The change is in part a result of a significant reorganization that has led to an increase in working-class voters supporting the Republican Party, largely due to their attraction to the populist language of Donald Trump.

According to KFF, a think tank, an estimated additional 470,000 individuals lack access to affordable options. Despite strong opposition from Texas and Florida, the two biggest states that have not chosen to expand their programs, resistance in other areas seems to be weakening.

Paul Lee, a state representative in Alabama and the leader of the House health committee, is among the increasing number of Republican supporters of expanding Medicaid. They believe that doing so would benefit individuals who are employed but do not have access to or cannot afford health insurance through their employer.

“I have observed that many people, including our neighbors, church members, and family, are unable to afford health insurance due to the financial strain of paying for basic needs such as electricity and clothing for their children. This issue is not limited to a particular group, and I have noticed a willingness among Republican lawmakers to address it.”

In the past, there was a rejection of a suggestion to increase postpartum benefits due to concerns that it would be seen as an expansion. Additionally, in Georgia, House Speaker David Ralston, who passed away in 2022, consistently refused to consider expansion, along with the governor and other Republican leaders.

Republican Georgia Gov. Brian Kemp’s partial Medicaid expansion, called Georgia Pathways to Coverage,
has struggled, enrolling only 2,344 people in its first five and a half months. But Robinson, who consults for the Georgia Alliance of Community Hospitals and the Georgia House GOP caucus, believes the program has created a path for a full expansion of Medicaid.

According to Robinson, the situation demonstrated that the issue no longer held significant political influence. No candidates faced primary challenges as a result of the issue, and it was not a topic of discussion during the campaign.

This has allowed for the emergence of new legislative figures, such as Burns in Georgia and Ledbetter in Alabama, who are now in their second year of leading the House, and White in Mississippi, who was chosen as speaker in January. They are now advocating for a new approach to the issue.

After the story was published, White stated that tackling the issue of inadequate healthcare options for low-income workers in the state will not only enhance healthcare results, but also strengthen a significant portion of our economy.

White expressed optimism for the future, stating that businesses in the state will continue to emphasize the importance of offering affordable healthcare to employees as a compassionate and beneficial investment.

According to Charles Murry, who represents Ledbetter, the speaker does not support the expansion of Medicaid. However, he believes that the state should consider all available options. This could include a partnership between public and private entities, similar to the one seen in Arkansas, where Medicaid funds can be used to buy private health insurance.

There was no response from Burns when asked for a comment.

It remains a challenge to get approval for Medicaid expansion in these states. During his 2023 reelection campaign, Mississippi Governor Tate Reeves opposed the concept, and Governor Kemp has labeled a complete Medicaid expansion as an ineffective and ill-suited policy.

Ivey, who has the power to enact an increase in coverage without legislative agreement, has been more transparent, stating that “the possibility of expanding Medicaid in Alabama will be thoroughly considered.”

Representatives for Reeves, Kemp, and Ivey did not reply to inquiries for a statement.

There is a significant rift between the traditional Wyoming Caucus and the extreme right Freedom Caucus. The leader of the Freedom Caucus has declared that they will not back any form of Medicaid expansion.

Republican leaders in Kansas are still strongly against any plans to expand Medicaid that are proposed by Democratic Governor Laura Kelly. In December, Governor Kelly’s latest proposal included a requirement for new enrollees to show proof of employment in order to qualify for coverage, but those who oppose the expansion were not convinced.

“I believe that Medicaid should only be given to those who truly require it, such as children, the elderly, and the disabled,” stated House Speaker Dan Hawkins, who has consistently opposed the expansion of Medicaid. “The program should be referred to as government expansion or something else, as it was intended for a specific purpose.”

Kelly’s workplace recently brought attention to the growth in Alabama, Georgia, and Mississippi, and expressed concern that their state may soon be one of only seven states that have not implemented the policy.

Stephanie Sharp, a former Republican state legislator who now works as a strategist in Kansas, believes that the Republican leaders in the legislature are not inclined to give Governor Kelly a victory on her push for expansion, which she has been advocating for since taking office in 2019. Sharp predicts that a change in legislative leadership, similar to what occurred in Georgia and Mississippi, may be necessary to move the issue forward.

Sharp stated that replacing long-standing leaders who have been involved in past Medicaid conflicts would result in less loyalty to their positions. This opens the possibility of bringing in newer individuals with fresh perspectives to achieve success.