States That Embrace ACA Have Lower Uninsured Rates, Survey Finds

States that have fully embraced the Affordable Care Act have seen the most reductions in uninsured residents, according to a Gallup poll released Tuesday, the New York Times' "The Upshot" reports (Sanger-Katz, "The Upshot," New York Times, 8/5).

For the poll, researchers interviewed 178,068 adults from Jan. 2, 2013, to Dec. 29, 2013, and 88,678 adults from Jan. 2, 2014, to June 30, 2014, for the Gallup-Healthways Well-Being Index survey.

According to the poll, the 10 states with the largest declines in uninsured rates, such as California, both expanded Medicaid under the ACA and established their own health insurance exchanges (Witters, Gallup Well-Being survey, 8/5).

Those states collectively experienced a four percentage point decline in uninsured residents.

Specifically, the survey found that Arkansas and Kentucky experienced the largest reductions in uninsured residents. Arkansas' uninsured rate dropped by more than 10 percentage points, from 22.5% in 2013 to 12.4% halfway through 2014. At the same time, Kentucky saw its uninsured rate drop by almost nine percentage points, from 20.4% in 2013 to 11.9% in 2014 (Alonso-Zaldivar, AP/U-T San Diego, 8/5). According to "The Upshot," both states had high numbers of uninsured residents that qualified for new programs implemented under the ACA.

In comparison, the survey found that neighboring state Tennessee -- which did not to expand Medicaid or set up its own exchange -- experienced a 2.4 percentage point drop in its uninsured rate ("The Upshot," New York Times, 8/5). States that did not expand Medicaid or establish their own exchanges saw a 2.2 percentage point drop in total uninsured rates, according to the poll (AP/U-T San Diego, 8/5).

Overall, the poll noted that the country's uninsured rate dropped from a peak of 18% in the third quarter of 2013 to 13.4% by the second quarter of 2014. It added, "While a majority of Americans continue to disapprove of the [ACA], the uninsured rate is declining, as the law intended" (Howell, Washington Times, 8/5).

ACA Could Have Significant Impact on Lower-Income States

According to the "The Upshot," the differences highlight the dramatic effect the ACA could have on many of the country's lower-income states ("The Upshot," New York Times, 8/5). Dan Witters, the poll's research director, said, "Those states that implement the law's major mechanisms are seeing a significantly greater decline in their uninsured rates" (AP/U-T San Diego, 8/5).