Over 60 percent of the Americans living in the Deep South support Obamacare’s Medicaid expansion, according to the results from a new poll that surveyed a broad sample of people in Alabama, Georgia, Louisiana, Mississippi, and South Carolina.

The poll, conducted between March and April by the Joint Center for Political and Economic Studies, found that support for Medicaid expansion is somewhat divided along partisan lines. Nevertheless, a solid majority of residents in each of the five Deep South states favor expanding the public insurance program to extend coverage to additional uninsured Americans:

That public support stands in sharp contrast to the five states’ political leaders, who have resisted cooperating with health care reform at any cost. The GOP governors in each of those Southern states — Govs. Robert Bentley (R-AL), Nathan Deal (R-GA), Bobby Jindal (R-LA), Phil Bryant (R-MS), and Nikki Haley (R-SC) — have refused to expand their Medicaid programs.

“This survey clearly shows that governors and state legislators in the South who are resisting the Medicaid expansion are out-of-step with their constituents,” Brian D. Smedley, the director of the Joint Center’s Health Policy Institute, pointed out.

The broad public support for Medicaid expansion in this region makes sense. Low-income Americans in the South who don’t currently qualify for their state’s Medicaid program are being forced to simply skip out on medical care, and expanding Medicaid’s eligibility levels would ensure that they can access the health treatment they need. Deeply red Southern states also tend to have worse health outcomes compared to Democratic-controlled states on the coasts, and expanding Medicaid could help lessen some of those disparities.

But political resistance to Obamacare, even in the states that stand to benefit the most from it, remains strong. The governors in highly uninsured states are still refusing to consider cooperating with the Medicaid provision of the health reform law. And even when Republican governors reluctantly agree that Medicaid expansion is the right decision for their constituents, GOP-controlled legislatures in their states continue to block it.

On Monday, illegal abortion provider Kermit Gosnell was convicted of first-degree murder for the barbaric crimes he committed in his unsanitary Philadelphia-area clinic. Throughout his high-profile murder trial, anti-choice activists claimed that Gosnell’s case proved that abortion is always an inherently dangerous procedure — attempting to conflate incredibly late-term abortion services with first-trimester medication abortions. Even though their claims often fly in the face of scientific fact, abortion opponents have been largely successful at obscuring the medical realities of different types of abortion procedures.

That’s partly why restrictions on the abortion pill, which is medically known as mifepristone, are advancing across the country. Despite the fact that mifepristone is perfectly safe for women to take outside of the doctor’s office — an option that many women prefer, since it allows them the added privacy of taking the medication in their own home — anti-choice Republicans claim that more restrictions are necessary to protect women’s health. But these kind of restrictive state laws actually drive up the cost of the abortion pill, and don’t do anything to improve reproductive health care.

Here are five states where anti-abortion lawmakers are advancing medically unnecessary restrictions on the abortion pill, ultimately inserting themselves between a woman and her doctor:

1. MISSOURI: On Monday, Missouri lawmakers gave final legislative approval to HB 400, a measure that requires doctors to be physically present to administer the first dose of mifepristone and schedule an in-person follow-up appointment two weeks later. Critics of the legislation say it will interfere with women’s relationships with their doctors, as well as impose a serious burden on the women who must travel from different parts of the state to terminate a pregnancy. According to Paula Gianino, the CEO of Planned Parenthood for the St. Louis region and southwest Missouri, about 1 in 5 patients seeking an abortion at her clinic travel at least 100 miles.

2. NORTH CAROLINA: Anti-choice Republicans in North Carolina are currently pushing a package of anti-abortion bills intended to limit reproductive rights from several different angles. The most far-reaching measure is SB 308, which would require the clinics that administer medication abortions to adhere to the same standards as surgical facilities, including making costly updates to the building and requiring physicians to obtain admitting privileges from local hospitals. That’s a common method of attacking abortion clinics, and it often forces them to either stop providing the abortion pill or shut down altogether.

3. INDIANA: Earlier this month, Indiana lawmakers successfully pushed through SEA 371, a measure that is solely intended to prevent a Planned Parenthood clinic in the state from providing the abortion pill to its patients. Just like North Carolina’s proposed bill, the new law in Indiana requires clinic that administer medication abortions to make costly and unnecessary updates to their facilities under the guide of “protecting women’s safety.” When Gov. Mike Pence (R) signed the bill into law at the beginning of May, he repeated the popular anti-choice myth that the abortion pill is “dangerous” — despite all scientific evidence to the contrary.

