Comparing the 19 states with the lowest HMO penetration with the 19 states carried last month by Republican Presidential nominee Bob Dole reveals a startling similarity. With only four exceptions, they're the same states. The resemblance would be even greater if HMO enrollment in pro-Clinton Louisiana (11.0 percent penetration) were to nose ahead of that in Dole-favoring North Carolina (11.1 percent). Are Democratic Party strongholds and managed care strongholds therefore one and the same? Not quite. Despite very low levels of HMO penetration, for example, Iowa (4.9 percent) and West Virginia (7.0 percent) were not only strongly pro-Clinton in '96, but even backed losing Democratic nominee Michael Dukakis in 1988; on the other hand, Utah, with a whopping 30.1 percent HMO penetration today, hasn't gone Democratic since Lyndon Johnson's landslide of 1964.
Note: Figures show HMO enrollment as a percentage of total population for each state. Enrollment is reported by HMO location rather than by enrollees' state of residence. That fact may distort percentages for states such as Utah, and it accounts for the lack of data for Alaska and Wyoming, which as of Jan. 1, 1996, claimed no home-based HMOs but had small numbers of residents enrolled in out-of-state HMOs.
SOURCE: HMO PENETRATION DATA FROM INTERSTUDY PUBLICATIONS, MINNEAPOLIS, MINN.