10 States That Would Suffer the Most by Getting Rid of Obamacare

It's apparently all fun and games for Republicans on Capitol Hill, where work to dismantle Obamacare, or the Affordable Care Act, is underway
Work to dismantle the Affordable Care Act is underway. | Chip Somodevilla/Getty Images

The Affordable Care Act, or Obamacare, is no longer new. But the radioactive aura of the law is still nowhere near its half-life. The health care reform, initially signed into law in 2010, has become one of the hottest political issues of the era. Many Republicans are disgusted with the law, which includes an individual mandate requiring everyone to have insurance. Democrats, on the other hand, see it as a grand compromise. It’s a stepping stone, some think, on the way to a single-payer system.

Some states stand to lose more than others if the law is repealed. To figure out which ones, WalletHub dug into the numbers. Citing a Congressional Budget Office report, WalletHub’s report says the ranks of the uninsured could rocket to as many as 32 million by 2026. And again, some states would feel the pinch more than others.

“In order to assess repeal’s impact on Americans based on where they live, WalletHub’s analysts compared the 50 states and the District of Columbia across seven key indicators of both economic and coverage losses,” the report says. “Our data set ranges from ‘growth in uninsured population by 2019 post-ACA repeal’ to ‘potential economic impact due to repeal of premium tax credits and Medicaid expansion (2019 to 2023).'”

In terms of which states would be the most affected by a repeal of the Affordable Care Act, here are the top 10.

10. Connecticut

Couples walk along a Connecticut beach
Cutting Medicare would hurt the state. | Spencer Platt/Getty Images

An Affordable Care Act repeal would be particularly disastrous for the state of Connecticut, which could leave about a quarter of a million residents without health insurance. Particularly damaging for Connecticut residents would be the contraction of Medicare. Connecticut was the first state to expand Medicare under the Affordable Care Act, and the state would lose more than $10 billion in federal funding over the next 10 years if the law is repealed.

9. Ohio

Supporters cheer for Trump during a campaign rally in Ohio
Supporters cheer for Donald Trump during a campaign rally in Ohio. | Jeff Swensen/Getty Images

Ohio was one of a handful of Midwestern states that swung the election for Trump. Tapping into the blue-collar economic woes of the Rust Belt, Trump would actually be doing his supporters a disservice by repealing the Affordable Care Act. The state stands to lose billions in federal subsidies, and even Republican Gov. John Kasich is issuing stern warnings about the fallout of a full repeal.

8. Michigan

A steel plant on the shores of Lake Michigan
Many residents are enrolled in the health care exchange. | Scott Olson/Getty Images

Bordering Ohio to the north, Michigan was another state that helped swing the election to Trump. And like their neighbors, Michigan residents would deal with a lot of negative consequences related to the Affordable Care Act’s repeal. In rural areas especially, repealing the law could affect people’s lives in a number of ways. More than 630,000 people have enrolled in the state exchange, which would change if Republicans gut the law.

7. New Hampshire

New Hampshire scenery
Lots of residents would lose coverage. | Darren McCollester/Getty Images

New Hampshire narrowly tipped to Hillary Clinton during the 2016 election. But the state’s unique position in our election system gave us a glimpse as to the nationwide support Trump would eventually win. And just like in many other states that leaned Trump, New Hampshire would be among the states most heavily impacted by the Affordable Care Act’s repeal. Residents are nervous, and a lot of people could be left without coverage in the case of a repeal.

6. North Dakota

Fargo, North Dakota, United States
State representatives have voiced support of a repeal. | iStock.com/Ben Harding

Yet another state that voted for Trump by a wide margin, North Dakota would feel the pinch if the Affordable Care Act is scrapped. As Republicans have postured to repeal the law, many North Dakota residents have started to sign up for plans in anticipation. Representatives from the state have been supportive of a repeal. We’ll have to wait to see what Republicans actually do to see the full effect.

5. Oregon

A sign for Mt. Hood National forest
The state’s economy would take a hit. | Craig Mitchelldyer/Getty Images

Oregon is a blue state, and its residents generally support the law. If Republicans trigger a repeal, Oregon’s economy stands to take a hit — and its residents would lose coverage. After the Affordable Care Act became law, Oregon’s uninsured rate dropped by half. If the law were repealed, that progress would be scrapped, as well.

4. Rhode Island

Providence, Rhode Island
The uninsured rate would climb. | iStock.com/Sean Pavone

Officials in Rhode Island are already positioning themselves for a potential repeal. The Affordable Care Act managed to lift 100,000 Rhode Island residents to the ranks of the insured after its passage — 30,000 through the state exchange and 70,000 through the Medicare expansion. A repeal would clearly create chaos.

“The state’s uninsured rate dropped to less than 4.5 percent, compared with nearly 12 percent in 2013, before the law went into effect,” said a report from Providence Journal.

3. Kentucky

A Mitch McConnell supporter at a Kentucky rally holding a sign calling for the repeal fo the Affordable Care Act
A Mitch McConnell supporter at a Kentucky rally holds a sign calling for the repeal of the Affordable Care Act. | Luke Sharrett/Getty Images

Kentucky might be the most interesting (and confounding) state when it comes to a repeal. For one, many of the state’s residents evidently don’t understand their state exchange, Kynect, is, effectively, Obamacare. As Vox’s Sarah Kliff reported, some parts of the state benefited more from the Affordable Care Act than anywhere else in the country. And yet they voted for Trump, who promised to repeal the law.

2. West Virginia

A coal scraper machine works on a pile of coal in West Virginia
A coal scraper machine works on a pile of coal in West Virginia. | Saul Loeb/AFP/Getty Images

West Virginia is largely in the same camp as Kentucky. It’s a state that has a lot to lose in the event of an Affordable Care Act repeal. But the state overwhelmingly supported Trump for president. The state would lose billions in subsidies, and people would lose coverage.

“The Affordable Care Act has had a wonderful impact on the state of West Virginia. It’s reduced the number of uninsured from 14 percent to 6 percent,” said Ted Boettner of the West Virginia Center on Budget & Policy, per a report from WOWK.

1. Massachusetts

The Massachusetts seashore
Thousands of residents would lose coverage. | Thinkstock

When it comes to a repeal, Massachusetts would be the biggest loser. Interestingly enough, Massachusetts’ former governor, Republican Mitt Romney, sowed the seeds of the Affordable Care Act by implementing Romneycare several years back. Now, if the nationwide law is repealed, more than 230,000 Massachusetts residents would lose coverage.

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