MONTGOMERY, Alabama — Today, the Southern Poverty Law Center (SPLC) released a report highlighting the urgent need for Medicaid expansion in the Deep South as a pressing matter of racial and disability justice. At a time when Republicans in Congress and President Donald Trump are pushing a budget reconciliation process that would dramatically cut Medicaid, preserving — and expanding — the program is critically important for the health and economic stability of families across the country.
“As health care costs rise and families struggle to pay for basic necessities, our elected leaders should be doing everything they can to expand access to health coverage, not force people to make impossible choices about how or whether to pay for life-saving care,” said Margaret Huang, president and CEO of the SPLC. “Unfortunately, as our report makes clear, politicians in the Deep South have a long history of valuing profit over people and perpetuating racial inequities in the health care system that trace back to slavery.
“The expansion of Medicaid promises a different path,” Huang continued. “Our leaders have the opportunity to address structural harm while improving health outcomes for millions of Americans in our region, especially Black people and others who have previously been denied care because of their race, income or ability. We urge them to protect this lifeline without delay.”
As of 2024, 40 states and the District of Columbia have adopted Medicaid expansion, including Louisiana. Despite increased interest and recent legislative efforts to expand Medicaid, 10 states have still not adopted expansion, including Alabama, Florida, Georgia and Mississippi.
Millions of recipients across the Deep South could be impacted under the current administration’s proposal for cuts, including:
- 1,097,000 children and adults enrolled in Alabama Medicaid
- 4,343,000 children and adults enrolled in Florida Medicaid
- 2,240,000 children and adults enrolled in Georgia Medicaid
- 1,856,000 children and adults enrolled in Louisiana Medicaid
- 667,000 children and adults enrolled in Mississippi Medicaid
The legacy of health care inaccessibility is still profoundly felt by Black communities across the country. Today, Black women suffer from some of the highest levels of diabetes and high blood pressure in the nation, Black men’s risk of a stroke is twice that of white men, and Black people are more than twice as likely to suffer from Alzheimer’s and other kinds of dementia compared to white people.
“Clearly, something must change at the systemic level to keep Black people from needlessly dying from treatable and preventable illnesses,” said Gina Azito Thompson, policy analyst at the SPLC. “The good news is our nation has already established a solution to redress these racial disparities: Medicaid.”
Benefits of Medicaid expansion include increased access to health care for people of color and people with disabilities, the preservation of rural community hospitals, and improved access to the basic health resources for communities that have been shut out of health care systems. The SPLC recommends that all states across the Deep South preserve current Medicaid coverage and expand Medicaid to more families in need by:
- Rejecting proposals that reduce state and federal money going toward Medicaid.
- Broadening Medicaid to include coverage for adults with low incomes at least up to 138% of the federal poverty level, without added work requirements.
- Bundling Medicaid assistance with housing assistance to help people with low incomes who have disabilities get back on their feet.
States have a large say in how their programs are conducted in part because of the Affordable Care Act. Although not mandatory, a state is incentivized to expand because the amount of federal matching dollars for its Medicaid program increases to cover additional people in those mandatory coverage groups. It is important that states continue to listen to the overwhelming support from constituents to add and continue to fund Medicaid expansion programs.
To learn more about the program and its impact in the Deep South, read the full report.
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About the Southern Poverty Law Center
The Southern Poverty Law Center is a catalyst for racial justice in the South and beyond, working in partnership with communities to dismantle white supremacy, strengthen intersectional movements and advance the human rights of all people. For more information, visit www.splcenter.org.