Fact of the Week: Percentage of Uninsured Drops Significantly since ACA Took Effect


August 12, 2015

Fewer than 12 percent of Americans remain uninsured in the first half of 2015, a sharp decline from over 17 percent in 2013 before the Affordable Care Act’s major expansion initiatives took effect. According to a Gallup report released on Monday, Arkansas saw the biggest drop in its uninsured rate – 13.4 percentage points – and four other states also showed double digit drops. No state saw a statistically significant increase in the percentage of uninsured over this time.
Seven states now have uninsured rates at or below 5 percent, while eight states have uninsured rates over 15 percent.  Nearly 21 percent of Texans, for example, remain uninsured, as do more than 18 percent of Wyomingites. See how the uninsured rate in your state improved thanks to the ACA.

Gallup noted that seven of the 10 states with the biggest improvements in coverage rates expanded Medicaid eligibility and established their own state-based health insurance exchange website or state-federal partnership exchange, where states manage certain functions and make decisions based on state information. Mississippi was the only state in the top 10 that used the federal healthcare.gov website for individuals and chose not to expand Medicaid; despite this, its uninsured rate dropped 8.2 percentage points. Overall, states that took both steps of expanding Medicaid and setting up a state exchange had a 44 percent reduction in their uninsured rate, compared to a 28 percent reduction for states that did either one or neither of these steps.

uninsured rate medicaid expansion and state exchange

states expanding medicaid

According to Families USA, 30 states and the District of Columbia have chosen to expand Medicaid thus far. Alaska Governor Bill Walker (R) announced just last month that he will use executive authority to expand Medicaid, which will provide coverage to adults with incomes up to 138 percent of the federal poverty line. Gov. Walker said Alaska will save $6.6 million in the first year of the expansion. Families USA also notes that nearly 1.2 million Texans would gain coverage if the state chose to take the option of extending Medicaid benefits to them (Under the ACA, the federal government at first pays the full cost of Medicaid expansion; after a number of years, states will pay no more than 10 percent of the cost, a much more favorable match rate than states are required to pay under the basic Medicaid program).

Despite the law’s success and the Supreme Court decision earlier this summer upholding the law’s subsidies, many conservative members of Congress and GOP presidential candidates continue to call for its repeal. Current proposals in House and Senate appropriations bills for the Departments of Labor, Health and Human Services and Education would defund the ACA, and attempts to dismantle the law are likely to surface again this fall as the budget battle continues.

As the Gallup study shows, these congressional proposals would strip health care from millions of Americans, many of whom are low-income and have health insurance for the first time. Additional enrollment data due out later this week from the federal government are expected to show similar improvements in the number of those struggling without health insurance. Members of Congress and state lawmakers should be moving forward – not backward – to ensure their low-income residents have access to quality, affordable, life-saving health care.

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