I believe that the future of the United States lies in Michigan and other blue (Democratic Party controlled) states rather than in the red (Republican Party controlled) states (see map below), in part because of dangerous healthcare policies in red states affecting women, girls, LGBTQ individuals and their physicians. As a result, I predict that there will be a population shift and business migration from red to blue states.
US state legislatures by party control. Source: Wikipedia
Michigan seeks to provide full rights and dignity to women regarding healthcare
Michigan voters recently enacted a constitutional amendment (Proposal 3) that guarantees reproductive rights for women and girls, including access to abortion. Other blue states have or are in the process of enacting similar laws.
These reproductive rights allow medical and surgical abortions under pre-Dobbs conditions without fear of criminal charges against physicians, women, girls or those who assist them. They confirm the continued availability of current birth control methods and in vitro fertilization. Physicians can act in the best interest of their pregnant patients, particularly when ectopic pregnancies, miscarriages, severe fetal anomalies and other pregnancy complications occur. Pregnant women and girls will not be prosecuted for miscarriages. Finally, all women and girls, whether pregnant or not, can get appropriate treatment for auto-immune disorders, cancer and other diseases even if the treatment might harm an unborn baby present now or in the future.
The above rights have been taken away from women, girls and physicians or are threatened in red states:
Red states have banned abortion and only rarely grant exceptions to abortion restrictions, even for incest or conditions threatening the life of the mother.
Red states are forcing women to get medically recommended pregnancy terminations out of state or to carry a baby for months that they know they will have to bury soon.
Red states are restricting access to abortion medication and threatening pharmacists who provide it.
There is concern that anti-abortion laws in red states will limit the use of in vitro fertilization.
Red states are threatening legislation to criminalize those involved in helping state residents obtain abortions in other states. Although this legislation may be unconstitutional, some nonprofit abortion funds that help people travel out of state have stopped their work based on existing laws.
Women have historically been prosecuted for having miscarriages and there is fear that this will increase in red states.
Red states are giving incentives to friends, family, hospitals and other confidants of women and girls to “snitch” on them about abortion activities illegal under their state laws.
Red states are threatening the availability of IUDs and other birth control methods.
Red states are jailing pregnant women, even without a criminal conviction, on suspicion of drug use.
Red states are defrauding women and girls by funding “pregnancy crisis centers” that lie to women and girls about pregnancy and violate medical safety standards without any repercussions.
Red states are interfering with the ability of physicians to practice medicine under the standards of our profession and in acting in the best interest of our female patients.
Red states are threatening physicians who provide abortions, even under legal conditions.
Red states are forcing physicians to delay or deny care, to the detriment of our patients, in cases of ectopic pregnancy, miscarriage, severe fetal anomalies and other pregnancy complications.
Red states are preventing physicians from providing necessary treatment to women and girls, pregnant or not, for autoimmune disorders such as rheumatoid arthritis, cancer and other diseases.
Red state policies threaten pulmonologists for advising women who have an underlying medical condition that places them at risk for life-threatening complications from pregnancy or childbirth.
Of note, red states, even pre-Dobbs, often had higher maternal mortality rates than the U.S. average of 20.4 per 100,000 live births (Source: Centers for Disease Control and Prevention) and weaker support for mothers and children.
These policies are causing some women and physicians to avoid red states.
Some women attending college are avoiding anti-abortion states because they would like to have the option of an abortion, if necessary; even men think similarly.
Physicians in training are avoiding anti-abortion states because they will have difficulty getting the training they want or need. For example, OB-GYN residency programs are required to have abortion training available, which is not possible in anti-abortion states.
Some physicians are avoiding or leaving anti-abortion states because they believe they cannot practice medicine there as they deem proper.
Blue states are trying to attract businesses in red states, whose residents may not want to live with an abortion ban. Some businesses in red states have already indicated they will leave or not expand there.
Michigan is protecting LGBTQ individuals
A recent poll found that 7.1% of all US adults identify as LGBTQ, including 21% of adults ages 18-25. Michigan and other blue states have taken steps to protect LGBTQ individuals against discrimination and to allow their physicians to provide appropriate healthcare. For example, Michigan’s new Democratic Party “trifecta” has taken steps to codify protections for LGBTQ people under the state’s civil rights law.
Map of states, counties, and municipalities that have sexual orientation and gender identity discrimination prohibited. Source: Wikipedia. See also LGBTQ Nondiscrimination laws.
On the other hand, many red states are increasingly pushing to limit LGBTQ rights and transgender healthcare.
There is concern that on abortion and LGBTQ issues, the U.S. is increasingly dividing into two nations: one that restricts and one that protects autonomy on sexuality and gender.
Other policy differences that may promote red to blue state migration
Red states and counties have higher COVID-19 death rates than blue states, most like due to policy differences on mask requirements, social distance mandates and vaccines or other factors influencing vaccine hesitancy.
Other policy differences don’t directly affect healthcare but may also promote migration: Red states are enacting rules that make voter participation disproportionately difficult for Americans of color, including strict voter ID laws and polling place consolidation, considered “the most intense voter suppression threat in decades”. In contrast, Michigan recently passed Proposal 2, which expands voting access and other blue states have passed or are considering similar actions.
Although red states are more likely to suffer from climate change due to geography, red states are punishing businesses that consider climate change in their business decisions.
It’s hard to move, but Americans have experience with migration
Americans are used to moving. After all, the United States has the largest immigrant population in the world. Many of our relatives emigrated to the U.S. to flee religious persecution, but today, we may encounter similar persecution in red states that force their religious views on abortion on state residents.
Moving is an emotional experience involving many factors. For the above reasons, I believe that we will slowly see an increase in migration from red to blue states, although it will take years to see studies documenting these trends. We may see some initial information from Match Day on 17 March 2023, which may tell us whether physician residents are preferring blue over red states. In addition, this blog will provide updates as information becomes available.