All 10 states that report the largest declines in uninsured rates expanded Medicaid and established a state-based marketplace exchange or state-federal partnership.
As Gallup previously reported, the states that chose to expand Medicaid and set up their own health exchanges had a lower uninsured rate to begin with: 16.1% compared with 18.7% for the remaining states — a difference of 2.6 percentage points. The already notable gap between the two groups of states widened through the first quarter to 4.3 points, as states that have implemented these core mechanisms of the Affordable Care Act reduced their uninsured rates three times more than states that did not implement these core mechanisms.
the uninsured rate is declining, as the law intended. Nationally, 17.3% of U.S. adults reported being without health insurance in 2013, a rate that had slowly increased from 14.8% in 2008. The uninsured rate peaked at 18.0% in the third quarter of 2013 — the three months immediately preceding the opening of the healthcare exchanges — and has since declined to 13.4% in the second quarter of 2014, the lowest quarterly rate in more than six years of Gallup-Healthways Well-Being Index trending.
There are two parts that amaze me:
- The law is working as intended–the number of insured is going down, the cost controls built into the program might be working, so far premiums don’t seem to be spiking. And yet, it seems to be less popular now.
- Republican governors made a big push to make sure that their citizens didn’t benefit from the expansion of affordable insurance (either through Medicaid or through subsidies in Obamacare) and yet they don’t seem to.
The place to watch is Kansas where the governor cut taxes and the state is now a bit of a mess; the governor didn’t expand Medicaid and the percent of people in the state without insurance went up by 5.1 percentage points.