WEDNESDAY, March 27 (HealthDay News) -- Poor people in the southern part of the United States are more likely to delay getting needed health care, mostly because states in that region impose the strictest eligibility requirements for Medicaid, new research says.
The problem is most pronounced in Texas and Florida, according to the report in the March 28 issue of the New England Journal of Medicine.
"There really is a great deal of variability across the country in access [to Medicaid]," said study author Dr. Cheryl Clark, from the Center for Community Health and Health Equity at Brigham and Women's Hospital, in Boston.
Counties in states with really restrictive Medicaid policies tend to have the greatest delays, said Clark, the center's director of health equity research and intervention.
The 2010 Affordable Care Act -- derided by critics as "Obamacare" -- aims to improve access to Medicaid by expanding the program and offering funding to states that adopt the expansion. Medicaid is a government-run program that offers health coverage to lower-income Americans.
States, however, don't have to adopt the expanded program and states that have the most restrictive Medicaid policies -- including Texas, Florida and Arkansas -- have opted out of expanded Medicaid.
"States make different decisions around whether they decide to accept federal support to expand their Medicaid programs," Clark said. "States are going to look very different in terms of their health care infrastructure and we may see a growing gap in health disparities."
Another factor causing delays in care is the number of primary care doctors. Delays in care are less likely in places like New England, where there are a lot of primary care doctors, than in areas in the South, where there are fewer such physicians, Clark's group noted.
Clark said that states that opt out of Medica
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