States with the Sharpest Reductions in Uninsured Rates

In the second quarter of 2014, the uninsured rate in American had sunk to 13.4%, with the most dramatic drops in Medicaid expansion states.

Gallup recently looked at the uninsured rates of each state to determine which ones saw the largest reductions from 2013 to the middle of 2014. The data found that Medicaid expansion and state exchanges were linked to a larger drop in the uninsured rate.

All 10 states with the largest reductions both expanded Medicaid and established a state-based marketplace or a state-federal partnership. While states that chose to expand Medicaid and set up a health exchange had lower uninsured rates to begin with, the gap widened through the first quarter, according to Gallup.

In 2013, those states that embraced multiple parts of the Affordable Care Act (ACA) had an uninsured rate of 16.1%, which dropped to 12.1% this year. In comparison, the remaining states had an uninsured rate of 18.7% in 2013, which was still 16.5% in mid-2014.

This blueprint does not work for all states, though. Iowa, which both expanded Medicaid and set up a state-federal partnership actually saw its uninsured rate increase from 9.7% to 10.3%. Massachusetts, which already had the lowest uninsured rate in the country, saw no change.

Texas, which implemented neither mechanism, has the highest rate of uninsured (24%) despite a decline of 3 percentage points.

“While a majority of Americans continue to disapprove of the Affordable Care Act, the uninsured rate is declining, as the law intended,” Dan Witters wrote in a report on the data gathered as part of the Gallup-Healthways Well-Being Index.

Currently, 26 states (including New Hampshire, this summer) have chosen to expand Medicaid. However, other states are considering dropping their state-based exchanges to move to the federal exchange.

10. Connecticut

Current uninsured rate: 7.4%

Uninsured rate 2013: 12.3%

Change (percentage points): -4.9

Hartford

Connecticut has one of the lowest uninsured rates in the country, now. However, the state is home to both a city with the very affordable healthcare (Hartford) and one of the most expensive insurance markets (Fairfield). The former has 8 area hospitals, while the latter is home to affluent New York commuters.

It’s possible that Connecticut had such success because its exchange website was easy and took just 4 steps to get to the insurance comparison page.

9. New Mexico

Current uninsured rate: 15.2%

Uninsured rate 2013: 20.2%

Change (percentage points): -5

Albuquerque

Insurance rates in New Mexico were expected to increase by 130%, but that didn’t deter residents from signing up, apparently. However, a majority of consumers (more than 60%) in New Mexico are increasingly concerned over healthcare costs, according to a report from TransUnion.

8. California

Current uninsured rate: 16.3%

Uninsured rate 2013: 21.6%

Change (percentage points): -5.3

Ventura

California’s healthcare costs (like most things in the Golden State) are slightly higher than average. San Diego and San Francisco are 2 of the most expensive cities in the country when it comes to primary care visits. In San Francisco, the average doctor’s visit can cost as little as $117 or as much as $461.

7. Oregon

Current uninsured rate: 14%

Uninsured rate 2013: 19.4%

Change (percentage points): -5.4

Porltand

Oregon was among the many exchanges that had troubles at the beginning. Its state exchange was not fully accessible until a few weeks after the enrollment period opened, but that didn’t hamper its performance any.

6. West Virginia

Current uninsured rate: 11.9%

Uninsured rate 2013: 17.6%

Change (percentage points): -5.7

Morgantown

Perhaps the reason West Virginians flocked to sign up for insurance is because the state has one of the lowest well-being scores in the country. Plus, it has one of the worst death rates and it ranked among the worst for its overall health.

5. Colorado

Current uninsured rate: 11%

Uninsured rate 2013: 17%

Change (percentage points): -6

Telluride

The state managed to reduce its uninsured rate by a large percentage despite the fact that during open enrollment, phone representatives gave the incorrect date for the last day to enroll, according to HealthPocket’s test.

4. Washington

Current uninsured rate: 10.7%

Uninsured rate 2013: 16.8%

Change (percentage points): -6.1

Burien

The city of Burien, just south of Seattle, is in the top 10 cities with the most affordable healthcare, likely because it has a high ratio of primary care physicians to residents (1:887). The state managed to reduce its uninsured rate sharply despite the fact that phone help for its exchange was difficult to get a hold of during the enrollment period.

3. Delaware

Current uninsured rate: 3.3%

Uninsured rate 2013: 10.5%

Change (percentage points): -7.2

Wilmington

Delaware currently has the lowest uninsured rate in the country, surpassing even Massachusetts. However, prior to the ACA, the state’s uninsured rate was only slightly better than average.

2. Kentucky

Current uninsured rate: 11.9%

Uninsured rate 2013: 20.4%

Change (percentage points): -8.5

Louisville

The cost for healthcare isn’t particularly high in Kentucky. Unfortunately, though, residents aren’t getting very good outcomes for their money. The state has one of the worst death rates, plus its overall health ranking is among the worst in the country.

1. Arkansas

Current uninsured rate: 12.4%

Uninsured rate 2013: 22.5%

Change (percentage points): -10.1

Little Rock

Last year, Arkansas had the second-worst uninsured rate in the country, behind only Texas. Now, it has one of the better rates. The state was able to reduce its uninsured population despite the fact that costs likely increased for individuals. A report from the Wall Street Journal reported that costs for a 27-year-old single male on the bronze plan would be $190 compared to $31 in Little Rock before the ACA.