The Treatment

What's the Matter With Arkansas (and Idaho, and Oklahoma, and…) With Maps!

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I noted in a previous post that wavering House members represent districts that have the most to gain from health reform. Thanks to my colleague Louis Woynarowski, we can see this in mapped form. He mapped uninsurance rates for every district represented by a wavering House member, as listed in FiredogLake's invaluable whip count. Each district is shaded to represent the percentage of nonelderly people who lack health coverage. The data comes from the Census Bureau's 2008 American Community Survey, as reported by Genevieve Kinney and colleagues. Darker colors indicate higher numbers of uninsured. Members' votes on the original House bill are indicated by a "Y" or an "N" superimposed over their districts.

(Click here to see a higher-resolution version of the map.)

Things look a little clunky, but two critical patterns are clear.

First, uninsurance is generally much higher in these districts than in the nation as a whole. Average uninsurance rates across all 435 districts is 17.0 percent. Most wavering members represent districts with markedly higher rates of non-coverage.

Second, there are pronounced regional differences.

Wavering northeastern members tend to represent districts with relatively mild uninsurance rates. Scott Brown’s implicit question: “What’s in it for us?” may most telling for these members.

Those from the Southwest and southern Texas represent districts with very high uninsurance rates, though many of these districts include large numbers of unauthorized immigrants who would not benefit from the current bill. In some ways, I am most sympathetic to these legislators, whose constituents have a legitimate beef in the absence of immigration reform.

Most remaining wavering members represent a broad swath of Appalachia and the deep South. This last, large group--roughly spanning Oklahoma, Arkansas, Mississippi, Georgia, North Carolina--represent districts with very high rates of noncoverage, in some cases more than 1/3 of the entire population. This is the bloc of representatives most hostile to health reform, and the group that stands the most to gain if this bill actually passes despite their own “No” vote.

Consider Dan Boren’s district in Oklahoma. According to calculations performed by the Energy and Commerce Committee , health care reform would extend insurance coverage to more than 135,000 constituents. It would provide tax credits to tens of thousands more, while guaranteeing that more than 21,000 people with preexisting conditions can obtain coverage. Boren opposes the bill.

Then there is Arkansas’s Marion Berry. The same calculations indicate that health care reform would extend insurance coverage to 83,500 of his constituents, and that 15,000 people with preexisting conditions would be guaranteed coverage. Health care reform would extend insurance coverage to 78,000 of Heath Shuler’s North Carolina constituents, too, while guaranteeing coverage to 14,500 people with preexisting conditions. Berry and Shuler oppose the bill. Then there are Mike Ross, Travis Childers, and many others.

Perhaps most inexcusable is another likely “NO” vote. Artur Davis. His Alabama district is one of the nation’s safest and poorest. Health care reform would extend insurance coverage to an estimated 61,500 of his constituents. It would provide especially large tax credits and other benefits to literally hundreds of thousands of people. Davis wants to be governor, and apparently believes that a “No” vote on health reform will help this effort. It won’t.

The list goes on, but the point is clear. Passing this bill will help millions of Americans, despite the best efforts of their own elected representatives. Thank goodness, the President and Speaker Pelosi have apparently found the votes they needed. Still, it’s the tough votes that test the content of politicians’ character. By the looks of that map, more than a few men and women in the United States Congress will fail that test tomorrow.

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