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Many Republican governors have taken a stand against Obamacare by refusing to expand Medicaid. Utah, which is one of the most Republican states in the nation, remains undecided. But in a state where the majority of the population are Mormons, one bishop from the Church of Jesus Christ of Latter Day Saints says helping the poor is a moral obligation. Andrea Smardon, from member station KUER in Salt Lake City, has more.
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ANDREA SMARDON, BYLINE: Ilene Martinez works full time as an assistant manager at a Dollar Tree store in Salt Lake City. She doesn't qualified for Medicaid, but she also doesn't make enough money to qualify for health insurance subsidies under the Affordable Care Act. That's a problem because Martinez has hepatitis C.
ILENE MARTINEZ: There's not a cure for that. So eventually, I'll die if I don't have the medication.
SMARDON: Martinez has some limited health insurance for low-income adults that allows her to see a primary care physician. But it doesn't cover the specialist that she needs to get a prescription. And the situation has become more urgent because her 21-year-old son has just been diagnosed with lupus, a genetic auto-immune disease.
They're living on about $17,000 a year, which doesn't quite pay all the bills. They're also members of the Church of Jesus Christ of Latter Day Saints. And Martinez says it's their neighborhood ward that helps them when they really need it.
There's sometimes when I've got so many bills to pay that I can't pay my rent. That's when the bishop comes in and helps me.
Mormon bishops use church resources, funds collected from other members to help their congregants. But Bishop David Heslington says there are limits to what the church can do. He estimates that 1 in 5 of his congregants falls in a coverage gap where they don't qualify for subsidies under Obamacare, and they don't qualify for Medicaid in Utah.
DAVID HESLINGTON: Not that we don't want to help, but we can't find the resources to help them. And much of it has to do with getting insurance for the services that are needed.
SMARDON: Bishop Heslington won't give an opinion on whether the state should expand Medicaid, but he says his congregants need help.
HESLINGTON: I think we're starting to see legislatures who are getting a clue about this large, underserved population that yes, there are people that need help, can't afford it, can't find it. And we see that they're trying to do something, and we support those efforts to help people out that need help.
RYLEE CURTIS: It's a huge breakthrough to have a bishop come out and talk about this issue.
SMARDON: RyLee Curtis is with Utah Health Policy Project, a health care advocacy group.
CURTIS: When we have these LDS church members contact our office and tell us the problems that they were running into, it was like an epiphany.
SMARDON: Curtis says many religious leaders in Utah have been advocating for an expansion of Medicaid. But the LDS church has been silent on this issue.
CURTIS: We've been two years into this debate now, and we're just now getting these people contacting our office.
SMARDON: While one bishop is speaking out, the church officially doesn't want to make a political statement, saying only that the Affordable Care Act is the law of the land. A majority of Utah's lawmakers are Latter Day Saints. They're also mostly conservatives who've been resistant to expanding a federal program like Medicaid.
As for Ilene Martinez, she doesn't care how it happens. She just wants that medication for hepatitis C. And she wants her son to see a specialist for his lupus.
MARTINEZ: We don't ask for much. It's not like we're on the streets, begging for money. I mean, I'm working, I'm doing what I'm supposed to be doing; and all we need is a little help.
SMARDON: Helping citizens in need is the state's obligation says Republican Gov. Gary Herbert, who is also Mormon. He's requesting a waiver from the federal government that would allow low-income Utahans to use Medicaid dollars to buy insurance on the private market.
For NPR News, I'm Andrea Smardon in Salt Lake City.
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INSKEEP: This is NPR News. Transcript provided by NPR, Copyright NPR.