Health Reform Money Is Aimed at Red States

Posted on Sep 24, 2009

By Marie Cocco

It is “a stunning assault on liberty” (Sen. Jon Kyl, Republican of Arizona). It is “trying to force or foist a one-size-fits-all solution on the states” (Sen. Orrin Hatch, Republican of Utah). It is a plan that “taxes too much and grows government too much” (Sen. John Cornyn, Republican of Texas).

It is also a massive shift of tax money from constituents of traditionally liberal and Democratic states to constituents of traditionally conservative and Republican states.

This went unremarked in the hours of bipartisan gas-bagging that opened the Senate Finance Committee’s markup of its version of health care overhaul legislation. As it happens, just as the panel began its arduous effort at reshaping the proposal put forward by Sen. Max Baucus, D-Mont., the Census Bureau was giving us a very good look at just which Americans would benefit most from an effort to cover more people—as well as who would really get those taxpayer subsidies to buy insurance, and which states would gain the most from Medicaid changes to assure the poorest reasonable access to medical care.

Overall, about 15 percent of Americans are uninsured, according to the 2008 American Community Survey. But here is the state-by-state picture:

“Thirty-one states and the District of Columbia had uninsured rates that were lower than the national figure,” an analysis written for the Census Bureau says. “All of the states in the Midwest and Northeast are included in this group. Nineteen states had uninsured rates higher than the national figure; 10 of these states were located in the South and the other nine were located in the West.”

The state with the highest proportion of uninsured is Cornyn’s Texas, where 24 percent of residents are without coverage. The other four states with uninsured rates of 20 percent or more are Alaska, Florida, Nevada and New Mexico.

States with uninsured rates between 17 percent and 20 percent also are in the Deep South and the West. They include Montana (Baucus), Arizona (Kyl) and Idaho, represented on the Finance Committee by Republican Mike Crapo.

If you superimposed the Census Bureau’s color-coded map of the states’ percentages of uninsured residents, it would bear quite a resemblance to those election-night maps of red and blue America. Yet blue-state America, through its mostly Democratic representatives, seems willing—for fiscal, political or moral reasons—to extend its hand and open its wallet so that red-state Americans can get health insurance. 

“It’s not a nationally uniform problem,” says Steve Zuckerman, senior fellow at the Urban Institute and an expert on Medicaid. Because there has to be a greater improvement in coverage in the South and West, Zuckerman says, “there will be a geographic redistribution.”

The low rates of coverage in the South and West result from low rates of employer-based insurance, Zuckerman says. Meanwhile, these states are also less likely to have tried to close the gap with Medicaid. They historically have imposed tight income restraints on and other eligibility barriers to the joint federal-state program for low-income people. In Texas, a working parent must have an annual income below 27 percent of the federal poverty level—that amounts to $5,953.50 for a family of four—in order to qualify for Medicaid, according to the Kaiser Family Foundation.

The regions are traditionally hostile to unions, and companies that are unionized tend to offer better insurance coverage than those that are not. Yet it is these very unionized workers and their employers who may be hit with a proposed excise tax on high-cost policies—taxes that would flow to the uninsured in the form of subsidies to buy insurance.

Legislation in both houses would require an expansion of Medicaid to cover more adults, as well as more children who are covered separately. In the Baucus proposal, this amounts to $287 billion in new federal spending, according to the Congressional Budget Office. Much of it would flow to states that have avoided expanding Medicaid coverage. States that already have extended coverage—the most generous are in the Northeast and Midwest—would not get such a large infusion of new money.

With all this cash flowing in their constituents’ direction, you might think that some red-state congressional Republicans would quiet the rhetorical warfare in the interests of their states’ well-being. Instead, they mimic those Republican governors who vowed to refuse federal economic stimulus money—only to take it and stage ribbon-cuttings in celebration.

Political hypocrisy knows no party and, often, no bounds. The wonder is that well-intentioned Americans put up with it—and are going to pay for it, too.

Marie Cocco’s e-mail address is mariecocco(at)washpost.com.

© 2009, Washington Post Writers Group

TAGS: baucus cocco congress democrats government health health care house insurance money politics republicans senate taxes

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By Joe B, October 13, 2009 at 4:26 pm #
(Unregistered commenter)

Great article. I wish more journalists wrote this kind of investigative and informative articles.

