State re­form bat­tles pose some para­doxes

Modern Healthcare - - Outliers -

Louisiana has a large pop­u­la­tion of unin­sured res­i­dents and one of the na­tion’s low­est life-ex­pectancy rates—but don’t you dare try to force its cit­i­zens to get health­care cov­er­age!

Out­liers raised an eye­brow af­ter not­ing that the Bayou State, which has one of the coun­try’s high­est rates of unin­sur­ance at 19.3%, has joined 17 other states in fil­ing a joint law­suit in fed­eral court to block last month’s na­tional health­care re­form law on the ba­sis that it cre­ates an il­le­gal fed­eral man­date to buy in­sur­ance.

“This will cause our poor­est peo­ple to be se­verely im­pacted by this far­reach­ing action by Congress,” Louisiana At­tor­ney Gen­eral James “Buddy” Cald­well says in a writ­ten state­ment. That “se­vere im­pact,” by the way, is the es­ti­mated $350 mil­lion bill that Cald­well says Louisiana will have to pay un­der the fed­eral law, and not the health im­pact on the 48.6% of Louisiana adults be­low the fed­eral poverty line who do not have in­sur­ance to­day.

Then again, you know some­thing bears more ex­am­i­na­tion when three of the na­tion’s top five unin­sured states are lead­ing the charge against a law that man­dates that their cit­i­zens have in­sur­ance.

Florida, which ini­ti­ated the law­suit in Pen­sacola just min­utes af­ter the pres­i­dent signed the re­form law March 23, has an unin­sur­ance rate of 20.2%. That’s the na­tion’s third-high­est per­cent­age of unin­sured, ac­cord­ing to the most re­cent fig­ures re­leased late last year. Florida was soon joined by Texas, which claims the na­tion’s high­est per­cent­age of unin­sured res­i­dents at 25.2%, and Louisiana, which is fifth in the na­tion.

Just for the heck of it, Out­liers looked up the life-ex­pectancy rates of the states protest­ing the health­care laws and found an­other in­ter­est­ing clus­ter. Four of the na­tion’s top five states with the short­est life­span are also among those su­ing to stop re­form: Mis­sis­sippi (short­est life span in the coun­try), Louisiana (No. 2), Alabama (No. 3), and South Carolina (No. 4).

What’s the mes­sage? Out­liers hes­i­tates to ven­ture into pol­i­tics here. But when a state like Texas—where 61.7% of adults be­low the fed­eral poverty line are unin­sured—starts talk­ing about the evils of help­ing peo­ple buy health­care cov­er­age, we must con­fess to be­ing a tad be­wil­dered.

West Vir­ginia (75.5 years)

New Mex­ico (23.2%)

Alaska (19.4%)

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