There’s a lot we still don’t know about how the American Health Care Act would impact insurance coverage here in Pennsylvania. The details of the Donald Trump-endorsed plan are fuzzy, and though it narrowly passed last week, there’s been no review by the Congressional Budget Office to estimate how many people would be impacted.
Here’s what we do know: The AHCA rolls back some protections for patients with preexisting conditions, meaning some 5.3 million people across Pennsylvania could face higher insurance premiums. It could also force states to make tough choices when it comes to funding Medicaid expansion, which provided some 700,000 additional Pennsylvanians with health insurance.
We also know how every Pennsylvania congressman voted on this legislation and the political implications that could have led to their vote. So we wanted to know: Which Pennsylvania congressional districts stand to lose the most if Obamacare is repealed? And how did those districts’ representatives vote?
Using census data, federal health insurance statistics and various studies, we were able to create a health insurance profile for each Pennsylvania congressional district that includes population data, median household income, cancer death rates, the number of disabled people in the district and more. That look also includes the number of people in each district who are insured, uninsured, or gained coverage through the marketplace or became newly eligible for Medicaid under expansion.
The below table breaks down the number of people in each congressional district who enrolled in health insurance under the Affordable Care Act, and is sortable by number of people per district who enrolled in a marketplace plan and number of people who became newly covered under expanded Medicaid. (Find your congressional district here.)
While there weren’t concrete numbers on the number of people with preexisting conditions in each congressional district, this table shows health indicators for each congressional district, including the number of people who are disabled and the average annual cancer death rate per 100,000 people.
For those of us who are more map-oriented (ahem), this includes the same information broken down by congressional district. Click anywhere inside a district to see its stats.
Here’s the same map, but color-coded based on the number of people enrolled in the health insurance marketplace under Obamacare. Darker blue corresponds with congressional districts that have higher numbers of constituents enrolled.
You’ll notice there’s a concentration of enrollees in southeastern Pennsylvania. In fact, the district with the most enrollees in a marketplace plan — more than 33,000 people — is the 8th congressional district that includes parts of Bucks and Montgomery counties. That district is represented by Rep. Brian Fitzpatrick, a Republican who voted against the AHCA.
The district with the second-most enrollees (28,300) is the 13th congressional district, which is the area that covers Northeast Philadelphia and parts of Montgomery County. Rep. Brendan Boyle of the 13th district is a Democrat and voted against the bill. The district with the third-most enrollees (28,100) was District 7, a suburban Philadelphia district represented in Congress by Rep. Pat Meehan. He’s a Republican who, like Fitzpatrick, also voted against the AHCA.
Let’s move on to Medicaid expansion. The below map is color-coded based on the number of constituents in a given congressional district who became insured under Medicaid expansion. Darker red colors correspond with higher numbers of people covered.
The district with the highest number of people covered under Medicaid expansion (70,744) was Philadelphia’s 1st congressional district, represented in Congress by Democrat Bob Brady, who voted against the AHCA. The second-highest number of people covered under Medicaid expansion (53,684) goes to Meehan’s district.
But in third place for the most number of people covered under Medicaid expansion? That would be the 9th congressional district, which saw 51,249 people in the district newly eligible for Medicaid under expansion. The district is represented in Congress by Bill Shuster, a Republican who voted in favor of the AHCA and appeared with President Trump at the White House following the bill’s passage in the House.
The AHCA now heads to the Senate. Republican leaders in the upper chamber have already indicated they’re working on an Obamacare replacement plan of their own.