Only thing I can think of that is (sort of) a political decision to “limit health care” is refusing to expand Medicaid.
I know that didn’t happen across the board for Republican counties/states, though, so what in the world are you claiming?
Credit where credit is due, Iowa and Hawaii actually rank very highly in terms of healthcare affordability and outcomes.
https://abcnews.go.com/Health/red-blue-america-glaring-divid...
https://www.nytimes.com/2021/11/08/briefing/covid-death-toll...
https://www.pewresearch.org/politics/2022/03/03/the-changing...