Washington state’s sickest regions would take biggest hit if Obamacare is repealed

Data show that regions in the state with the highest percentage of people with insurance made possible through the Affordable Care Act — better known as Obamacare — are in rural areas that also have the highest rates of death from medical conditions among people under 65.

A repeal of Obamacare would hit Washington hard — but nowhere harder than in parts of the state where people are the sickest.

The Affordable Care Act (ACA) — better known as Obamacare — vastly expanded Medicaid enrollment by extending eligibility to low-income people under age 65. Washington is one of 31 states, plus the District of Columbia, that had adopted the Medicaid expansion.

Here in Washington, data show that regions with the highest percentage of people under 65 with insurance made possible by ACA are in rural areas where people are more likely to die from disease at a relatively young age.

The Legislature has divided Washington into 10 regions for the administration of health services. Of these, two regions have a significantly higher concentration of people insured through Obamacare: Timberlands and Spokane.

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The highest percentage of people newly insured because of the ACA is in the Timberlands region, which is made up of five counties in the southwest corner of Washington: Grays Harbor, Pacific, Lewis, Cowlitz and Wahkiakum.

As of November, 2016, 18 percent of the population under 65 — more than 38,000 people — have gained coverage either through the Medicaid expansion enabled by the law, or by the state’s health exchange.

That’s a good thing, because this also happens to be the sickest area in the state.

In 2015, the most recent year for which data is available, people under 65 in this region died from disease at the highest rate in Washington: 217 per 100,000 population, after adjusting for age. That’s about double King County’s rate.

The Spokane region,…

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