Southern conservatives have for years privately flirted with extending public health benefits to more low-income people. Those talks are now moving out of the shadows.
House speakers in three Republican-controlled states — Alabama, Georgia and Mississippi — have said in recent weeks that they need to consider covering more people through their state-run health insurance programs.
Their comments represent a stark departure from more than a decade of lawmakers in conservative statehouses arguing vehemently against expanding Medicaid or similar benefits — many of them because of a reflexive revulsion to Obamacare.
The shift is partly a byproduct of a historic realignment that has seen more working-class voters gravitate to the GOP, largely driven by an affinity for the populist rhetoric of Donald Trump.
The changing attitudes could reshape health care in the South by allowing nearly half a million uninsured people to obtain coverage, improving the finances of some of the nation’s most beleaguered hospitals and helping communities with high rates of chronic disease, maternal mortality and avoidable deaths.