The Kaiser Family Foundation
finds that the refusal of Republican lawmakers to accept Medicaid expansion under Obamacare is increasing racial inequality in health care. The "longstanding and persistent disparities in accessing health coverage that contribute to greater barriers to care and poorer health outcomes" are becoming even more stark, according to KFF's analysis, and could "contribute to widening disparities in health and health care over time."
There are now an estimated 3.7 million people in the Medicaid gap—living in the states that didn't accept the Medicaid expansion to people with incomes at or below 138 percent of the federal poverty level ($16,105 for a single person in 2014, $32,913 for a family of four). Those states are clustered in the south and have high minority populations. In other words, high proportions of minority people living in poverty. Minority populations have historically had the highest numbers of uninsured people, and that continues now.
More than a quarter of Hispanic or black adults are uninsured now, compared to 14 percent of whites. If all states expanded Medicaid, 41 percent of uninsured people of color would be eligible. Blacks would gain the most—57 percent of the currently uninsured would be eligible, and blacks are now losing the most.
Over one in three (34%) of the 2.9 million uninsured Black adults who could gain Medicaid fall into the coverage gap because they disproportionately reside in the southern region of the country where most states have not adopted the expansion. In contrast, Hispanics are less likely to fall into the gap since several key states that have large numbers of uninsured Hispanics have adopted the expansion, including California, New York, and Arizona. As a result, one in four of (25%) of the 3.6 million uninsured Hispanic adults who could gain Medicaid fall into the coverage gap. […]
The impact of the coverage gap varies by race and ethnicity, with poor uninsured Blacks most likely to fall into the gap, since they disproportionately reside in the southern region of the country where most states are not implementing the expansion. The continued disparities in access to health coverage will likely lead to widening racial and ethnic as well as geographic disparities in coverage and access to care.
That's devastating for communities of color in these states, but it's also really bad for those states, particularly economically. Compare the rewards Arkansas and Kentucky are now experiencing economically from Medicaid expansion to other southern states that are losing critical healthcare dollars, and healthcare resources. Like emergency rooms and rural hospitals.
Republican refuseniks might see making life worse for brown people as a feature rather than a bug of their opposition, but they're dragging their whole states down with them.