Reform, irony, and self-interest

REFORM, IRONY, AND SELF-INTEREST…. A couple of weeks ago, Sam Stein noted the states with the highest rates of uninsured people, which just so happen to be the states where opposition to reform is strongest. Gallup found “large swaths of populations in the South and West” with large segments lacking coverage, and these are the same parts of the country with “the largest percentage of populations who believe widely perpetuated mistruths about the Obama agenda.”

In other words, those in states that stand to benefit most from reform have been convinced to oppose reform. The LA Times had a related story today.

Some of the most vociferous opposition to the proposals before the House and Senate comes from residents of rural states that could benefit most if the present system is revamped.

“The states that tend to be more conservative have a higher rate of people who are uninsured,” said Ron Pollack, executive director of FamiliesUSA, which backs a healthcare overhaul. “As a result, healthcare reform is going to provide a disproportionate amount of resources to those states.”

In Wyoming, for example, nearly 1 in 3 people younger than 65 went without health insurance at some point during the last two years, according to Pollack’s group. A huge majority of the uninsured have jobs, but work for employers who don’t provide coverage.

The problem pervades other rural states as well, where a high percentage of employers are small businesses. Although there is a consensus in Congress for keeping the current employer-based system of medical insurance, that system is riddled with holes in coverage that disproportionately affect rural states.

In addition, both in the West and South, such states tend to set higher thresholds for Medicaid eligibility, leaving few options for low-income earners who can’t afford individual insurance coverage.

Moreover, residents of rural states often have lower incomes than those in other parts of the country. It’s more difficult to find healthcare providers. And they have little, if any, choice in the private insurance market, which is typically dominated by one or two companies in a region.

And yet, lawmakers from the South and West are not only the most likely to oppose reform, they’re also the most likely to have hosted raucous town-hall events last month, where organized opposition to reform is strongest.

This, coupled with the polling data, points to a frustrating landscape: “Theoretically, the president should be receiving more support in his efforts to expand coverage from those who currently lack it. The opposite, however, seems to hold true.”