States’ Rights Leads to Inequities in Healthcare


Medicaid expansion-sm
by Pamela Powers Hannley

This map exemplifies what is wrong with letting states' rights. State-by-state decisions lead to inequities, discrimination, legal inconsistencies, and redundant bureaucracies. 

The map– created by The Advisory Board Company– shows how the states stack up (so far) regarding implementation of the Affordable Care Act insurance exchanges and Medicaid expansion. How does this patchwork quilt of policies make sense? Why should people in New York get better, more affordable care than people in Texas, Oklahoma, Mississippi, or even neighboring New Jersey? 

Letting states decide who gets medical care is absurd. Tell me again why we don't have universal healthcare? Oh, I forgot, healthcare is about making money– not keeping people healthly, preventing disease, or reducing unnecessary premature death.

To read the full story about implementation of the Affordable Care Act, go to ObamaCare In Plain English: What It Means For You. It's a very well written and thorough explanation of what is unfolding. 


  1. Well, except that the map is out of date. Not only have most states now agreed to the Medicaid expansion, but that includes New Jersey, where Governor Christie recently reversed himself and decided to buy into it.