4. MISSISSIPPI: At the end of April, Gov. Phil Bryant (R) approved SB 2795, which will require women to take the abortion pill in the presence of a physician as well as come in for a follow-up physical examination two weeks later. The measure takes effect on July 1 of this year — and it could represent a significant burden for women in the state. There’s only one abortion clinic left in all of Mississippi, and it’s fighting to remain open as anti-choice Republicans keep trying to shut it down.

5. LOUISIANA: Last month, the Louisiana Senate approved SB 90, a measure that would require a doctor who has completed a residency in obstetrics or gynecology to be physically present when administering medication abortions. If the bill becomes law, doctors who violate the new rule could be fined $1,000, imprisoned for two years, or both.

Requiring doctors to be physically present to administer the pill, even though most clinics don’t currently use that protocol, is a thinly-veiled attempt to ban abortion procedures conducted with the help of internet technology. Allowing doctors to prescribe mifepristone over a video conference helps improve low-income and rural women’s access to abortion services, since they may not be able to make a long trip to the nearest abortion clinic. Studies have shown that this type of abortion procedure is safe and effective. Nonetheless, anti-choice lawmakers continue to launch attacks at so-called “webcam abortions.”

West Virginia Gov. Earl Ray Tomblin (D) announced in a press conference on Thursday that his state would take part in Obamacare’s optional Medicaid expansion, calling the decision “the best choice for West Virginia.” But many states still remain up in the air with their decisions, either because they haven’t decided yet or because state executives and legislators are at odds with each other on the issue — and time is running out.

Speaking at St. Francis hospital and flanked by nurses, doctors, and hospital administrators, Tomblin laid out the medical and financial case for expanding Medicaid eligibility — a conclusion that he reached after commissioning a study to examine such a move’s effects on West Virginia. “Expansion will allow us to provide insurance coverage to 91,500 West Virginians,” said Tomblin.

Indeed, West Virginia has much to gain and very little to lose by embracing the Obamacare provision. The state has abysmal health demographics, and over half of West Virginia’s uninsured population lives below 138 percent of the Federal Poverty Level (FPL). These poor and vulnerable populations would gain access to health coverage under the Medicaid expansion, leading the Kaiser Family Foundation to conclude that expansion will reduce the number of uninsured West Virginians by a staggering 67 percent.

Those numbers likely led Tomblin to his decision. But the moderate Democrat has an advantage that governors of other conservative — and highly uninsured — states don’t: the almost assured support of his legislature. Democrats hold a supermajority in the state Senate and an eight seat edge in the House of Delegates, and both of West Virginia’s U.S. senators also support expanding Medicaid, making intraparty barriers unlikely.

The same cannot be said of Republican Govs. Jan Brewer (AZ) and Rick Scott (FL), who have been lobbying for Medicaid expansion after intense pressure from hospital associations and advocates for the poor. Their Republican-controlled state legislatures have been bending over backwards to stop it from happening. Although there is no hard deadline for expanding Medicaid under Obamacare, many of these states’ legislative sessions are quickly coming to an end — meaning that if no agreement is reached soon, they won’t receive the additional federal funds and won’t be able to extend coverage to low-income residents for at least the first full year of Obamacare implementation.

Texas and Louisiana face similar issues. Although some GOP lawmakers in those states are contemplating Arkansas Gov. Mike Beebe’s (D) alternative “private option” — which would take federal money and use it to help an expanded Medicaid pool buy private insurance — those efforts also remain in limbo, as former and current Republican presidential aspirants Govs. Rick Perry (TX) and Bobby Jindal (LA) have oscillated between flat-out rejecting expansion and being coy about their intentions.

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Forget congressional quibbling in Washington. One of the most telling fights over the future of U.S. health care is actually taking place right now in Louisiana.

Last week, the Louisiana House Committee on Health and Welfare advanced HB 527 to consideration by the full House. If passed, the controversial and heavily-lobbied legislation would redefine “optometrists” — who are primary care eye doctors — as “optometric physicians,” giving them expanded authority to prescribe medications and perform minor eye surgeries that they wouldn’t have been allowed to conduct before. Unlikely though it may sound, the future of American health care largely depends on whether or not bills like this can expand access to quality care while lowering costs — or whether they will instead make common medical procedures more dangerous, and ultimately more costly.

HB 527′s most ardent opponents are a different group of eye doctors — ophthalmologists — who are specialists in eye-related surgeries. Ophthalmologists wearing lab coats branded with “Oppose 527″ testified against the bill, asserting that its passage would open up Louisiana residents to a “blatant expansion of [optometrists'] services without training.” “The problem is, the optometrists want … this designation as a physician and yet, when it comes to oversight they want to be designated as an optometrists. Well, you cannot have it both ways,” said former Louisiana congressman and ophthalmologist John Cooksey.

