Implementation Along The Red/Blue Divide

 

Partisan political differences have led to geographic differences in implementation. 

Red- resisted or only partially implemented

Blue- enthusiastically and fully implemented

Increased role of both state and federal governments in providing healthcare access. 

• States must decide whether to expand medicaid, create insurance exchanges,  enforce insurance regulations.
• Federal creates and upholds new national insurance regulations, state and individual mandates, changes to medicaid which it mostly subsidizes for the states.

Positive Aspects of Expanding Medicaid

• improves health, especially for the most vulnerable
• poor have access issues that emergency care can't remedy
• brings federal dollars into state coffers

Ironies

• Red states allowed greater federal government control by defaulting to government exchange- healthcare.gov
• rejected reform that would have led to greater social and economic equity
•  Blue states embraced health reform even though they have far fewer uninsured