Last week, the
New York Times analyzed
data from Enroll America and the data group Civis Analytics to determine how to find the still uninsured to help get them signed up for health insurance in the next enrollment period for Obamacare, which starts November 15. What this analysis found, though, was the remarkable difference in the uninsured rate in states that expanded Medicaid versus those that didn't, and the Times
is following up on that story
. That's shown in the above map.
According to their analysis of the data, about three million people—mostly concentrated in the South—remain without insurance coverage because of the refusal by Republican lawmakers to accept the expansion. Based on the Enroll America/Civis Analytics data, the uninsured rate would drop by two percentage points nationally if the 24 hold-out states took the expansion. The rates in those states, though, would drop dramatically.
Today, the odds of having health insurance are much lower for people living in Tennessee than in neighboring Kentucky, for example, and lower in Texas than in Arkansas. Sharp differences are seen outside the South, too. Maine, which didn’t expand Medicaid, has many more residents without insurance than neighboring New Hampshire. In a hypothetical world with a different Supreme Court ruling, those differences would be smoothed out.
And that was the idea behind the Affordable Care Act. Before the law passed in 2010, the country had a highly regional approach to health policy and widely disparate results in both health insurance status and measures of public health. One of the main goals of the law was to provide some national standards and reduce those inequities by using federal dollars to buy coverage for low-income people in every state.
The law has in large part done just that—reduce inequality—in the states with expansion. Blacks, Latinos, young adults, women, rural people, and the working poor have all benefited the most from the law and from Medicaid expansion. The uninsured rate in the nation's poorest counties fell by 9 percentage points
thanks to Obamacare. That includes many of the red states that didn't expand Medicaid largely from the woodworker effect—people applied for insurance on the exchanges only to find out that they did qualify for Medicaid already. But that rate would have dropped substantially more in those states had the Supreme Court ruled differently in 2012, and not given the states the option to reject the additional funding.
You want to know why midterms matter? Look at all those uninsured people, whose legislators and governors have left behind. At least 3 million of them, and purely out of political spite.
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