Mississippi is one of just 14 states that has not accepted federal dollars to expand Medicaid under the Affordable Care Act.

As Mississippi’s gubernatorial candidates stump in the weeks leading up to the August primaries, one issue that both Republicans and Democrats have pushed before voters across the state is Medicaid expansion. According to a new poll released Friday morning, however, voters appear to be less unified behind this position.

Just over one-third of Mississippi voters—or 35 percent—said they’d be more likely to vote for a candidate who supported expanding Medicaid. Another 33 percent said they would be less likely to support a candidate who favored Medicaid expansion and 31 percent said a candidate’s position on the issue wouldn’t affect their vote, according to a NBC News/SurveyMonkey poll done in collaboration with Mississippi Today.

The disparity is even more stark among Republicans, despite the fact that two of Mississippi’s three Republican gubernatorial candidates—Rep. Robert Foster, R-Hernando, and former Chief Justice of the state Supreme Court Bill Waller Jr.—include some version of Medicaid expansion as a major plank in their platforms.

Just 21 percent of Republican-leaning voters said they would be more likely to support a candidate who favored Medicaid expansion while nearly half—48 percent—said support for Medicaid expansion would make them less likely to support a candidate.

Democrats, who made up just under 40 percent of those polled, overwhelmingly supported expansion, with 61 percent saying they would be more likely to vote for a candidate who supported Medicaid expansion and just 13 percent saying a candidate’s support for the issue would make them less likely.

Attorney General Jim Hood, who is the Democratic front-runner, has seized on the issue’s popularity among his party’s voters. On the day he announced his candidacy in October of 2018, he pitched expansion as an economic issue for the state, saying “we shouldn’t leave hundreds of millions of federal dollars on the table.”

Mississippi remains one of just 14 states that has not accepted federal dollars to expand Medicaid under the Affordable Care Act, despite the fact that Mississippi qualifies for the highest match rate in the country, with the federal government spending nine dollars on the program for every one dollar the state spends.

Despite their support for expansion, it’s possible that Foster and Waller know members of their own party would be wary of supporting something long considered the defining policy of Barack Obama’s presidency.

Although the plans that Waller and Foster have pitched rely on federal funding made accessible through the Affordable Care Act, both Waller and Foster have been quick to correct reporters who label their proposals “Medicaid expansion,” branding them “Medicaid reform” instead and emphasizing that they’re modeled on the version that U.S. Vice President Mike Pence rolled out when he was governor of Indiana.

“We’re asking them to have a little skin in the game. It’s like Pence’s Indiana plan,” Foster told Mississippi Today in February, describing a plan that, like Healthy Indiana, would require beneficiaries to pay a copay.

In this same poll, jobs and the economy ranked as a top concern for over a quarter of Republican voters, second only to immigration as the most important issue. And both Foster and Waller have sold support for expansion as an economic issue, with Waller frequently referencing a report that said that more than half of the state’s rural hospitals were at high risk of closure.

“Mississippi is a poor state, a rural state. We need the network of 115 hospitals that we have in the state to provide the resources, the health care, the employment for our citizens. Over 60,000 people are employed in that sector,” Waller told Mississippi Today last week.

Lt. Gov. Tate Reeves remains the only Republican gubernatorial candidate who has refrained from advocating for any form of Medicaid expansion. In spite of this, last week the Mississippi Medical PAC, which is the political arm of the Mississippi State Medical Association, endorsed Reeves.

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Larrison Campbell is a Greenville native who reports on politics with an emphasis on public health. She received a bachelor’s from Wesleyan University and a master’s from Columbia University's Graduate School of Journalism.Larrison is a 2018 National Press Foundation fellow in public health, a 2019 Blue Cross Blue Shield Foundation of Massachusetts fellow in health care reporting and a 2019 Center for Health Journalism National Fellow.