State Health Disparities Trace Medicaid Expansion

Two maps illustrate the link between states that rank low in population health and states that have not committed to Medicaid expansion.

Most of the states that are rejecting or noncommittal on Medicaid expansion also rank near the bottom in population health in an annual survey. Conversely, the residents in many of the states that have embraced the expansion are among the nation's healthiest. America's Health Rankings for more than 20 years has ranked state population health on measures that include diabetes, obesity, smoking, and physical activity. States at the bottom of the list include: No. 50, Mississippi; No. 48, Louisiana; No. 47, Alabama; No. 44, Oklahoma; No. 43, South Carolina; No. 42, Tennessee.

"It is amazing," says Sara R. Collins, vice president, healthcare coverage and access, at The Commonwealth Fund. " States that are not expanding have among the highest rates of diabetes and obesity among lower income families. These are people earning less than $25,000 a year. These are families, many of them are uninsured, who would significantly benefit from the insurance coverage provided by the Medicaid expansion if those states were to expand."

"These states also have among the highest rates of uninsured in the country. Texas has the highest rate of uninsured, or more uninsured as a percentage of the population than any other state. So, the taxpayers in the states are contributing to the cost of the Medicaid expansion. It's important that all states expand their programs not only so that their residence can benefit but so that they can get the benefit from the federal spending that is leaving their states in the form of tax revenues."