Millions of Americans are getting health insurance because of Obamacare. But you’re a lot less likely to be among them if you live in one of the “red” states than if you live in one of the “blue” states—and there’s no great mystery why.
It’s because the conservative officials who run most of the red states want it that way.
You can see that pattern clearly in new reports on the Affordable Care Act that became available last week. They come from surveys demonstrating that the law is thinning the ranks of the uninsured across the country. But two of the reports—one from the Commonwealth Fund, the other from the Urban Institute—broke down the data by state and found a striking, if predictable, disparity.
Officials in states like California, Maryland, and Michigan have done just what Obamacare called upon them to do. They have opted to expand their Medicaid programs, so that all low-income people are eligible. Officials in other states, including Florida, Missouri, and Texas, have refused to expand their programs. To be eligible for Medicaid in one of those states, you have to fall into a special category, like low-income pregnant women, who were eligible before.
Source: The Urban Institute
In states that have made Medicaid universally available to the poor, the Urban Institute’s researchers found, the proportion of non-elderly adults without coverage fell by 6.4 percentage points between the second quarter of 2013 and the second quarter of 2014. In states that have not modified Medicaid, the rate fell by just 2.8 percentage points over the same time interval. These surveys aren't that precise, particularly when it comes to state-level data. But the pattern makes perfect sense.
And here’s what makes those figures even more depressing. The states where officials are blocking expansion are the ones where residents need help the most, because they are poorer and more likely to have no insurance in the first place.
These sorts of disparities are nothing new. The residents of blue states tend to be wealthier and healthier than the residents of red states. They also benefit from more generous public programs. Conservatives insist that red states are making the right choice on Medicaid—because expanding the program would require officials to increase the size government, the program doesn't work as well as it should, and so on. But it's hard to see how the people living in those states are actually better off.
—Jonathan Cohn
Things to know
ECONOMY: Today is the fourth anniversary of the passage of the Dodd-Frank financial regulatory bill. House Republicans are releasing the report that finds that Too Big To Fail still exists—something President Obama doesn’t exactly disagree with. (Victoria McGrane, Wall Street Journal)
GUNS: Alec MacGillis explains how the U.S.'s lax gun laws are helping fuel the violence in Central America—and thus are contributing to the border crisis. (The New Republic)
IMMIGRATION: The Obama administration was warned of the border crisis months before it became national news. The good news is that the number of migrants kids crossing the border has decreased in recent weeks, but it’s unclear if that will continue. (David Nakamura, Jerry Markon and Manuel Roig-Franzia, Washington Post)
WALL STREET: There's a subprime loan bubble for used cars, and the warning signs look a lot like the subprime mortgage crisis of 2008. (Jessica Silver-Greenberg and Michael Corkery, New York Times)
Things to read
Income Inequality: Tyler Cowen explains that while income inequality has grown in the United States over the past 30 years, it has fallen dramatically worldwide. (New York Times)
Health: Poor women are giving birth to healtheir newborn babies, but the gap between them and high-income mothers is still large. (Zachary Goldfarb, Washington Post)
LGBT: The Supreme Court's Hobby Lobby decision split the gay rights movement and set back years of progress, even as Obama signs an executive order prohibiting federal contractors from discriminating based on sexual orientation. (Molly Ball, The Atlantic)
Things to watch
Financial regulation will be in the news on Dodd-Frank's anniversary. Throughout the week, Congress will also debate legislation to address the border crisis.
Things at QED
Dr. Jen Gunter, an OB-GYN, sets Megyn Kelly straight about contraception since the Fox News host recently misrepresented Gunter's New Republic article. Rebecca Leber notes that Republicans blocked Obama's nominee to the U.N. agency that oversees international aviation. The Senate will vote on the nomination in the coming days.