A new analysis of how health care reform will affect the states suggests that if Senators and Representatives dropped their ideological allegiance and voted to advance the interests of their constituents, the health care reform effort would would actually attract bipartisan support. Writing in Health Affairs, Claudia Schur and Marc Berk examine how Congress’ different approaches to financing health reform (tax on the rich vs. tax on high-cost plans) would benefit the states and conclude that “States with the most to gain under health care reform are overwhelmingly represented by Republicans, while those states likely to do worse are much more likely to have Democratic senators”:
Here’s how our categorization of states works—we classified states as “High Benefit” if the percentage of uninsured is above the national average and as “Low Benefit” if the rate is less than the national average. We then classified states by whether they would be “High Cost”—the top half of the distribution—for each of the financing approaches.
As Exhibit 1 shows, the states most likely to “win” as a result of health care reform are Arkansas, Idaho, Kentucky, North Carolina, Oklahoma, Tennessee, and Utah. All of these states have a relatively high number of uninsured and all are in the bottom half of states in terms of cost under both financing mechanisms….Among the states most likely to “lose” are Delaware, Nebraska, and New Hampshire as well as the District of Columbia. Each of these states has a relatively lower-than-average proportion of uninsured residents, and each would fall in the “High Cost” category under either of the financing options. There are four states—Alabama, Indiana, Michigan, and Rhode Island—that while also “Low Benefit” are “Low Cost” as well.
Look for yourself:
The authors note that “The benefits of reform, as we measure them, are higher in ‘red’ states. This is not surprising. Medicaid eligibility correlates with lack of insurance, which in turn is our measure of potential benefit, and conservative states are less likely to provide broad social-welfare benefits for the poor.” This line of reasoning also suggests that conservative states leading the health care industry-funded effort to repeal health care reform are working to deprive reform from Americans who need it the most.