New Orleans I’m not going to say that we’re not making progress because enrollment under the Affordable Care Act continues to increase despite opposition. On the other hand there is no way not to be disappointed and outraged about the millions of uninsured adults that are caught in the gap between politicians and good public health policy
because of the failure to expand coverage to all states in the country.
The Kaiser Foundation released a report on what the people look like that are caught in the gap, and, unsurprisingly, they are disproportionately non-white, black, and brown.
Overall, more than four in ten (41%) uninsured adults of color would be eligible for Medicaid (based on income, immigration status, and age) if all states adopted the Medicaid expansion, comparable to the share of White uninsured adults who would be eligible. If all states expanded Medicaid, nearly six in ten (57%) uninsured Black adults would be eligible, but only about a third (34%) of uninsured Hispanic adults,
reflecting the fact that a greater share would not qualify based on their immigration status
This isn’t pretty at all and of course it’s life and death.
The southern states is where most of the damage is done, and given their size the worst of it is obviously in Texas, Florida, and North Carolina.
Overall, more than half (53%) of poor adults in the coverage gap reside in just three states, including Texas (26%), Florida (18%), and North Carolina (10%). However, the distribution of people in the gap across states varies by racial and ethnic group. For example, four in ten (42%) of the 1.6 million uninsured poor White adults in the coverage gap reside in Florida (20%), North Carolina (11%), and Texas (10%), while nearly half (47%) of the 1.0 million uninsured poor Black adults in the coverage gap reside in Texas (18%), Florida (14%) and Georgia (14%). Among Hispanics, more than eight in ten (81%) of the 0.9 million uninsured poor adults in the coverage gap reside in just two states, with six in ten (61%) in Texas and one in five (20%) in Florida.
It makes me wonder how Republican candidates for President can pretend that they might want to increase their share of Hispanic votes in the case of Bush and Rubio in Florida and Cruz in Texas, when they have not advocated expansion of care. What says Rand Paul from Kentucky, where care has been expanded, and he is trying to position himself to get more black votes? Is he going to step up for expansion?
We could go down the list of the Republican hopefuls.Scott Walker of Wisconsin and Bobby Jindal of Louisiana are clear in their call to “let my people die!” But how about Huckabee, the former governor of Arkansas who had his own healthcare plan once upon a time?
Expansion for all should be a litmus test for voters in 2016, just as firmly as it has been a litmus test for the opposition in Congress for the last half-dozen years.