Recommended: The data wizards at the New York Times Upshot blog take a look
at who would be covered if Medicaid expansion wasn't optional. Thus far, 26 states plus the District of Columbia have expanded Medicaid; 24 states have refused. You can see on the map above how much difference that makes in terms of the number of uninsured (county by county, the darker areas have higher uninsured rates; head on over to the Upshot site where the map is interactive
, and you can scroll over each individual county to see how much the uninsured rate hypothetically would have been reduced
if a given refusnik state had expanded Medicaid.
The big picture: 3 million people, most of them in the South, are uninsured because states refused to accept the federal money to expand their Medicaid programs.
The reason that some states could refuse was because of the Supreme Court's decision to uphold Obamacare but strike down the portion of the law which would have essentially forced the states to expand Medicaid (by tying all Medicaid funding to expansion). The Court gave the choice to each state. That decision by the Court had legal ramifications and political ramifications. But it's worth noting the practical impact on the lives of human beings too: 3 million without insurance.
Of course, it wasn't just the Court. It was also the leaders of 24 states who made a choice which prevented their low-income citizens from gaining coverage. If you look at the map on the left, you'll see that Arkansas looks different than the surrounding states. That's because the state found a way forward: thanks to the private option, the uninsurance rate in Arkansas was cut nearly in half, one of the largest declines in the nation.
After the jump, from the Upshot, a look at the human cost to the Supreme Court ruling and the policy decisions in the refusnik states. The gray bars represent reductions in uninsurance after enactment of Obamacare; the green bars represent a hypothetical further reduction in uninsurance that could have happened if states expanded Medicaid. The bulk of coverage gains would be zapped in Arkansas if the private option went away, and the state would go back to uninsurance rates over 20 percent (one in four between the ages of 19-64 were uninsured before the private option). Turning back that clock is precisely what Tom Cotton proposes to do, in Arkansas and across the country.