August 6, 2014 — States that have fully embraced the Affordable Care Act (PL 111-148) 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 (Witters, Gallup Well-Being survey, 8/5).
According to the poll, the 10 states with the largest declines in uninsured rates both expanded Medicaid under the ACA and established their own health insurance marketplaces (Al-Faruque, The Hill, 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 who qualified for new programs implemented under the ACA.
By comparison, the survey found that neighboring state Tennessee -- which did not expand Medicaid or set up its own marketplace -- experienced a 2.4 percentage point drop in its uninsured rate ("The Upshot," New York Times, 8/5). States that did not both expand Medicaid and establish their own marketplaces saw a 2.2 percentage point drop in their 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 (Howell, Washington Times, 8/5).
According to the "The Upshot," the differences highlight the dramatic effect the ACA could have for many of the country's lower-income states ("The Upshot," New York Times, 8/5).