There was a compelling article recently in the New York Times about Americans struggling to work extra hours because they fall in what’s termed the “Medicaid gap.”
While all states have the opportunity to take part in the federal government’s expansion of the Medicaid program—which would cover all adults with incomes up to 138 percent of the federal poverty level—twenty-two states have decided to opt out. This means that residents in these states who earn too much to qualify for regular Medicaid, but too little to qualify for subsidized private insurance, are left high and dry.
Not all of these states are created equal when it comes to this Medicaid gap, as my colleague Harold Pollack shows. If you create a map in which every state was resized proportional to the number its residents who fell into the gap—as Pollack did—the United States looks very different.
Source:“Martin Luther King Wouldn't Be Very Happy With This Medicaid Map”, Huffington Post, http://www.huffingtonpost.com/2015/01/19/mlk-medicaid_n_6503324.html
Surprise! Almost 90 percent of adults who fall in the gap live in red states in the South. (Note: states such as New York and California, which are gapless, had to be apportioned a fake 2,000 people in the gap, otherwise they simply would not show up on the map.)
It’s hard to talk about policies affecting low-income populations in the South without acknowledging a history of racial inequality. As Pollack points out, the fact is, southern states contain large populations of poor minorities currently feeling the brunt of the Medicaid gap’s pain.
I thought that, given this reality, it would be interesting to take a deeper look at how minority populations are faring under states’ refusal to expand Medicaid.
As it turns out, while 37 percent of America is nonwhite, over half of those who fall in the Medicaid gap are nonwhite. And recasting Pollack’s map so that it displays each state by its overrepresentation of nonwhites falling in the Medicaid gap, we get a picture of where minority status correlates greatest with no health care.
Interestingly, while a lack of health care is still more likely to correlate with race in the South, the states where the chances of minority noncoverage are highest are South Dakota and Idaho. You are actually more than twice as likely to land in the gap if you are nonwhite and living in South Dakota. These are states with comparatively large Native American populations, a group that has always been saddled with health care inequities. While 19 percent of all adults are uninsured in the United States, 30 percent of Native Americans and Alaska Natives are uninsured.
When we break down the racial component of the Medicaid gap by sheer numbers, though, southern states still take home the prize.
Interestingly, while a lack of health care is still more likely to correlate with race in the South, the states where the chances of minority noncoverage are highest are South Dakota and Idaho. You are actually more than twice as likely to land in the gap if you are nonwhite and living in South Dakota. These are states with comparatively large Native American populations, a group that has always been saddled with health care inequities. While 19 percent of all adults are uninsured in the United States, 30 percent of Native Americans and Alaska Natives are uninsured.
When we break down the racial component of the Medicaid gap by sheer numbers, though, southern states still take home the prize.
Texas alone accounts for almost a third—an astonishing 31 percent—of all minorities that fall into the Medicaid gap. In absolute numbers, that adds up to nearly three-quarters of a million people. It also accounts for nearly 60 percent of all Hispanics that fall into the gap. Meanwhile, Florida and Georgia—in second and third place—collectively contribute a third of all blacks that are shut out.
Remember, these are people—not numbers—who would gain access to health care right away, if only their states had accepted Medicaid expansion. And they would be covered, with no immediate cost to their states—the federal government pays 100 percent of expansion costs for the first three years, and 90 percent thereafter, until 2022.
So what’s the big holdup?
Tags: medicare, medicaid
Another Look at the Medicaid Gap
There was a compelling article recently in the New York Times about Americans struggling to work extra hours because they fall in what’s termed the “Medicaid gap.”
While all states have the opportunity to take part in the federal government’s expansion of the Medicaid program—which would cover all adults with incomes up to 138 percent of the federal poverty level—twenty-two states have decided to opt out. This means that residents in these states who earn too much to qualify for regular Medicaid, but too little to qualify for subsidized private insurance, are left high and dry.
Not all of these states are created equal when it comes to this Medicaid gap, as my colleague Harold Pollack shows. If you create a map in which every state was resized proportional to the number its residents who fell into the gap—as Pollack did—the United States looks very different.
Source:“Martin Luther King Wouldn't Be Very Happy With This Medicaid Map”, Huffington Post, http://www.huffingtonpost.com/2015/01/19/mlk-medicaid_n_6503324.html
Surprise! Almost 90 percent of adults who fall in the gap live in red states in the South. (Note: states such as New York and California, which are gapless, had to be apportioned a fake 2,000 people in the gap, otherwise they simply would not show up on the map.)
It’s hard to talk about policies affecting low-income populations in the South without acknowledging a history of racial inequality. As Pollack points out, the fact is, southern states contain large populations of poor minorities currently feeling the brunt of the Medicaid gap’s pain.
I thought that, given this reality, it would be interesting to take a deeper look at how minority populations are faring under states’ refusal to expand Medicaid.
As it turns out, while 37 percent of America is nonwhite, over half of those who fall in the Medicaid gap are nonwhite. And recasting Pollack’s map so that it displays each state by its overrepresentation of nonwhites falling in the Medicaid gap, we get a picture of where minority status correlates greatest with no health care.
Interestingly, while a lack of health care is still more likely to correlate with race in the South, the states where the chances of minority noncoverage are highest are South Dakota and Idaho. You are actually more than twice as likely to land in the gap if you are nonwhite and living in South Dakota. These are states with comparatively large Native American populations, a group that has always been saddled with health care inequities. While 19 percent of all adults are uninsured in the United States, 30 percent of Native Americans and Alaska Natives are uninsured.
When we break down the racial component of the Medicaid gap by sheer numbers, though, southern states still take home the prize.
Interestingly, while a lack of health care is still more likely to correlate with race in the South, the states where the chances of minority noncoverage are highest are South Dakota and Idaho. You are actually more than twice as likely to land in the gap if you are nonwhite and living in South Dakota. These are states with comparatively large Native American populations, a group that has always been saddled with health care inequities. While 19 percent of all adults are uninsured in the United States, 30 percent of Native Americans and Alaska Natives are uninsured.
When we break down the racial component of the Medicaid gap by sheer numbers, though, southern states still take home the prize.
Texas alone accounts for almost a third—an astonishing 31 percent—of all minorities that fall into the Medicaid gap. In absolute numbers, that adds up to nearly three-quarters of a million people. It also accounts for nearly 60 percent of all Hispanics that fall into the gap. Meanwhile, Florida and Georgia—in second and third place—collectively contribute a third of all blacks that are shut out.
Remember, these are people—not numbers—who would gain access to health care right away, if only their states had accepted Medicaid expansion. And they would be covered, with no immediate cost to their states—the federal government pays 100 percent of expansion costs for the first three years, and 90 percent thereafter, until 2022.
So what’s the big holdup?
Tags: medicare, medicaid