In 2012, the Supreme Court ruled that a cornerstone of the Affordable Care Act — its expansion of Medicaid to low-income people around the country — must be optional for states. But what if it had ruled differently?
More than three million people, many of them across the South, would now have health insurance through Medicaid, according to an Upshot analysis of data from Enroll America and Civis Analytics. The uninsured rate would be two percentage points lower.
Today, the odds of having health insurance are much lower for people living in Tennessee than in neighboring Kentucky, for example, and lower in Texas than in Arkansas. Sharp differences are seen outside the South, too. Maine, which didn’t expand Medicaid, has many more residents without insurance than neighboring New Hampshire. In a hypothetical world with a different Supreme Court ruling, those differences would be smoothed out.
And that was the idea behind the Affordable Care Act. Before the law passed in 2010, the country had a highly regional approach to health policy and widely disparate results in both health insurance status and measures of public health. One of the main goals of the law was to provide some national standards and reduce those inequities by using federal dollars to buy coverage for low-income people in every state.
[For more of this story, written by Kevin Quealy and Margo Sanger-Katz, go to http://www.nytimes.com/interac...p;abt=0002&abg=0]
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