Variations in the impact of health coverage expansion proposals across states

Most estimates of the consequences of alternative health insurance proposals focus on national impact, but the extent of cross-state diversity in uninsurance rates, economic and labor-market characteristics, and health care markets suggests that the impact of strategies will also vary. We illustrate this variation by comparing the effects of standard tax credit and Medicaid expansion proposals across states. Some states do well (or poorly) under all policies; others benefit under some but not others. Across policies, state effects on uninsurance rates vary by at least a factor of 2.5. Uniform national strategies that target the uninsured do not generate uniform national outcomes.