The ACA: Health Rankings and Health Exchanges

Most of the least healthiest states' governors opted to not pursue a state-level health exchange.

Of the 12 unhealthiest states in 2012, only one -Kentucky- opted to set up its own state health exchange under the Affordable Care Act.  Arkansas and West Virginia chose to set up joint Federal-state exchanges. All three states had Democratic governors in 2012.  

One other state in the bottom quarter of health rankings also had Democratic governor in 2012.  Missouri voters in 2012, however, passed a law blocking their governor from setting up a state health exchange. 

The other 8 unhealthiest states currently have Republican governors.

These maps underscore the political element involved in decisions to expand health insurance to the states with the most serious health challenges.

Ranking America's Health

The Southern states rank as America's least healthy.

As a Southerner, I'm somewhat used to rankings that often find the Southern states where I live, work, and visit family as among the worst on a host of social indicators:  poverty, low education, and disease.  The University of Wisconsin recently received funding from the Robert Wood Johnson Foundation (RWJ) to synthesize a large number of health indicators and rank the states and counties for health.  America's Health Rankings (for states) and its sister site, County Health Rankings, generated considerable news coverage and controversy as you would expect anytime you rank places.  Below is a map of the health rankings for the year the ACA was enacted by Congress:  

As you can see, the least healthy states tend to be in the southern tier of the country.  Of the former Confederate states, only Virginia ranks among the healthiest half of states.