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A national study found that Americans' access to care depended greatly on where they live.
Wednesday, September 18, 2013
In a study that found great disparity in health care for the poor based on where they live — to the point of there being “two Americas” — Virginia scores somewhere in the middle.
Virginia ranked 30th of the 50 states and the District of Columbia in a report released today by The Commonwealth Fund, a private foundation supporting independent research on health policy.
Access to affordable health care and the quality of care for low-income people vary greatly depending on where they live, the study found in a state-by-state comparison.
The gaps were so pronounced that the study, based on 30 indicators drawn from 2010 and 2011 data from each state, was titled “Health Care in the Two Americas.”
In Virginia, 41 percent of the low-income population aged 19 to 64 is uninsured. In that category, the commonwealth ranked 35th nationally.
Virginia ranked even lower, 38th and 40th respectively, for potentially avoidable emergency room visits and hospital readmissions within 30 days for Medicare patients.
The state’s highest ranking — 19th — was in the category of prevention and treatment.
Nationally, “we found repeated evidence that we are often two Americas, divided by income and geography when it comes to opportunities to lead long and healthy lives,” said Cathy Schoen, a senior vice president for the Commonwealth Fund and lead author of the report.
The five top-ranking states were Hawaii, Wisconsin, Vermont, Minnesota and Massachusetts. The bottom five were Mississippi, Oklahoma, Louisiana, Alabama and Arkansas.
In areas such as premature deaths, infant mortality, smoking, obesity and oral health, there was a two- to threefold difference between the leading and lagging states.
“The good news,” Schoen said during a teleconference Tuesday, “is that the Affordable Care Act offers new resources to bridge this divide.”
Under the new federal health care law, Virginia has the option of expanding Medicaid, the government insurance program for the poor and disabled.
People making up to 138 percent of the federal poverty guideline — about $16,000 for an individual, $32,000 for a family of four — would become eligible for Medicaid in a state that currently has some of the strictest criteria in the country for receiving assistance.
Although as many as 400,000 low-income Virginians would benefit from an expansion that would be financed largely by federal funds, Virginia is still on the fence.
The General Assembly decided earlier this year that Medicaid would expand only if certain reforms to the program are made, and a legislative commission is currently evaluating the progress of those moves. A decision is expected by year’s end.
If Virginia opts against an expansion, critics say, the poorest of the poor will be left untreated while those who are slightly better off will become eligible for subsidized insurance through an online marketplace set to open Oct. 1.
“Lack of Medicaid will only exacerbate the disparities that our scorecard illustrated,” said Dr. David Blumenthal, president of The Commonwealth Fund.
Should all states follow the leads of those at the front, the study concluded, an estimated 86,000 fewer people would die prematurely each year, and tens of millions of adults and children would receive needed preventative care such as vaccines, check-ups and cancer screenings.
“These are not just statistics,” Schoen said. “They add up to real lives.”
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