How Obamacare Increased Insurance Coverage in Every State

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46. Arkansas
> Ppt change in uninsured rate, 2012-2015: -8.6
> Expanded Medicaid?:
yes
> Pct. population without health insurance, 2012: 16.4% (15th highest)
> Pct. population without health insurance, 2015: 7.8% (24th lowest)

An estimated 16.4% of Arkansas residents did not have health insurance in 2012, the 15th highest rate at the time. By March this year, the percentage had fallen by 8.6 percentage points, the fifth largest drop nationwide. After the coverage increase, 7.8% of state residents still did not have health insurance, the 24th lowest share in the country. Low-income Arkansas residents were by far the largest group to benefit from the ACA. As a result of the Medicaid expansion, 268,000 state residents gained health insurance, the vast majority of the total improvement.

Arkansas was the first state to announce its intentions to partner with the federal government to roll out the Affordable Care Act. Recently, Governor Asa Hutchinson received approval from the HHS to take full control of the health insurance exchange. The program will be fully state-run by 2016.

47. California
> Ppt change in uninsured rate, 2012-2015: -9.0
> Expanded Medicaid?:
yes
> Pct. population without health insurance, 2012: 17.9% (9th highest)
> Pct. population without health insurance, 2015: 8.9% (21st highest)

California established its own state-run exchange, Covered California, early on and expanded Medicaid. To assist the state with building its health insurance exchange and expansion programs, California received more than $1 billion in federal grants between 2010 and 2014.

In 2012, before the Health Insurance Marketplace open enrollment period began, 17.9% of California’s population did not have health insurance. Since then, the uninsured rate has fallen by 9 percentage points to 8.9%, just lower than the national rate. The state’s expansion of Medicaid was by far the largest contributor to the decline in the uninsured rate. As of January, more than 3 million low-income residents in California gained health insurance under the expansion.

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48. Oregon
> Ppt change in uninsured rate, 2012-2015: -10.1
> Expanded Medicaid?:
yes
> Pct. population without health insurance, 2012: 14.9% (18th highest)
> Pct. population without health insurance, 2015: 4.8% (7th lowest)

An estimated 14.9% of Oregon residents did not have health insurance in 2012. By March this year, since the implementation of the Affordable Care Act, the percentage had fallen by 10.1 percentage points to 4.8%, the third largest drop nationwide. Low-income residents were by far the largest group to benefit from the ACA. As of January, since the state expanded Medicaid, more than 400,000 Oregon residents had received health insurance.

Oregon was one of five states that experienced significant technical issues with the roll out of its online exchange. Had the state exchange been implemented without a hitch, the 10.1 percentage point drop in the uninsured population may have been even larger.

49. New Mexico
> Ppt change in uninsured rate, 2012-2015: -10.2
> Expanded Medicaid?:
yes
> Pct. population without health insurance, 2012: 18.4% (5th highest)
> Pct. population without health insurance, 2015: 8.2% (25th highest)

After open enrollment in the Health Insurance Marketplace began on October 1, 2013, health insurance coverage in every state increased. In New Mexico, the percentage of the population without health insurance decreased from 18.4% in 2012 to 8.2% as of March this year, the second largest improvement nationwide. With a poverty rate of 21.9% — the second highest nationwide — Medicaid expansion under the ACA had an especially large impact in New Mexico. As a result of the expansion, 230,000 New Mexicans received health insurance.

Initially, New Mexico opted to manage its own health care insurance exchange for small businesses, while the federal government managed the marketplace for individuals. Later, the state implemented its own all-encompassing exchange website, BeWellNM.com, for individuals and businesses.

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50. Kentucky
> Ppt change in uninsured rate, 2012-2015: -10.4
> Expanded Medicaid?:
yes
> Pct. population without health insurance, 2012: 13.9% (23rd highest)
> Pct. population without health insurance, 2015: 3.5% (4th lowest)

Nearly 600,000 Kentucky residents did not have health insurance in 2012, or 13.9% of the state’s population. As of March 2015, since the Affordable Care Act was implemented, the percentage of Kentuckians without health insurance had dropped by 10.4 percentage points — the largest decline compared to other states. Kentucky was one of 31 states to expand Medicaid under the ACA, and low-income residents were among the primary beneficiaries of the legislation. Nearly half a million people gained health insurance as a result of the expansion.

The state also chose to run its own health care exchange, Kynect, which has been praised as among the best-run exchanges in the nation. Future reductions in the rate of the uninsured population largely depend on decisions from state officials, and future leaders could have a significant impact on the program’s success going forward, particularly in Kentucky. GOP gubernatorial candidate Matt Bevin recently vowed to dismantle the exchange and cancel the Medicaid expansion.