Joe

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By moi, September 28, 2009 at 8:54 pm #
(Unregistered commenter)

G. Anderson has it right.
From what I can gather, proposed Healthcare plans will bring coverage to primarily lower income individuals rather than a blend of all income levels. There is a direct correlation between health problems and income levels so such a plan would likely be unsustainable—much to the delight (and design)of those opposed to ANY plans. “See, we told ya-the Gov. just can’t do it right!” Our Congresspeople are too beholden to corporate, medical and other interests to represent the real needs of citizens. Until we reform campaign financing, our legislators will represent themselves first and foremost.

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By JenniferBedingfield, September 26, 2009 at 10:23 pm #

MO where I live in is not one of those red states getting the kind of aid described. It has to be a deep red state to qualify !

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By G.Anderson, September 26, 2009 at 1:10 am #

There are other countries in the world that have fought civil wars over issues, less than the divisions we face in this country.

But when it comes right down to it, this country is still fighting over slavery.

In this country right now, the corporations want a slave class, one that tirelessly works to sevice their debts, one that can never be free of the chains of work that does not support them, that live in insecurity and ill health, and they definately do not want a free and strong American citizenry secure, indpendent, or confident.

The current slave class, has no rights, none what so ever. They are constantly bombarded with corporate propaganda, by those that are masters of disinformation, and deceit.

Not only have the coproations poisoned the air, the water, and the food we all eat, but the hearts and minds of the people, they are insidious and without conscience.

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By Dick H. in Southern Illinois, September 25, 2009 at 12:11 am #
(Unregistered commenter)

I just lived through the the last thirty years of parents on the news, night after night, weeping and wailing over their dying, cancer stricken children, who for one reason or another “didn’t qualify” for a life saving treatment. In every case the failure to qualify was the cost of the treatment. The insurance companies had accepted decades of premiums only to deny treatment when the need arose. Americans are unreal! Now they don’t want the terrible government involved in their health care. How did they suddenly fall madly in love with their children’s killers?

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By Squeeky, September 24, 2009 at 6:28 pm #

Get this one!

The city of Libby in the great state of Montana, of which Senator Baucus is supposed to represent, has been a festering sore in the side of the EPA since 2000.

Apparantly a mining company, who shall remain unnamed, has been mining vermiculite, of which asbestos is a byproduct, for decades. Despite vast numbers of asbestos related health problems, to include mesothelioma, I have yet to see this little jewel pop up on the health care radar.

I wonder who is flipping the medical bills for this screw up? I wonder if Baucus’s health plan will tax these innocent souls who just happened to be in the wrong place at the wrong time.

If this is’nt hypocracy in action then I don’t know what is.

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By nickmammano, September 24, 2009 at 5:16 pm #

Very interesting column. Good research.  Following the money really unearths some ironies, doesn’t it?

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By Louise, September 24, 2009 at 4:09 pm #

OK you folks in Montana. Will you please come get your Bachus!

He’s hurting a lot of folks who didn’t put him there and making Montana look like a collection of backward inbred shit-kickers who never pay attention. We expect that from some of those deep South states, but you guys are way North!

Besides, I know you-all are smarter than that, so will you please come get your Bachus!

And while your at it see if you can get Utah to come along and take their Hatch back! I think he’s sprung a leak.

Or maybe it’s just dementia setting in.
Or rust.

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By herewegoagain, September 24, 2009 at 1:49 pm #
(Unregistered commenter)

Jason writes: “Most “red” states pay more in fed taxes then they get back. Texas for example gets 90% or so back while California receives 120%. so i guess you could say, the mismanagement of blue states is being payed for by red.”

It is the exact opposite and you know it. Even the ultra-conservative Tax Foundation admits the red states sponge the off higher taxes generated by the higher-income earning blue states.

For the record, California gets back .78 cents for every dollar it sends to the Federal Government. Texas gets back .94 cents.

Here is the full list. Note the Top Ten Recipients of Federal Largesse…red states all except for one: http://www.taxfoundation.org/taxdata/show/266.html

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By jason, September 24, 2009 at 9:00 am #
(Unregistered commenter)

interesting.

Most “red” states pay more in fed taxes then they get back.

Texas for example gets 90% or so back while California receives 120%.

so i guess you could say, the mismanagement of blue states is being payed for by red.

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By ardee, September 24, 2009 at 5:42 am #

Single payer health care, for all Americans, red, blue or purple….

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