Poll: Uninsured Rate Declined More in States That Embraced ACA
States that fully embraced the Affordable Care Act by expanding Medicaid and creating state-run exchanges saw larger decreases in their uninsured rates than states that did not, according to a Gallup poll released Monday, the Washington Times reports (Howell, Washington Times, 8/10).
Gallup's biannual survey compared responses from more than 178,000 U.S. adults in 2013, before the ACA's coverage expansions took effect, with responses from 88,667 adults in the first half of this year (Lauter, Los Angeles Times, 8/10).
Overall, Gallup found the U.S. uninsured rate fell from 17.3% in 2013, before the ACA's coverage expansions took effect, to 11.7%. The survey found the 22 states that adopted both Medicaid expansion and state-run exchanges on average saw a 7.1-percentage-point reduction in their uninsured populations, while the 28 states that adopted just one or none of those provisions saw average reductions of 5.3 percentage points (Sullivan, The Hill, 8/10).
According to the poll, Arkansas and Kentucky -- which both expanded Medicaid and ran or partnered with the government to run its own exchange -- saw the largest reductions, with the states' uninsured rates falling by about 13 percentage points and 11 percentage points, respectively, over the past two years. Further, Oregon, Rhode Island and Washington saw uninsured rates drop by at least 10 percentage points (Washington Times, 8/10). California, which expanded Medicaid and opted to run its own insurance exchange, saw its uninsured rate drop by 9.8 percentage points (Witters, Gallup poll, 8/10).
In addition, six states -- Connecticut, Hawaii, Iowa, Massachusetts, Minnesota and Vermont -- saw their insured rates increase to at least 95%. Previously, Massachusetts was the only state to reach that level (Washington Times, 8/10).
Meanwhile, the survey found that Mississippi, which did not expand Medicaid or run its own exchange, saw its uninsured rate drop from 22.4% to 14.2% (The Hill, 8/10). According to the Los Angeles Times, 14 states in October 2013 had uninsured rates higher than 20%. Now, only Texas has an uninsured rate above 20%, according to the poll (Los Angeles Times, 8/10).
Gallup said there still are challenges for the ACA. For example, Gallup noted that Medicaid enrollment under the law's expansion could be close to its limits. According to Gallup, "While some additional progress can be made ... in the reduction of the uninsured rate via further Medicaid expansion, this mechanism for reduction has likely reached most of its potential unless additional states choose to implement it." Gallup added, "As such, the marketplace exchanges that enable people to select and purchase their own plan directly from insurers will likely be the primary means by which the national uninsured rate would be reduced in the immediate future" (Washington Times, 8/10).
Disagreement Over ACA Likely Will Persist
Following the survey's release, Democrats touted the results as evidence the ACA is working and lambasted attempts to dismantle the law. Rep. Frank Pallone (D-N.J.) said, "I hope that now, with even greater evidence that the ACA is working and saving lives, my Republican colleagues can move on and accept the transformative and positive impact the law is having on our country."
Robert Blendon, senior associate dean for policy translation and leadership development at Harvard University, said Republican voters still oppose the ACA, meaning GOP lawmakers likely will continue to argue the ACA is "too costly for middle-income Americans whose incomes aren't growing and it's affecting employment" (Adams, CQ News, 8/10).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.