Speaking of state exchanges and the color purple (prose or otherwise) heading into the final weekend before Tuesday’s gubernatorial election here in Kentucky, just a gentle reminder of what’s at stake here should Republican Matt Bevin win over Democratic AG Jack Conway and Kynect and Medicaid expansion goes away for 450,000 Kentuckians.
Two years into Obamacare, clear regional patterns are emerging about who has health insurance in America and who still doesn’t.
The remaining uninsured are primarily in the South and the Southwest. They tend to be poor. They tend to live in Republican-leaning states. The rates of people without insurance in the Northeast and the upper Midwest have fallen into the single digits since the Affordable Care Act’s main provisions kicked in. But in many parts of the country, obtaining health insurance is still a problem for many Americans.
These trends emerged in an analysis we undertook with the help of two organizations that are closely monitoring the progress of the health law. Last year, we used similar data to show the the substantial effects Obamacare had on reducing the number of Americans without health insurance. This year, the same groups updated their estimates of where America’s uninsured live, and the change is a lot less drastic. States that were late to expand Medicaid, including Pennsylvania and Indiana, showed substantial reductions in their uninsured residents compared with last year. In other places, the changes have been more modest. In a few — like Mississippi — things appear to have gotten worse, with fewer people having health insurance this year than last.
A county-by-county map makes this even more clear:
Now that Indiana and Pennsylvania are on board with Medicaid expansion, it’s very clear that the red states in the South (and Missouri) that are under GOP rule are in real trouble. Arkansas is the lone holdout as GOP Gov. Asa Hutchinson hasn’t been able to kill it yet after inheriting it from his Democratic predecessor.
But you’d better believe that Matt Bevin will put Kentucky back into the nearly solid purple of the South if he wins in a few days. He’s gone from wanting to scrap it totally to considering the same block grant expansion/private insurance hybrid mess that Hutchinson wants in Arkansas, but that would still kick hundreds of thousands of people off Medicaid onto private plans, and he still wants to scrap Kynect completely and force Kentucky to go to a federal exchange (again wasting millions of taxpayer dollars in the process) in order to get those plans, and at a far more expensive monthly premium level.
It’s a pretty clear choice on Tuesday, folks.
It’s a clear choice? My sympathies to those about to throw out their insurance to stick it to the negroes.
@ruemara: In a 92% white state, too.
@Zandar: As I watch even supposedly liberal minded people say comply or die in regards to black people and police; yeah, it kinda is.
What do the polls say, Zandar?
I thought Conway was way up.
Man, the Democrats running in Tennessee and North Carolina over the next few years need to zoom in on that map and show their state vs. their neighbor to the north and ask “What is Kentucky/Virginia doing right that Tennessee/North Carolina is not? Electing Democrats.”
Paul in KY
@BGinCHI: He’s up, but not ‘way’ up.
@Paul in KY: Low turnout election means crazy white people rule.
Not a good scenario in a state with plenty of those to spare.
@ruemara: and teh gheys.
The logical choice is Bevin.
He’ll fuck the sluts and their slutty pro-abortion agenda, as well as protect Kentuckians Second Amendment rights.
He’ll also cut taxes and protect the coal industry from big government over reach.
He’ll probably sue the Obama Administration over some of Obama’s illegal activities and raping of the Constitution.
The Dem in KS was “way up” a week before the 2014 elections, and Brownback still won. Rigged or not, the old angry whites will show up to punch their ballots for the GOP. Looks like poor KYians (seemingly a vast majority of KYians) can save their healthcare by voting, or be lazy and lose it.
Consequences, elections, yada yada.
@gene108: Is that what American Exceptionalism means?
If you click on the first link, the whole map opens up. We in California have a big ugly chunk of purple out in the high desert — gotta figure out a way to get insurance to people in those very rural and very poor areas.
Also, it’s pretty clear that Medicaid expansion helps, but it’s not the whole story. Arizona and New Mexico both expanded Medicaid but still have a lot of purple. Anyone want to guess the party identification of their governors? It’s not hard.
@Punchy: and Paul was awfully snooty to Kansans suggesting there might have been fraud. I just hope KY has better luck.
At the Gubernatorial level, yes.
At the Presidential level it also means talking tough and not showing weakness to foreign enemies.
@dedc79: True, If they can first convince their electorate that being insured is a good thing.
But a tough slog to get that universally acknowledged.
Paul in KY
@BGinCHI: We will see.
Did anyone see the item at TPM that the Healthcare exchanges ( and expanded medicaid enrollment centers) should be registering people to vote? Obama admin is being sued to include that. IN case the GOP did not hate the exchanges enough already.
Paul in KY
@Bobby Thomson: Me Paul or another Paul?
It seems like it’s not “a few” places where things are getting worse: almost everywhere that there were a lot of uninsured in 2014, things were even worse in 2015. Whereas in the places with few uninsured in 2014, the situation continued to get better.
Most of the bad-and-worsening places look to be sparsely populated, which is how it’s possible to reconcile this with the overall number of uninsured going down.
Still, it’s a disturbing enough pattern, and it persists even in some states that did expand Medicaid.
…hmm, though the Black Belt counties of SC and Georgia are an interesting exception: things are pretty bad there but slowly getting better.
Virginia has not expanded Medicaid. I think the lower uninsured rates probably has to do with the NoVA having a lot more jobs that provide benefits than anything in other Southern states, plus the huge military presence in the southeastern part of the state.
If you look at the “white stripe” running down the middle of NC, it looks to track along RTP, which would have comparable higher income jobs as NoVA.
@BGinCHI: Conway is up 45-40% over Bevin, with Fark.com founder Drew Curtis at 6% in the final Bluegrass Poll this week.
54% want to maintain Kynect as is, 24% want it reversed, 22% aren’t sure.
Related, an LGM thread on rural poverty:
Every interaction with any level of government should offer that opportunity, almost by definition.
I’d bet Conway loses. He’s up against a coal industry shit storm.
@Paul in KY: Well if the democrat is ‘up but not way up’ and if the adult portion of those 400k KYNECT recipients show up and vote their economic interests it should be a shoe-in for the democrates. But that is a big if.
The Gray Adder
@Zandar: Drew Curtis is polling outside the margin of error? That’s FARKed.
I would hazard a guess that there are plenty among the 400k who don’t know there’s an election or who’s running. And when they lose their insurance, a good share of these people will blame Obama.
@Punchy: Almost everyone in Kentucky is an angry old white person. Even the young people and the the Democrats. Never been a state that loved to hate its politicians more than Kentuckians. They start hating them the first day on the job and then reelect them so they can hate them some more.
This poem’s a hundred and thirteen years old, and yet it still captures the essence of the place better than any other description I’ve ever seen.
@NCSteve: Okay, not the part about “their little hearts are truest.”
Good luck. From up here in Canada, I can tell you that turnout is everything. I hope enough people have learned to value Kynect to make sure they keep it.
After GRIMES lost. ..the DNC should have put up billboards with this simple message:
But to be frank, ZANDAR, if they vote against their own best interests….I have no sympathy for them.
@Punchy: The kansas election was probably stolen. A statistician found it out pretty easily. http://americablog.com/2015/08/mathematician-actual-voter-fraud-kansas-republicans.html