Federal data show health disparities among states

Published on NewsOK Modified: December 12, 2013 at 1:20 pm •  Published: December 12, 2013
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JEFFERSON CITY, Mo. (AP) — Residents in some parts of the U.S. are signing up for health care coverage at a significantly greater rate than others through the new online insurance marketplaces now operating in every state.

The discrepancy may trace back to the political leanings of their elected leaders.

Newly released federal figures show more people are picking private insurance plans or being routed to Medicaid programs in states with Democratic leaders who have fully embraced the federal health care law than in states where Republican elected officials have derisively rejected what they call "Obamacare."

On one side of the political divide are a dozen mostly Democratic leaning states, including California, Minnesota and New York. They have both expanded Medicaid for lower-income adults and started their own health insurance exchanges for people to shop for federally subsidized private insurance.

On the other side are two dozen conservative states, such as Texas, Florida and Missouri. They have both rejected the Medicaid expansion and refused any role in running an online insurance exchange, leaving that entirely to the federal government.

The new federal figures, providing a state-by-state breakdown of enrollment in the new health care program through November, showed that the political differences among leaders over the initiative are turning into differences in participation among the uninsured.

Even though many conservative states have higher levels of poverty and more people without health coverage, fewer of them may receive new insurance, said Dylan Roby, an assistant public health professor at the Center for Health Policy Research at the University of California, Los Angeles.

With the patchwork implementation of the federal health care law, "the gap will exacerbate," Roby said

The U.S. Health and Human Services Department reported this week that 364,682 people had signed up for private coverage through the new health insurance marketplaces as of Nov. 30 and an additional 803,077 had been determined eligible for Medicaid.

But the rate of residents gaining health coverage was more than three times as great in the states embracing the federal health care law than in those whose leaders have resisted it.

In the dozen states embracing the overhaul, more than 50 percent of those who applied for coverage picked an insurance plan or were eligible for Medicaid. That rate was barely 15 percent in the two dozen states that aren't cooperating in the implementation of the federal health care law.

"It's very frustrating," said U.S. Sen. Claire McCaskill, a Missouri Democrat who voted for the federal law only to see it twice rebuffed in a statewide vote and repeatedly rejected by her home state's Republican-led state Legislature.

"The political point has trumped the services that Missourians need," McCaskill said.

In Texas, which has the highest rate of uninsured residents in the U.S., the GOP-controlled state Legislature opted not to create a state-run insurance marketplace and Republican Gov. Rick Perry also declined to expand Medicaid to cover more of the working poor. As of the end of November, just 14,000 Texans had signed up for insurance through the federally run marketplace and fewer than 17,000 of the nearly 245,000 applicants on the exchange had been determined to be eligible for Medicaid.



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