Gallup, the polling and survey organization, recently reported on the nation’s uninsured rate since enrollment in the Affordable Care Act marketplaces began. The overall uninsured rate in the second quarter of 2014 (after the initial open enrollment period of the ACA) fell to an historical low.
It was the lowest quarterly average recorded since Gallup began tracking the percentage of uninsured Americans in 2008. (In the third quarter of 2013, just before the health insurance marketplaces opened, the national uninsured rate was the highest ever.)
Uninsured rates dropped sharply in almost every state from 2013 to midyear 2014, again corresponding to the initial ACA enrollment period. State uninsured rates failed to decline in only five states. Uninsured rates increased in Iowa, Kansas, and Virginia, and remained unchanged in Massachusetts and Utah from 2013 to midyear 2014. Arkansas and Kentucky, two states aggressively expanding their Medicaid programs in rural areas, reported the most significant decreases in their uninsured rates.
Most interesting is that state uninsured rates decreased substantially more in states that fully embraced the ACA. Those states that undertook both the ACA’s expansion of Medicaid and state-based marketplaces (21 states) had uninsured rate decreases nearly twice as large as the 29 states that had one or neither ACA initiative.
These results demonstrate that, at least initially, the ACA is a success in providing health insurance, decreasing the uninsured rates nationally and particularly in states that have embraced it.
Troubling is the long-term implication of a two-tiered health insurance system – one set of states aggressively embracing ACA methods to reduce the uninsured and witnessing the results, and another set of states choosing not to do so and seeing their uninsured rates falling less (or actually increasing).
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