People wait to receive a wristband number for medical treatment at the Remote Area Medical (RAM) clinic in Wise, Virginia, July 20, 2012.
The South has the majority of people in the U.S. without health insurance—44 percent of the nation's uninsured are Texas, Florida and Georgia—and the highest rates of chronic disease. These are among the findings of the Kaiser Family Foundation
in a survey they presented at a March meeting of health care stakeholders from the South, released publicly this week. (Note: KFF uses the Census Bureau region, so they include Maryland, Delaware, the District of Columbia in the East, and Oklahoma in the West in their review.) The South also has the states most in need of Medicaid expansion, and most resistant to it.
Nearly four million of the five million people nationally who fall into the Medicaid gap live in the South. That's the population left uninsured because Republican states have refused to take the Medicaid expansion money available to them under Obamacare. The people in the gap make too little to qualify for subsidies on the health insurance exchanges, but too much to qualify for traditional Medicaid. KFF attributes the high rate of uninsurance in the South to the prevalence of blue-collar and service industry jobs, as well as small businesses, that don't provide coverage. Buying in the individual market has been too expensive. Workers in the South earn less than in other regions. And Southerners are far more likely to report having poor health than people in other regions, and the South contains states with the highest rates of diabetes, heart disease deaths, infant mortality and cancer deaths.
Medicaid expansion in these states wouldn't just improve access to health care (also a big problem, with only the rural West reporting less access to care than the South) and health outcomes for the region. It would be an economic boon. Southern states would experience the largest percentage increases in federal funds compared with states in other regions if they were to expand. "If all states expanded Medicaid, Southern states could also experience a 25 percent increase in Medicaid payments to hospitals relative to no expansion—the highest percentage increase of any region."
One regional health leader, Dr. Harry Heiman, director of health policy at the Satcher Health Leadership Institute in Georgia, calls the states' refusal to accept Medicaid expansion "baffling."
"More than anything, [the report] reconfirmed to me the unique challenges in the South. […] It's the juxtaposition of the significant disease burden and significant disparities in the South against this incredible opportunity to leverage federal dollars to address these problems."
The greatest need and the greatest opportunity, squandered by Republicans who are putting politics ahead of people.