A new study finds that Medicaid expansion improved people’s health in Southern states, resulting in fewer declines in people’s health.

The study published in Health Affairs finds that Medicaid expansion made declines in health status 1.8 percentage points less likely in states that expanded the medical coverage.

It examined 12 Southern states, including those that have accepted the expansion of Medicaid under the Affordable Care Act, like Kentucky, West Virginia, Arkansas and Louisiana, and those that have not, like Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina and Tennessee.



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“We found that Medicaid expansion was associated with lower rates of self-reported health declines and a higher likelihood of maintaining baseline health status over time,” the study finds.

A majority of the 14 states that have rejected the expansion of Medicaid are in the South.

Resistance to Medicaid expansion has been declining, with multiple red states accepting the expansion in recent years, often through ballot initiatives that put the question to voters in the state.

Medicaid expansion passed by ballot initiative in Utah, Nebraska and Idaho in 2018.

Protecting Medicaid was one of the top rallying cries for activists fighting Republican ObamaCare repeal efforts in 2017, and advocates are now trying to build on that movement by expanding the program in the 14 states that are still resisting expansion. Texas and Florida are the main prizes, as they have the highest populations of the holdout states.

“Medicaid expansion improved health,” John Graves, one of the study’s authors and a professor at Vanderbilt University, wrote on Twitter. “But improvements are as much, if not more, a result of stemming of health declines as they are a result of moving people to better states of health.”