Ann Marie Marciarille: Obamacare: Winners and Losers

CNN's Money Blog has an interesting map outlining who loses out under Obamacare.  You can look at it here: http://politicalticker.blogs.cnn.com/2013/07/25/who-loses-out-under-obamacare/.

When you look at it you will see Missouri squarely within the non-expansion states, a decision estimated to affect 4.9 million uninsured Americans nationwide.  But there's more to the story than that, of course, and you may drill down into the demographic characteristics of those who make up the majority of uninsured individuals at less than the 138% federal poverty level of ACA Medicaid expansion, to see who really loses out on the decision not to expand Medicaid.

You can see these numbers presented graphically at the website of the Kaiser Commission on Medicaid and the Uninsured: http://kff.org/disparities-policy/issue-brief/the-impact-of-current-state-medicaid-expansion-decisions-on-coverage-by-race-and-ethnicity/.

What do we learn? Nearly six in ten uninsured Blacks at less that 138% FPL reside in states not moving forward with Medicaid expansion at this time. This compares with four in ten uninsured Hispanics and four in ten uninsured Whites and just about one quarter of uninsured Asians in these low income groups. This is another way of illustrating that the decisions of Texas, Florida, and Georgia not to expand Medicaid under the ACA will disproportionately harm African Americans. So much press coverage focuses on the state by state head count, when it might more usefully focus on the total population head count.

Maybe a glance at the first map already told you this, if you know anything about the demographics of non-expansion states. But maybe seeing the differential skewed not just by income but by race helps to clarify just who wins and loses here. For that matter, a population-oriented analysis shows who really benefits here as well.

 

 

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