Recently, the House Republicans pulled the American Health Care Act (AHCA) from consideration, signaling a failure to repeal and replace the Affordable Care Act (ACA), commonly known as Obamacare. However, the AHCA would have left parts of the ACA intact; the only parts that are outright repealed are the individual, and employer mandates, and subsidies for out-of-pocket expenses. Everything else is either altered, or untouched. Many Republicans refused to vote for the AHCA because they thought it didn’t repeal enough of the ACA. However, when compared to similarly advanced economies, the United States health care system is rather unique in that it doesn’t provide universal coverage.
In the United States, people get their health care coverage from a variety of different places, but almost half get coverage from their employer.
Under Obamacare, the Federal Government provided more funds for Medicaid expansion, attributing to much of the increased coverage. Medicaid is the government program that provides healthcare to those with fewer resources, typically below the poverty line. However, 19 states have yet to accept Medicaid expansion. These 19 states are
- Idaho
- Utah
- Wyoming
- South Dakota
- Nebraska
- Kansas
- Oklahoma
- Texas
- Missouri
- Tennassee
- Mississippi
- Alabama
- Georgia
- Florida
- South Carolina
- North Carolina
- Virginia
- Maine
- Wisconsin
In the graph below, states (and DC) in red have expanded Medicaid under the ACA (Wisconsin didn’t accept expansion but already covers all families under the poverty line) and those in blue didn’t accept Medicaid expansion. We can see that more states that have accepted have lower uninsured rates. I have yet to check whether these states already had lower rates of uninsured, but their is certainly a correlation between states that have expanded Medicaid and fewer uninsured Americans. If this is not just correlation, but causation, it seems that the Medicaid expansion has had a large role in covering more Americans.
The AHCA would only have continued the federal funds for Medicaid expansion until 2020, so it wouldn’t be unreasonable to suggest that had the AHCA passed, we would have expected to see uninsured rate increase, particularly after 2020 in the states that had expanded Medicaid.
Thoughts? Disagreements? Reasons I may have missed?