BILOXI, Miss. — Michael White’s high blood pressure is acting up again.

The 51-year-old casino janitor has recurring seizures and recently awoke in an ambulance after passing out at a bus stop.

“It doesn’t hit me suddenly,” White said. “It creeps up on me. I get this feeling like I’m outside of my own body.”

If White had insurance, he’d be under the care of a primary physician and taking medications regularly. But he can’t afford job-based health insurance on his $8-an-hour wage and he earns too much to qualify for Medicaid, the state-federal health plan for poor people and those with disabilities.

So White takes his place in a growing line of uninsured patients outside the Bethel Free Health Clinic on the grounds of a federal housing project in Biloxi, Miss. It’s his off day, so he’s in no rush. He just wants to be one of the dozen or so patients lucky enough to see a doctor.

White is one of 300,000 Mississippians who’d likely qualify for Medicaid next year when the health care overhaul extends coverage to adults who earn up to 138 percent of the federal poverty level. That’s nearly $16,000 a year for an individual in 2013, or roughly $32,500 for a family of four.

But Mississippi and eight other contiguous Southern states, all led by Republican governors, have decided not to implement the Medicaid expansion, even though the federal government has pledged to pay all medical costs for the newly eligible enrollees in 2014, 2015 and 2016 and no less than 90 percent of their costs thereafter.

All of them – Tennessee, North Carolina, South Carolina, Georgia, Alabama, Mississippi, Louisiana, Texas and Oklahoma – say they can’t afford it under those terms.

The wall of Southern opposition is one of the last major obstacles to President Barack Obama’s goal of universal health coverage for all Americans. If it remains intact, nearly 5 million of the newly eligible won’t have Medicaid coverage in 2022, according to estimates by the nonpartisan Kaiser Family Foundation, a health care research group.

Besides shared borders and conservative political leadership, most of the nine states have something else in common: By a host of measures – from obesity to infant mortality – all but North Carolina and Georgia are among the unhealthiest in the nation, according to the 2012 edition of America’s Health Rankings.

Read more here: http://www.mcclatchydc.com/2013/04/11/188297/health-challenged-southern-states.html#storylink=cpy