Where uninsured rates dropped the most
It's still early to assess uninsured data from 2014; most go-to data sources have not yet released information about the year. To get some early insight, we used data from a Gallup survey released earlier this year.
According to the data, the five states that experienced the largest reductions in their uninsured rate from 2013 to 2014 were:
- 1. Delaware, where the uninsured rate decreased by 68.57%;
2. Arkansas, where it decreased by 44.89%;
3. Kentucky, where it decreased by 41.67%;
4. Connecticut, where it decreased by 39.84%; and
5. Washington, where it decreased by 36.31%.
It's no surprise that all these states expanded Medicaid, and most of them created their own insurance exchange. (Only Delaware and Arkansas did not launch state health insurance exchanges, instead urging consumers to use the federal one.)
Overall, New York Times' "The Upshot" blog notes, states that "fully embraced" the ACA are the ones who did the best.
In Arkansas, the uninsured rate dropped 10 percentage points, from 22.5% in 2013 to 12.4% in 2014. Joe Thompson, Arkansas' surgeon general, credits the decrease to his state's unique solution for Medicaid expansion, which uses federal funding to purchase insurance subsidies for low-income residents. He says approximately 80% of residents who bought new coverage in Arkansas did so with those subsidies.
Where uninsured rates did not go down
The Gallup data found that three states saw their uninsured rates increase—and two saw no change at all:
- 1. Kansas, where the uninsured rate increased by 40.8%;
2. Iowa, where it increased by 6.9%;
3. Virginia, where it increased by 0.75%;
4. Massachusetts, where the uninsured rate did not change;
5. Utah, where the uninsured rate did not change.
However, it's important to note that the margin of error for the 2013 Gallup data was +/- 1 to +/- 2 percentage points. For the 2014 uninsured data, the margin of error was as high as +/- 5 percentage points for states with smaller populations.
The states making the bottom five list from the Gallup data do so for different reasons.
In Kansas, experts say the lack of Medicaid expansion was a key factor. Kansas Insurance Commissioner Sandy Praeger also says that the public now has a better understanding of insurance coverage, making people less likely to accidentally report that they have insurance if they do not. Praeger also suggested Gallup's polling methodology may have influenced the data.
In contrast, Gallup's Dan Witters says that Massachusetts made the bottom five because it already had a very low uninsured rate prior to 2014.
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