Alabama, Georgia, Louisiana, Mississippi and South Carolina have a lot in common: The summers are hot and the political climates are conservative. These are states where Mitt Romney handily beat Barack Obama in the 2012 presidential election, so it's not surprising to learn that the president's signature health law is unpopular there.
But despite the law's unpopularity, its expansion of Medicaid is supported by almost two-thirds of adults in these states, according to a survey by the Joint Center for Political and Economic Studies, a left-leaning think tank.
The survey found only 33 percent of adults in the five states have a favorable opinion of the 2010 health law — ranging from a low of 31 percent in Louisiana to a high of 35 percent in Alabama. Yet 62 percent say they support expanding Medicaid to cover more low-income, uninsured adults — ranging from a low of 59 percent in Mississippi to a high of 64 percent in Alabama.
By comparison, an April poll by the Kaiser Family Foundation found that Americans overall support the Medicaid expansion by only a 50 percent to 41 percent margin. (KHN is an editorially independent program of the foundation.)
The Supreme Court ruled last year that the federal government cannot force states to expand their joint federal-state Medicaid programs for the poor. According to health care consultant group Avalere Health, none of the five states in this survey plans to expand its Medicaid program under the health law.
The survey found even stronger support for the law's creation of health insurance marketplaces — also called exchanges — for small businesses and individuals. Three-quarters of respondents expressed a favorable opinion of the marketplaces, ranging from 73 percent in Louisiana and Georgia to 77 percent in Mississippi. All five of these states have chosen not to build their own online insurance marketplaces, so the federal government will be running the marketplaces in these states.
Not all provisions of the law were regarded favorably, however. By a 65 percent to 31 percent margin, respondents had an unfavorable opinion of the law's individual mandate that will require all Americans as of 2014 to either sign up for health insurance or pay a penalty.
The Joint Center's poll surveyed 500 people in each of the five states for a total sample of 2,500 adults. It was conducted between March 5 and April 8 and has a margin of error of +/- 2 percentage points for the full sample and +/- 4.4 percentage points for each of the state samples.