Jun 6, 2017

Who's feeling the pressure with the Senate health care bill

Some states have benefitted more than others under the Affordable Care Act. We've broken down the 52 Republican senators based on how the uninsured rate changed in their state, whether their state expanded Medicaid or not, how many people gained coverage under expansion and how quickly they'll face voters for reelection.

Note: Louisiana expanded Medicaid in July 2016 and expansion numbers were unavailable. North Dakota's Medicaid Expansion program, where a person's benefits are administered by Sanford Health Plan, is not the same as traditional Medicaid, where the state of North Dakota processes claims and pays providers directly. Medicaid Expansion has different benefits and program rules. Data: Kaiser Family Foundation, U.S. Census Bureau

Why this matters: This serves as a "who to watch" in the weeks ahead. It shows who will be under the most political pressure when the Senate produces a draft health care bill. If a state has seen drastic coverage gains under the ACA, it stands to reason it could see the most coverage losses under the Republican bill undoing the law.

Yes, but: This doesn't get at philosophical reasons behind repealing and replacing the ACA. For example, Sen. Pat Toomey represents Pennsylvania, one of the states with the most people enrolled in Medicaid under expansion. But Toomey is a budget hawk and believes government spending must be reduced to be sustainable. Thus, he's been fighting for a slower Medicaid spending growth rate under the bill, which leads to larger cuts. It also doesn't account for who could gain coverage or pay less under the Republican bill.

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