The Supreme Court’s ruling on the Affordable Care Act last week has hardly made the bill any more popular—in fact, 49% of Americans disagree with the decision, according to a CNN poll yesterday. Looking at those numbers, however, reveals something more interesting than the typically expected partisan divide.
Harvard’s Jeff Frankel has shown that the greater the index of obesity in a state, the more likely they are to oppose the health care act.
Curious data, considering that morbidly overweight individuals are some of the ones that stand to benefit the most from the reformed legislation. Before Obama passed the Affordable Care Act—by the slimmest of margins, with no Republican votes—insurance companies could turn away those with pre-existing conditions, or charge them higher rates if they were pre-disposed to illness. The new bill eliminated those restrictions and discrimination, providing essential support to obese Americans, who incur medical costs 42% higher than those with healthier, slimmer waistlines.
States with some of the highest rates of obesity, such as Mississippi, Tennessee, and Alabama, were among the most strongly opposed to the health care act, and also the most likely to benefit from it. “People are not voting in their self interest,” Frankel notes. “For every one percentage point increase in obesity, support for Obamacare declines by an estimated four percentage points on average.” How to explain this disconnect?
Two explanations that Frankel postulates are 1) ignorance of what the new law does, and 2) pure and simple partisanship
Many think that it reduces personal responsibility for health care. But the truth is the opposite. Under the current system, hospitals are required to treat patients who show up at the emergency entrance with a heart attack – even if their condition is partly their fault, due to habits of overeating and under-exercising. The hospitals have to pass the costs on, and the rest of us end up footing the bill. The individual mandate is designed to fix that, by making everyone pay for the health care they get (and perhaps even encouraging them to see a doctor who will advise them to adopt a healthy life style).
It is worth noting that poverty, lack of education, and obesity are three deeply interrelated factors. The top three least healthiest states—Mississippi, Louisiana, and New Mexico—are the same top three poorest states. These states also rank near the top of the worst-educated lists.
Those with the highest percentages of overweight or obese individuals also tend to consistently vote Republican, making their opposition to the bill a matter of political ideology rather than pragmatic reason. Reduced access to education diminishes the possibility of escaping state-sponsored partisanship, and making informed decisions.