|
 That's among the findings of the America's Health Rankings Senior
Report released in May by the United Health Foundation. The report
ranks the 50 states by assessing data covering individual behavior,
the environment and communities where seniors live, local health
policy and clinical care.
Minnesota took top honors for the second year in a row, ranking high
for everything from the rate of annual dental visits, volunteerism,
high percentage of quality nursing-home beds and low percentage of
food insecurity. This year's runners-up are Hawaii, New Hampshire,
Vermont and Massachusetts.
The researchers base their rankings on 34 measures of health. But
here's one you won't find in the report: state compliance with the
Affordable Care Act (ACA). While the health reform law isn’t mainly
about seniors, it has one important feature that can boost the
health of lower-income older people: the expansion of Medicaid.
The ACA aims to expand health insurance coverage for low-income
Americans through broadened Medicaid eligibility, with the federal
government picking up 100 percent of the tab for the first three
years (2014-2016) and no less than 90 percent after that. But when
the U.S. Supreme Court affirmed the ACA’s legality in 2012, it made
the Medicaid expansion optional, and 21 states have rejected the
expansion for ideological or fiscal reasons.
And guess what: Most of the states with the worst senior health
report cards also rejected the Medicaid expansion.
Nearly all Americans over age 65 are covered by Medicare. But the
Medicaid expansion also is a key lever for improving senior health
because it extends coverage to older people who haven’t yet become
eligible for Medicare. That means otherwise uninsured low-income
seniors are able to get medical care in the years leading up to age
65 - and they are healthier when they arrive at Medicare’s doorstep.
Two studies from non-partisan reports verify this. The U.S.
Government Accountability Office reported late last year that
seniors who had continuous health insurance coverage in the six
years before enrolling in Medicare used fewer and less costly
medical services during their first six years in the program; in
their first year of Medicare enrollment, they had 35 percent lower
average total spending.
The GAO study confirmed the findings of a 2009 study report by two
researchers at the Harvard Medical School. That study looked at
individuals who were continuously or intermittently uninsured
between age 51 and 64; these patients cost Medicare an additional
$1,000 per person due mainly to complications from cardiovascular
disease, diabetes and delayed surgeries for arthritis.
[to top of second column] |
Fifty-two percent of Medicaid-rejecting states ranked in the study’s
bottom third for senior health, including two very large states,
Texas and Florida. Many of these states also can be found in a list
of states with the highest rates of poverty among people over 65.
What emerges is a north-south divide on senior health. “Many states
that haven't expanded Medicaid are in the South, and there’s a clear
link between socioeconomic status and health status,” says Tricia
Neuman, senior vice-president at the Henry J Kaiser Family
Foundation and director of the foundation's Medicare policy program.
"Insurance may not be the only answer, but it certainly is helpful."
The United Health Foundation - a non-profit funded by the insurer
UnitedHealth Group - didn't consider insurance coverage in its
study, but it did consider poverty. Minnesota's rate was 5.4 percent
- well below the 9.3 percent national rate. Mississippi ranked dead
last, with a 13.5 percent poverty rate.
In states that rejected the Medicaid expansion, we are witnessing a
victory of politics over compassion and morality. Jonathan Gruber,
an economics professor at the Massachusetts Institute of Technology
and a key architect of health reform in Massachusetts and under the
ACA, summed it up in an interview with HealthInsurance.org earlier
this year, saying that these states "are willing to sacrifice
billions of dollars of injections into their economy in order to
punish poor people. It really is just almost awesome in its
evilness."
(Follow us @ReutersMoney or at http://www.reuters.com/finance/personal-finance.
Editing by Douglas Royalty)
[© 2014 Thomson Reuters. All rights
reserved.] Copyright 2014 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
