanded eligibility for Medicaid. In households with annual incomes under $15,000, 82 percent favored Medicaid expansion, compared with 54 percent in households earning more than $90,000.

The five states in the poll have the largest percentages of black residents among Southern states, said the poll's author, David Bositis, a senior research associate at the center. Polling calls were weighted to reflect the demographics of each state, Bositis said.

Overall poll results have a margin of error of 2 percentage points, while the results for individual states have a margin of error of 4.4 percentage points.

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