If states had similar healthcare standards, 86,000 fewer deaths

High-income people who live in states with poor healthcare rankings are worse off than low-income people in states with high rankings, U.S. researchers say. The Commonwealth Fund study found there were two Americas when it comes to healthcare, divided by geography and income. However, having a low income does not mean worse healthcare or worse health. Except for all but six indicators, low-income adults in top-performing states for healthcare exceeded the national average for all incomes, the report said. The Commonwealth Fund's Scorecard on State Health System Performance for Low-Income Populations analyzed 30 indicators of access, prevention and quality, potentially avoidable hospital use, and health outcome. The Scorecard documented sharp healthcare disparities among states -- between leading and lagging states, up to a fourfold disparity in performance exists on a range of key healthcare indicators for low-income populations. There are also wide differences within states by income. However, if all states could reach the benchmarks set by leading states, an estimated 86,000 fewer people would die prematurely and tens of millions more adults and children would receive timely preventive care, the report said. Moreover, many benchmarks for low-income populations in the top states were better than average and better than those for higher-income or more-educated individuals in the lagging states. The report defined "low income" as below 200 percent of the federal poverty level, or $23,000 annual income for an individual or about $47,000 for a family of four. Nationally, as of 2010–11, 55 percent of those age 65 and younger with incomes below 200 percent of poverty -- nearly 57 million people -- were either uninsured, or if insured, were spending a relatively high share of their incomes on medical care, the report said. This is sometimes referred to as being "underinsured." The percentage uninsured or underinsured ranged from a low of 36 percent in Massachusetts to more than 60 percent in 10 states -- Alaska, Colorado, Florida, Idaho, Montana, Nevada, New Mexico, Texas, Utah and Wyoming.