Report Finds Health Care Access, Quality Differs Among U.S. States

U.S. residents' access to affordable, quality health care varies widely from state to state, according to a report released Wednesday by the Commonwealth Fund, the Los Angeles Times reports.

For the report, researchers examined 30 health indicators across the nation (Levey, Los Angeles Times, 9/17). For example, researchers examined factors such as the rate of insured and uninsured residents per state, the number of residents who visited an emergency department instead of a physician and how well a state's health system protected residents from dangerous medicines. They also compared states based on access and affordability, prevention and treatment, avoidable hospital use and health lifestyles.

Overall, the study found that states in the North and Northwest typically had strong health care systems, while the states in the South, Southeast and Southwest scored lower. It also found that a resident's state was a greater determinate of their level of health care than their income. For example, low-income elderly residents in Connecticut and Wisconsin are less likely to receive dangerous medications than high-income elderly residents in Alabama, Louisiana and Mississippi, according to Commonwealth Fund President David Blumenthal (Kennedy, USA Today, 9/18).

Further, the report found that low-income adults in the highest-performing states are:

• More likely to be covered by health insurance;
• More likely to have a regular source of health care;
• More likely to receive recommendations for preventive care, such as cancer screenings; and
• Less likely to die prematurely or end up in the hospital for conditions such as diabetes and asthma. 

States That Resist ACA Tend To Score Lower

The report also found that states that have resisted the Affordable Care Act often scored lower, while states that have embraced all or part of the ACA tended to score higher, according to the Times.

For example, states that have opted out of the Medicaid expansion under the ACA have high uninsured rates among low-income adults, such as Texas -- where 55% of adults with annual incomes below 200% of the federal poverty level are uninsured -- and Alaska, Florida and Georgia, where uninsured rates for low-income adults are 40% or higher.

The report also found that:

• Seven of the eight states with uninsured rates for low-income adults below 30% -- including Connecticut, Delaware and Hawaii -- have expand their Medicaid programs under the ACA;
• Massachusetts, which guarantees its residents health care coverage under a 2006 state reform law, has the lowest uninsured rate for low-income adults at 12% (Los Angeles Times, 9/17); and
• Alabama, Mississippi, Oklahoma and Louisiana -- all of which decided against a state-run health exchange and are not expanding Medicaid -- ranked in the bottom quarter across all health indicators (USA Today, 9/18).