State-by-State Health Care Openness and Access Rankings

Published December 15, 2016

The Mercatus Center at George Mason University recently released a new research project ranking states across the nation based on their access and openness to health care. Dr. Darcy N. Bryan, an associate clinical professor at the University of California-Riverside School of Medicine and an author of the study, describes the Healthcare Openness and Access Project (HOAP) as a “set of tools providing state-by-state measures of the flexibility and discretion that patients and providers have in managing health and health care. In other words, how open are each state’s laws and regulations to institutional variation in the delivery of care, and how much access to varying modes of care does this confer on the state’s patients and providers?”

The top-ranked states for openness and access in the study are Idaho, Montana, Missouri, Mississippi, and Utah. The lowest-ranked states are Georgia, New Jersey, New York, Connecticut, and Rhode Island.

After the passage of the Affordable Care Act (ACA), citizens, health care professionals, and elected officials lost much of the power they previously had to make health-care-related choices, and until now, many of the parties did not have a way to quantify what had been taken away by the implementation of the ACA. Mercatus created this study and its state-by-state rankings to fill that void.

Robert Graboyes, a senior research fellow at Mercatus and one of the authors of the HOAP report, noted, “[S]tates control many important aspects of health care, which they can alter without seeking approval from the federal government. … Who may practice medicine? Which services can nurses provide? Who can own a medical practice? What constitutes malpractice? Can doctors and patients interact via remote video technology? Can new hospitals freely challenge existing institutions? The way states answer these questions has an enormous effect on the cost and quality of health care,” Graboyes wrote.

In a recent In The Tank podcast, Heartland Graphic Designer Donny Kendal and Government Relations Director John Nothdurft discussed the Mercatus Center study, arguing it successfully brings a degree of transparency to the complex system of health care laws and regulations now in operation throughout the country using dozens of reliable indicators, including direct primary care rules and health-care-related taxes.

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