Most Of The States Where People Struggle Most To Afford Health Care Aren’t Expanding Medicaid

The majority of the states in the U.S. where residents struggle most to afford health care and medicine — Alabama, Mississippi, North Carolina, Oklahoma, South Carolina, Florida, and Texas — have refused to address this issue by implementing Obamacare’s optional Medicaid expansion.

According to a new report from Gallup, the people who live in Alabama are the most likely to struggle to pay for their health care needs. When Gallup collected the data in 2013, one in four Alabama residents reported there were times in the past 12 months when they didn’t have enough money to pay for health care and/or medicine for themselves or their families. West Virginia and Mississippi residents are in a very similar situation, with about 23 percent of residents reporting that they had recently faced health needs that they couldn’t afford.

Unsurprisingly, the states that are home to a lot of people who are struggling to afford health care also tend to have some of the highest uninsurance rates in the nation:

But seven out of the 11 states on the list have refused to expand their Medicaid programs under Obamacare, a policy that would extend public health insurance to additional low-income residents. Even though the federal government will fund the full cost of the expansion for the first three years, and at least 90 percent of the cost after that, anti-Obamacare lawmakers have dug in their heels against health reform in some of the areas where their constituents need it most.


In addition to losing out on billions of dollars in federal funding, the states rejecting the Medicaid expansion are also leaving a total of about 5.8 million impoverished Americans without any access to affordable insurance — a reality that disproportionately impacts communities of color. Researchers from Harvard recently estimated that as many as 17,000 people will die directly as a result of their states refusing to expand Medicaid.

Some of the residents of these states have been mobilizing to try to pressure elected officials to change their minds about Medicaid. Earlier this month, several protesters were arrested in South Carolina after engaging in an act of civil disobedience to urge Medicaid expansion. And grassroots activists in Texas are trying to turn Medicaid into an election issue with a new “Texas Left Me Out” campaign.