Numbers Of Americans With Health Plans Way Up, But States Vary

Aug 6, 2014
Originally published on August 6, 2014 9:47 am

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

In the latest survey, the percentage of uninsured Americans dropped from 18 in September 2013 to 13.4 in June 2014. States that chose to follow the health law's provisions most closely, by both expanding Medicaid and establishing their own health insurance marketplaces, saw their uninsured rate drop nearly twice as much (as a group) as states that declined those opportunities.

"So there's a clear difference in the states that have implemented those mechanisms versus those that haven't," says Gallup's Dan Witters.

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," says Dr. Joe Thompson, Arkansas' surgeon general. Thompson lobbied for his state's unique, bipartisan Medicaid expansion, which uses federal funding to buy private insurance for people with low incomes. He says about 80 percent of those with new, private insurance in Arkansas purchased it with Medicaid subsidies.

"Those other states that have chosen not to make something good happen out of the Affordable Care Act," Thompson says, "are missing that opportunity on behalf of their citizens."

Those states include Georgia, Indiana and Mississippi, all of which saw their own rates of uninsured residents drop less than 2 percentage points.

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

"Access to health care is not expanding Medicaid," he says. "Mainly from a financial standpoint we simply cannot afford to expand Medicaid and we will not expand Medicaid." Mims says the Legislature is taking steps to expand access to health care, such as allocating more money to federal clinics, opening access to mental health clinics, and working on programs to get more doctors and dentists to the state.

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

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

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

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Poll numbers are starting to confirm what a lot of healthcare analysts have been predicting. The number of people with health insurance in America is growing, and levels are up significantly more in states that have embraced the Affordable Care Act. Eric Whitney reports on the latest Gallup survey.

ERIC WHITNEY, BYLINE: Late last year when the website was having big problems, Republican congressmen like Cory Gardner of Colorado were on the attack. Here's Gardner on MSNBC in November talking about how many people had received cancellation notices telling them their current health coverage didn't meet the law's new standards.


CONGRESSMAN CORY GARDNER: It's 250,000 people in Colorado who have lost their insurance thanks to Obamacare. The president's bill is not working, and it's time that we replace it with something that will work.

WHITNEY: Fast forward to today and the release of a new Gallup poll on the number of uninsured now. Dan Witters works for Gallup.

DAN WITTERS: Colorado's had a net decline in the uninsured as has the United States.

WHITNEY: Witters says the uninsured rate nationwide is about four and a half percent lower now versus a year ago. That was before Americans were required to have health insurance. But the Gallup poll shows a lot depends on where you live. Some states chose to impliment two of the health care law's major but optional mechanisms - to expand Medicaid and to set up their own health insurance marketplaces or exchanges.

WITTERS: Those states that have not embraced those two major mechanisms have had about half of the decline in uninsured. So there's a clear difference in the states that have implemented those mechanisms versus those who haven't.

WHITNEY: States like Mississippi, Missouri and Indiana, which are resisting the law, saw only small declines in the number of uninsured. Kentucky, California and Delaware saw larger drops. The state with the biggest reduction in the number of uninsured was Arkansas which saw a 10 percent drop. Doctor Joe Thompson is Arkansas' Surgeon General.

JOE THOMPSON: So we clearly are having an impact that benefits our citizens, and 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.

WHITNEY: Colorado Congressman Cory Gardner declined to comment for this story. Colorado ranks fifth among states that have seen the biggest drop in the number of uninsured, according to the Gallup poll. Gardner is in a close U.S. Senate race and continues to campaign on repealing the federal health care law. Gallup and other polls show that nationwide, most Americans continue to disapprove of the law. For NPR News, I'm Eric Whitney.

BLOCK: This story is part of a reporting partnership of NPR and Kaiser Health News. Transcript provided by NPR, Copyright NPR.