Optometrists disagree. “In the end, this bill is about access, access to quality eye care for all the people of Louisiana,” said James Sandefur, executive director of the Optometry Association of Louisiana. “Our patients, and especially those in the rural areas, do not have access to these procedures. This bill would give them the access they deserve.” What Sandefur doesn’t mention is that having certain surgical procedures provided by optometrists would actually also lower health care spending, since optometrists wouldn’t be billing as much for their services. And the combination of these two factors — increased access to medical care for vulnerable populations and lowering costs — are really the cornerstones of health care reform.

As more and more people gain access to insurance under Obamacare, the assumption is that they will begin to consume more health care services. That means that more medical workers will be needed to provide care for these newly-insured populations — many of which will be poor, rural, or some other combination of vulnerable and secluded. The vast majority of care consumption isn’t the expensive kind; it’s the preventative and primary care kind, like doctor’s check ups and minor outpatient procedures. That has led some to worry that there won’t be enough primary care doctors to meet the increased demand once Obamacare is in full effect, and that the U.S. health care sector will be overwhelmed.

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Last Friday, the U.S. Department of Health and Human Services (HHS) announced that it would allow states to pursue waivers letting them privatize their Medicaid expansions under Obamacare — an idea that took root with a deal worked out by Arkansas Gov. Mike Beebe (D) and the Obama HHS last month. Commentators and policy-makers heralded it as a “game-changer” for the reform law, as it could influence red states — many of which have high poverty levels and massive uninsurance rates — to extend coverage to poor people and help facilitate a major Obamacare provision.

But as Medicaid policy expert and George Washington University professor Sarah Rosenbaum smartly pointed out to the Washington Post’s Sarah Kliff in March, using federal dollars to put Medicaid-eligible populations into privately-contracted plans isn’t a novel concept at all — to the contrary, states have actually been doing it for decades through their increasing use of Medicaid managed care (MMC) arrangements. These arrangements contract beneficiaries’ care out to private insurers and providers, and a full “two-thirds of Medicaid enrollees now receive most or all of their benefits in managed care.”

Republicans have historically been strong proponents of MMC, touting its potential to cut costs while protecting poor Americans’ benefits. But with HHS’s new offer to institute a wide-scale version of this program now on the table, several notable Republicans are balking at the idea — including some who have pushed for similar measures themselves in the recent past:

1. TEXAS GOV. RICK PERRY. The 2012 presidential aspirant has been on an anti-Medicaid bender of sorts lately, declaring that “Texas will not be held hostage by the Obama administration’s attempt to force us into the fool’s errand of adding more than a million Texans to a broken system.” Yet, during his presidential run in late 2011, Perry struck a massive deal with federal officials allowing him to move close to a million Medicaid beneficiaries into managed care. Perry heralded the move in a press release, saying, “By approving Texas’ Healthcare Transformation and Quality Improvement Program Waiver, state and local officials can provide more efficient and effective care, and implement locally-tailored health solutions.” Apparently, Perry doesn’t view the Obama Administration’s offer on privatized Medicaid to be a similar opportunity for implementing “locally-tailored” solutions.

2. LOUISIANA GOV. BOBBY JINDAL. One of Obamacare’s most ardent critics, Jindal has steadfastly refused to expand Medicaid in his low-income state, saying that “Medicaid still operates under a 1960s model of medicine with inflexible, one-size-fits-all benefits and little consumer engagement and responsibility.” So far, he has stuck by that decision despite the urging of local lawmakers and his own state’s hospital chains. But back in 2011, Jindal aggressively — and successfully — pushed through an expansion of Louisiana’s MMC program, shifting 900,000 Medicaid and CHIP beneficiaries onto private, managed care. The measure was actually Jindal’s number one health care-related priority for 2012, and his administration publicly sold it “as a way to save taxpayer money and provide better care through coordination among doctors, hospitals and other medical professionals.”

3. MISSISSIPPI GOV. PHIL BRYANT. In an interview with Kaiser Health News, the Mississippi governor said, “I would rather pay extra to Blue Cross [to help cover uncompensated costs for the uninsured], rather than have to raise taxes to pay for additional Medicaid recipients” — a tacit endorsement of a managed care scheme. In fact, in 2012, Bryant signed a bill allowing Mississippi’s Medicaid division to increase the proportion of beneficiaries who could be placed onto managed care programs from 15 percent to 45 percent of the aggregate pool. Bryant has attributed his opposition to Medicaid expansion to his view that the program disincentivizes people “to find a better job, or to go back to school, or to get [into] a workforce training program.”