State Health Disparities Trace Medicaid Expansion

John Commins, for HealthLeaders Media , December 16, 2013

Two maps illustrate the link between states that rank low in population health and states that have not committed to Medicaid expansion.


>>>View Medicaid Expansion Maps

Most of the states that are rejecting or noncommittal on Medicaid expansion also rank near the bottom in population health in an annual survey. Conversely, the residents in many of the states that have embraced the expansion are among the nation's healthiest. America's Health Rankings for more than 20 years has ranked state population health on measures that include diabetes, obesity, smoking, and physical activity. States at the bottom of the list include: No. 50, Mississippi; No. 48, Louisiana; No. 47, Alabama; No. 44, Oklahoma; No. 43, South Carolina; No. 42, Tennessee.

"It is amazing," says Sara R. Collins, vice president, healthcare coverage and access, at The Commonwealth Fund. " States that are not expanding have among the highest rates of diabetes and obesity among lower income families. These are people earning less than $25,000 a year. These are families, many of them are uninsured, who would significantly benefit from the insurance coverage provided by the Medicaid expansion if those states were to expand."

"These states also have among the highest rates of uninsured in the country. Texas has the highest rate of uninsured, or more uninsured as a percentage of the population than any other state. So, the taxpayers in the states are contributing to the cost of the Medicaid expansion. It's important that all states expand their programs not only so that their residence can benefit but so that they can get the benefit from the federal spending that is leaving their states in the form of tax revenues."

John Commins is a senior editor with HealthLeaders Media.

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1 comments on "State Health Disparities Trace Medicaid Expansion"

Robert C. Bowman, M.D. (12/17/2013 at 9:46 AM)
It is interesting that these disparities have been present for at least three decades without much comment. So it should not be a surprise regarding misinformed opposition to expansion or a Supreme Court made up of justices unaware of the disparities of our design. And Commonwealth and others push pay for performance and other penalties that clearly will impact areas with disparities to a greater degree. The same disparities that shape lower concentrations of clinicians and poor access and poor local economics derived from health care - are the same ones that shape penalties. Our designers need a better awareness of most Americans if there is any hope of improving health and health care for an entire nation.




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