Wednesday, November 19, 2014

Latest Civil Marriage Laws Map


With the decision today from a Montana judge, marriage licenses are now being issued in all the states within the jurisdictions of the 9th, 10th, and 4th Federal circuit courts and these appellate courts' rulings striking down same-sex marriage bans.  Same-sex couples can now marry in 35 of the 50 states plus the District of Columbia.

There's still LOTS going on:


  • State officials in South Carolina, Kansas, and Montana continue to try to fight marriage legalization even as some counties in these states are issuing licenses.  In Kansas the legal situation is chaotic with the state Supreme Court allowing marriages to go forward in some counties but not clearly stating that marriage licenses must be issued statewide.
  • In the 6th Circuit, a 2-1 split decision upheld marriage bans in MI, OH, KY, and TN.  This split has now been appealed to the US Supreme Court.  Based on the 6th Circuit's decision -and in spite of prior public statements by Michigan's Republican governor that the state was issuing legal marriage licenses- Michigan's Republican Attorney General is now claiming that 300 or so same-sex marriages that occurred there before a stay never legally existed.  This is a lawsuit in the making for sure.
  • A Federal judge in Puerto Rico has also upheld that island territory's marriage ban and so that case will now head to the 1st Circuit where every state has same-sex marriage including Massachusetts, the first state to adopt same-sex marriage.
  • Court cases also continue in the 8th, 5th, and 11th Circuits.

Friday, November 14, 2014

ACA Open Enrollment Starts


Open enrollment through the Affordable Care Act starts tomorrow (November 15, 2014) and runs through February 15, 2015.  Here is a map updated in October for which states are providing their own health insurance exchanges and which are relying on the Federal www.healthcare.gov.  For the initial 2013-2014 enrollment period, the state exchanges outperformed the Federal exchange generally with Kentucky's KYNect being the star of the show.

Wednesday, November 5, 2014

Election 2014: Marijuana Laws


Recreational Marijuana:  Alaska, the District of Columbia, and Oregon on November 4th became the latest US jurisdictions to legalize recreational marijuana.  The vote in DC, however, must be approved by Congress so it may not go through.

Medical Marijuana:  The US territory of Guam also approved medical marijuana.  The majority of Florida voters did vote to approve medical marijuana in the Sunshine State, but the vote narrowly missed the 60% of votes cast needed to approve medical marijuana in Florida.

Thursday, October 30, 2014

Updated Medicaid Expansion Map


This map shows which states have taken up the Affordable Care Act's (ACA) opportunity to expand each state's Medicaid program to citizens earning 101-135% of the Federal Poverty Limit (FPL).  The majority of states and DC are now participating with the Federal government picking up the entire tab for the expansion for the first year or so.  Then the states will after a few years have to pay for 10% of the expansion and the Federal government will continue to pay 90% of the tab.

Several key points:

  • If you are like me and live in a state whose governor and legislature has chosen not to expand Medicaid insurance, then you and your fellow citizens are paying taxes into the Federal government to support the expansion, but your state is not getting any of the direct benefits.
  • By some estimates 8 million uninsured Americans were eligible for their states' Medicaid programs but were unaware or at least not enrolled.  The media attention and efforts to sign people up for insurance, however, may be providing the indirect benefit of getting more people to sign up for Medicaid who are eligible.
  • The ACA was designed for all the states to expand Medicaid to the poorest uninsured.  People earning <101% of the FPL were already eligible for Medicaid.  Those earning >135% up to 400% of the FPL get a subsidy to help them pay for private insurance purchased through the health insurance exchanges.  Everyone must by law have insurance.  So in states that did not expand Medicaid, these poorest of the uninsured must by law purchase insurance but do not get Medicaid ...and they get no subsidy.  They are trapped in the "Medicaid donut hole" as some are calling it.


Tuesday, October 28, 2014




This series of maps shows the classification of the state's 159 counties along a continuum from urban to rural.  This classification was developed by the US Department of Agriculture (by a fellow named Beale originally) and now is standardized by the US Office of Management and Budget (OMB).  It is based on urban population and commuting patterns for a county's workforce.  Thus, a rural county where a large percentage of the workforce commutes to a metro area would be classified as more urban than if its workers didn't access a more urban area regularly.

Saturday, October 25, 2014


This map is a little rough.  I need to clean up some of the borders.  Here though is a map showing the Peach State's MSAs.  A Metropolitan Statistical Area is defined by urban population and workforce commuting.  

Thursday, October 23, 2014

Georgia's AHECs


Most?  all?  states have AHECs (Area Health Education Centers).  This map shows Georgia's counties, health districts, and AHECs on one easy map.