The Affordable Care Act (ACA) expands Medicaid so that it can provide health insurance to a larger pool of low income uninsured adults, including adults with no children and whose incomes are below about $16,000 a year. The federal government will pay the entire cost for the first three years, and after that states will pay 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.
This study examines how the public in these states views the Affordable Care Act generally and the Medicaid expansion specifically.