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Poor Americans want Medicaid, even in red states, study says

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Posted at 11:21 PM, Oct 15, 2014
and last updated 2014-10-19 09:49:48-04

Medicaid is popular, just don’t call it Obamacare.

A recent Harvard study said that the vast majority of people who would benefit from Obamacare’s expansion of Medicaid want it. Even in very red states.

“Across the board we saw about 80 percent of adults supporting Medicaid expansion,” said Benjamin D. Sommers, a health economist and author on the study.

Low-income people surveyed in Kentucky, Arkansas and Texas reported significant medical needs – with high rates of depression, anxiety, high blood pressure and respiratory issues. More than half said they have a chronic medical condition.

Three-fourths of the nearly 3,000 surveyed lived at or below the poverty line. Yet, only about one-third knew that Medicaid expansion was a political issue.

The states in the study were politically conservative, with about one out of five people identifying as liberal. But they differed in their response to Obamacare: Texas rejected Medicaid expansion, Kentucky accepted it and Arkansas will use the money for private subsidies.

“There’s a lot of unmet medical need in this population,” Sommers said. “This is not a trivial issue. There are a lot of people that can really benefit.”

Before the Affordable Care Act, families might qualify for Medicaid health coverage if their income was 100 percent of the federal poverty level or below, depending on their state's requirements. That was $23,550 for a family for four in 2013.

The Medicaid expansion, a tenet of Obamacare, allows families to qualify for Medicaid at up to 133 percent poverty level. But there’s a catch – their state has to opt in.

The so-called “Medicaid gap” is an unintended crack knocked into in Obamacare by the U.S. Supreme Court. The 2012 court decision left Medicaid expansion up to the states.

In states that turned down the expansion, some people are too well off to qualify for pre-Obamacare Medicaid. But they’re also below the income level to get a tax subsidy on the health care exchanges.

So far, 27 states and the District of Columbia are implementing the expansion of Medicaid, and a handful are debating it.

Sommers said Obamacare is popular on its merits, with the exception of the individual mandate, which require people to be insured or face a fine.

“It’s only when you put it all together and label it Obamacare that the opposition comes up,” Sommers said.

The study was published in the journal “Health Affairs.”

Gavin Stern is a national digital producer for the Scripps National Desk. Follow him on twitter at @GavinStern or email him at gavin.stern@scripps.com.