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Kentucky, Arkansas post largest drops in uninsured rates

Staff Writer |
Kentucky and Arkansas have seen the greatest reductions in their adult uninsured rates since several major aspects of the Affordable Care Act (ACA) went into effect, each down over 12 percentage points since 2013.

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The other four states whose residents report at least 10-point declines since that time are West Virginia, New Mexico, California and Oregon.

Nationwide, the uninsured rate fell to 10.9% in the fourth quarter of 2016, from 17.3% in 2013.

These data, collected as part of the Gallup-Healthways Well-Being Index, are based on Americans' answers to the question, "Do you have health insurance coverage?"

The state-level data are based on daily surveys conducted from January through December 2016 and include state-level sample sizes ranging from 465 randomly selected adult residents in Delaware to more than 17,000 in California.

The data for 2013 were also collected over a 12-month period and are based on similar sample sizes for each state. A full list of the 2013 and 2016 uninsured rates for all 50 states appears at the end of this article.

The ACA marketplace exchanges opened on Oct. 1, 2013, and most new insurance plans purchased during the fourth quarter of that year kicked in on Jan. 1, 2014.

Medicaid expansion among initially participating states also began in 2014, with many more states expanding since that time. The ACA originally mandated that states expand their Medicaid programs to provide healthcare coverage to more low-income adults.

A Supreme Court ruling later overturned this part of the law, essentially making Medicaid expansion for any given state optional. The onset of these two major mechanisms at the beginning of 2014 makes 2013 uninsured rates the natural benchmark point for comparison.

All 10 states with the greatest reductions in their uninsured rates have expanded Medicaid as part of their implementation of the Affordable Care Act.

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