Last year was the first year in which the Affordable Care Act's (ACA's) new health insurance exchanges were operating.  Starting in 2014, almost all Americans must now have health insurance or face a tax penalty.

Premiums varied widely.  Today's map shows the 10 most expensive health insurance markets for 2014.  Citizens can purchase a variety of plans from different private insurers.  The standard for comparison looks at Silver plans for a 40 year old non-smoker.  In 2014, the average monthly health insurance premium for a Silver plan for a non-smoking, 40 year old adult was $328/month.  Rates were lowest in 2014 in Minnesota and highest in western Colorado.

So, are there any patterns to markets with high or low premiums?  Yes.

*Some fairly wealthy areas such as western Connecticut and western Colorado have relatively healthy people but appear to be paying more.  Why?  I guess because insurers feel the markets in these areas can bear higher premiums.  That is just a guess.

*Other areas are a) remote with limited medical providers, b) are in areas where Americans are in fairly poor health, or c) both.  Georgia has the dubious honor of having 2 of the 10 most expensive markets in the country AND having the greatest disparities of any state between the high costs around Albany, GA, compared to the relatively lower costs in the Atlanta market.  Wyoming, northern Nevada, western Wisconsin, Alaska, and coastal Mississippi all have issues with few providers and/or sick populations.

*Vermont ranks in the 10 most expensive because of a policy in that state.  Unlike in other states which have opted to allow insurers to charge older residents more than younger people, Vermont law requires insurers to charge everyone regardless of age the same premium for the same plan.  As a result insurers increased premiums across the board in Vermont.

The new 2015 premiums came out in mid-November and there are relatively big fluctuations in premiums.  Minnesotans will be paying more.  Mississippians will pay less.  Overall prices nationally are either slightly down or steady after years of rapidly rising premiums.  The geography of premiums, however, continues to be sorted out as insurers and their actuaries figure out if they are charging enough to cover the health issues of their populations AND make a profit (since the Republican-invented ACA model relies on government subsidies and private insurance companies rather than the single-payer Democratic alternative).  It will likely be at least 3 years (circa 2017) before we can see more stable premium data as the system finds its groove.

Save the Tatas

This quick map shows data from the CDC's 2010 Behavioral Risk Factor Surveillance Survey (BRFSS) broken into standard deviations.  The pale gray states represent states where the percentage of women over the age of 40 reporting they have had the recommended mammogram in the past 2 years.  Gold states have better mammogram percentages.  Purple states have worse.

Massachusetts stands out as having the highest percentage of women over 40 who have had a mammogram. This much higher percentage for the Bay State likely results from the high percentage of women who have health insurance thanks to the program signed into law by Gov. Mitt Romney that has since become the model for the Affordable Care Act.

On the other extreme are the western states of Oklahoma, Utah, Nevada, Idaho, Wyoming, and Montana where significantly lower percentages of women have had mammograms.

UPDATED MAP: Kentucky!!!! and Same-Sex Marriage Lawsuits

The legal situation involving the push to legalize same-sex marriage in most of the states is rapidly changing. As of today new lawsuits in Wisconsin, Missouri, and Louisiana are expanding the states with legal challenges to same-sex marriage bans.  A previous lawsuit in Louisiana was dismissed in December over legal standing issues.

Also, a new lawsuit in Ohio does not seek the legalization of same-sex marriages at the state level there. Instead it seeks to have the names of both parents listed on birth certificates when an Ohio or out-of-state adopting couple are legally married elsewhere.  This Ohio case would expand on an earlier Federal judge's ruling that Ohio must list same-sex spouses legally married elsewhere on Ohio death certificates.  That case is being appealed.

And today a Federal judge in Texas is hearing a challenge to that state's same-sex marriage ban.  Nevada's Attorney General also announced she will not defend Nevada's same-sex marriage ban from a legal challenge there because of the ban's likely unconstitutionality.

UPDATE:  Even as I posted this map over lunch, a Federal judge in Louisville, KY, ruled that my home state of Kentucky must recognize same-sex couples legally married in other states.  This particular lawsuit did not address whether same-sex couples could marry in Kentucky.  So now Kentucky will either join Oregon in recognizing same-sex couples married elsewhere or join Utah and Oklahoma in appealing this ruling.

Map: Where You Are Most Likely to Be Stuck in a Part-time Job

This map looks at the percentage of workers who want a full-time job but can only find part-time work.  In technical terms, this map shows the highest rates of underemployment in the United States.

The Western states of Nevada, California, Oregon and Washington have considerably higher underemployment.  North Dakota and South Dakota have low overall unemployment and relatively few part-time workers unable to find full-time work.

Map: What States Have the Most Discouraged Workers?

This map shows the variation in discouraged workers nationally.  Discouraged workers are unemployed Americans who have given up looking for a job for awhile and have not applied for any jobs in the past 4 weeks.

In no states does the percentage of discouraged workers exceed 1%, so the numbers are relatively low. This map calculates discouraged workers as the U4 unemployment measure by the Bureau of Labor Statitistics minus U3.  U4 consists of the official unemployment measure (U3) plus discouraged workers.  So I've pulled discouraged workers out and looked at the spread of data by standard deviations.

North Dakota's oil-fueled jobs boom continues to keep that state's unemployment the lowest in the US.  Nevada's 9.7% unemployment (U4 measure) is actually higher than South Carolina's 9.3% rate, but the Palmetto State has the highest percentage of discouraged workers in the country -at least in December 2013.  Neighboring Georgia, Alabama, and Florida also have higher percentages of discouraged workers compared to the mean for the United States.

Maps: Comparing the Unemployment Measures

This series of maps shows the 4 highest unemployment measures for December 2013:

• U3 -the official unemployment rate
• U4 -U3 plus discouraged workers
• U5 -U4 plus marginally employed workers
• U6 -U5 plus part-time workers unable to find full-time jobs

You can see more discussion of the six measures of unemployment here.

 U4:  The addition of discouraged workers who have not looked for a job in the past 4 weeks because of the lack of jobs pops Nevada's unemployment rate to over 10%.

U5:  Marginally employed workers are those who report they would like a job but are not looking.  If the jobs market was better, they report they would look for work.

U6:  This is the highest measure of unemployment computed by the US Bureau of Labor Statistics.  In December 2013 Nevada led the country in unemployment with a figure of 18.1% on U6.  In other words, almost 1 in 5 workers in Nevada cannot find a full-time job.

Map: The OFFICIAL December 2013 Unemployment Figures by State

Last week I posted about the 6 measures of unemployment (U1 - U6) calculated by the US Bureau of Labor Statistics. This map shows the official measure of unemployment (U3).  The national U3 number is 6.7% of the civilian labor force is unemployed.  Nevada has the highest unemployment.  North Dakota has the lowest unemployment in December 2013.