Health Care In The States

Survey: Insurance Rates Lag In Health Law Holdout States

By Eric Whitney

August 6th, 2014, 8:00 AM

A Gallup poll released Tuesday says that the Affordable Care Act is significantly increasing the number of Americans with health insurance, especially in states that are embracing the law. It echoes previous Gallup surveys, and similar findings by the Urban Institute and RAND Corp.

The latest Gallup survey found that, nationwide, the number of uninsured Americans dropped from 18 percent in September 2013, to 13.4 percent in June 2014. States that chose to follow the ACA’s provisions most closely, both by expanding Medicaid and establishing their own new health insurance marketplaces, as a group saw their uninsured rate drop nearly twice as much as states that declined to do so.

“Those states that have not embraced those two major mechanisms have had about half of the decline in uninsured,” said Gallup’s Dan Witters. “So there’s a clear difference in the states that have implemented those mechanisms versus those who haven’t.”

Arkansas saw the biggest decline in its uninsured rate, from 22 percent to 12 percent. Kentucky, Delaware and Colorado also saw significant declines.

“To drop 10 percent in the uninsured rate within really just six months is really an incredible achievement,” said Arkansas Surgeon General Dr. Joe Thompson. Thompson lobbied for his state’s unique, bipartisan Medicaid expansion, which uses federal funding to buy private insurance for low income people. He says about 80 percent of those with new, private insurance in Arkansas purchased it with Medicaid subsidies.

“Clearly we are having an impact that benefits our citizens,” said Thompson. “Those other states that have chosen not to make something good happen out of the Affordable Care Act are missing that opportunity on behalf of their citizens.”

Among the states that didn’t expand Medicaid or set up their own exchanges are Georgia, Indiana and Mississippi, all of which saw their uninsured rates drop less than 2 percentage points.

Sam Mims, a Republican state legislator from southwest Mississippi, said the Affordable Care Act is still not the right way to go for his state.

“Access to health care is not expanding Medicaid,” Mims said.  “I still believe Mississippi cannot afford it for several reasons. Mainly from a financial standpoint we simply cannot afford to expand Medicaid and we will not expand Medicaid.”

He said the legislature is taking steps to expand access to health care, such as allocating more money to federal clinics, expanding mental health clinics and working on programs to get more doctors and dentists to the state.

Not every state that expanded Medicaid saw big drops in the percentage of uninsured. Massachusetts and Hawaii  saw declines of less than 1 percentage point, for example. Gallup’s Witters said that’s because those states already had very low uninsured rates prior to the ACA.  California, which fully embraced the law but has a higher number of uninsured than any other state, saw a decrease of 5.3 percentage points in its uninsurance rate, according to the survey.

Kansas saw its uninsurance rate pop up by 5.1 percentage points, and Virginia and Iowa also saw slight increases in their uninsurance rates that were within the poll’s margin of error of plus or minus 1 to 2 percentage points.

The telephone poll was part of the Gallup-Healthways Well-Being Index, and it included more than 178,000 people interviewed in 2013 and more than 88,000 people surveyed in the first half of 2014.

Jeffrey Hess of Mississippi Public Broadcasting contributed to this report.

This story is part of a reporting partnership between NPR, Mississippi Public Broadcasting and Kaiser Health News.

4 Responses to “Survey: Insurance Rates Lag In Health Law Holdout States”

  1. Harry says:

    Sad to say, roughly half of America’s fifty states never progressed too far past the 18th century when it comes to their culture. Time stood still in southern and mid-western America while the rest of America moved on. In the south and mid-west, intellectual and artistic awareness, education, cultivation, enlightenment, discernment, discrimination, good taste, refinement, polish, sophistication and, of course, healthcare all somehow got frozen in time. The irony is, the people that live there seem to like it! How do we know? They keep electing Republicans. There’s no better way to stay in the dark ages than to vote for Republicans. Electing Republicans to Congress and to local government will guarantee you a ticket back in time. Back to the age of Neanderthals. So, if living in communities that still have dirt roads and raw sewage running into creeks and streams, then vote Republican!

  2. CharleyX says:

    In response to the comment above… How many people retire in the South and move to the North?

  3. Miller says:

    As a result of The Great Bush/Cheney Recession of 2008, most people lost their entire retirement nest egg. Only a moron would ask such a stupid question knowing full well that only the most wealthy people can retire someday. Whether they have a dream to retire in the North or in the South, it matters not. Average Americans will never get a chance to retire in their lifetime. Average Americans will work until they drop. Duh! What a moronic question!

  4. Vanessa says:

    People who retire in the south do it for one of three reasons: it is warmer, it is cheaper, or they have family there. It is NOT because it is more enlightened, more fair, more politically aware, more environmentally safe, more culturally advanced, or safer. I have lived in the west, the mid-west, and the south. The south is by far the least favorable for any cultural purposes. It is cheaper for a reason: low wages that are a result of a culture that values exploiting labor, and politicians who strip all services and ignore all infrastructure.