How The Political Fight Over Medicaid Will Widen The Gulf Between Our Healthiest And Sickest States

Medicaid proponents rally in Ohio (Credit: Columbus Dispatch)

As the political fight over Obamacare continues, Republican legislators in highly uninsured states have turned their back on Medicaid expansion — despite the fact that expanding the public insurance program could extend coverage to millions of their constituents. Of course, even if stringently anti-Obamacare politicians refuse to cooperate with health reform, the law will still take effect. But that doesn’t necessarily mean those red states won’t feel the impact of refusing to add more residents to their Medicaid rolls.

Health care outcomes already vary widely across states. Unfortunately, health policy does too. The states that are already among the nation’s healthiest are the ones taking steps to ensure their low-income residents will have the insurance coverage they need — while the unhealthier, more highly uninsured GOP-led states are refusing to do the same. As an analysis from the Los Angeles Times points out, the health care reform law can’t change the fact that the stubborn lawmakers resisting Medicaid expansion are likely going to deepen the health disparities that already exist across the country:

With nearly every GOP-leaning state on track to reject an expansion of the government health plan for the poor, the healthcare law’s goal of guaranteed insurance will become a reality next year mostly in traditionally liberal and moderate states. These states already have higher rates of health coverage.

Residents of these states — concentrated in the Northeast, upper Midwest and West Coast — also have better access to doctors and are less likely to die from preventable illnesses.

Colon cancer deaths in states opposing Medicaid expansion, for example, are an average of 16% higher than in pro-expansion states, according to a Los Angeles Times analysis of state health data.

Deaths from breast cancer are 8% higher on average in anti-expansion states. And adults under 65 are 40% more likely on average to have lost six or more teeth from decay, infection or gum disease.

An earlier analysis found that the governors for the most unsinsured cities in the United States have been resistant to expanding Medicaid. And even after some of those governors started to come around — most notably, Florida’s Rick Scott — the Republicans in the state legislature have continued to block the initiative. Opposition persists despite the fact that the poor Americans in the South, who are already being forced to delay their medical care because they can’t afford it, stand to gain the most from Medicaid expansion.

This isn’t the only example of health disparities becoming sharply divided by region. Abortion access, another area of health policy that’s largely been left up to states’ interpretation, also varies widely from California to Mississippi to North Dakota to New York. “It shouldn’t be that simply because you live in Mississippi that you don’t have the same health care that you can get if you lived in California,” one abortion doctor who travels to practice at Mississippi’s last remaining abortion clinic recently pointed out. Nonetheless, that’s the growing reality for the entire health care sector.