Alabama and Tennessee are getting 73 cents per person to help residents understand the Affordable Care Act and decide if they want coverage through a health insurance exchange. Georgia is receiving even less.
Organizations in all states are receiving federal funds to help explain the new system to the uninsured and get them signed up.
Federal funding figures show that the amount is lower in the tri-state area than many other states because they decided not to create state-run health insurance exchanges and are leaving it to the federal government to create them by Oct. 1. That meant these state governments, among others, didn't seek and didn't get any of the millions in federal funds available for outreach and advertising.
The Tennessee Justice Center, an advocacy group on public policies affecting the poor, said the inequity is not a problem with the health care law, but with the states' decisions not to participate.
The consequence of the state not running its exchanges means that it does not qualify for most of the funding for outreach, said Executive Director Gordon Bonnyman.
"The result is that the people who are unfortunate to live in states that did not participate are much less likely to get the word and the assistance that they need to sign up for the benefits they're entitled to," Bonnyman said.
The U.S. Department of Health and Human Services reports that in Alabama, it has awarded nearly $1.1 million to community groups for outreach and $2.4 million to health centers that serve the poor. The health centers report they plan to hire a total of 50 people to explain the program and get people signed up by going to churches, community centers and other locations.
Alabama's nearly $3.5 million in federal funding amounts to 73 cents per person in the state.
Alabama's neighboring states also didn't set up state-run exchanges. Alabama's 73 cents in per capita funding compares with 64 cents in Georgia, 73 cents in Tennessee, 74 cents in Florida and $1.12 in Mississippi.
By comparison, Arkansas, which is smaller than Alabama, decided to establish an exchange. It is getting more than $2 million for promotion by local groups and more than $22 million for the state government to use for outreach and advertising. That amounts to $8.38 per capita, according to the federal figures.
The Kaiser Family Foundation reported 18 percent of Arkansas residents are uninsured, compared with 14 percent of Alabama residents.
Bonnyman said the inequity in outreach assistance will be "dwarfed" by the gaps in health care coverage between states that chose to expand their Medicaid programs and those that do not.
"This is just a down payment on much larger losses we're going to be seeing as a result of not expanding Medicaid," he said.
Staff writer Kate Harrison and The Associated Press contributed to this report.