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New Study Confirms What We Already Knew: The Affordable Care Is Working


The rate of uninsured continues to drop to record lows, according to new data from Gallup — and it’s declining the fastest among the communities who have historically lacked adequate access to health care. The findings indicate that the Affordable Care Act is effectively expanding coverage to the people who need it the most.

The latest figures on the the uninsured rate were hotly anticipated, as they are the first to capture some of the effects of the late-March surge in enrollment. The findings are solid.

According to Gallup, the uninsured rate plunged to 13.4% from a peak of 18% last October. The sharp decline in the number of Americans without insurance coincided with the opening of the federal and state insurance marketplaces established under the Affordable Care Act, as well as the expansion of the federal Medicaid program in 27 states and the District of Columbia. This marks “the lowest monthly uninsured rate recorded since Gallup and Healthways began tracking it in January 2008.”

Here’s the chart from Gallup showing the history of its tracking on the question, including the peak last year followed by the sharp decline:


The uninsurance rate fell across all demographic groups, but Gallup’s researchers noted that it dropped particularly significantly among non-white and lower-income Americans. Those are the groups that were expected to benefit the most from the provisions in the Affordable Care Act, since they’ve traditionally suffered from higher rates of uninsurance. Compared to the fourth quarter of 2013, the uninsurance rate among black adults fell by 7.1 percentage points, the biggest drop among any group. Among Hispanics, the rate is down 5.5 points. And among Americans with an annual household income of less than $36,000, the rate also dropped by 5.5 points.

But the recent gains aren’t being dispersed equally across states. As Gallup has noted, the uninsured rate is falling much faster in states that have expanded Medicaid. In more than 20 states, Republican governors and legislators are continuing to refuse the Affordable Care Act’s optional Medicaid expansion, a move that’s denying health care for millions of the working poor. The impact of the GOP’s opposition to expanding Medicaid disproportionately harms low-income people of color. Moreover, the states refusing the Medicaid expansion are the ones that need it the most: residents of these states were already more likely to be uninsured, and Gallup’s new findings show that this disparity is only getting worse. And to top it off, the GOP-led states refusing to expand Medicaid are home to people who tend to be poorer and sicker than the residents in other states.

Unsurprisingly, previous Gallup studies show that states that have embraced the Affordable Care Act — including the Medicaid expansion — are faring significantly better than those where Republican governors failed to fully implement the health care law. The uninsurance rate is falling the fastest in the states that implemented the Medicaid expansion and set up their own statewide exchanges in the health insurance marketplace. Meanwhile, residents in states like Oklahoma, Texas, Wyoming, Alabama, and Missouri — where GOP legislators have refused to lift a finger to implement the health care law — don’t know as much about their options for enrolling in health insurance and are less likely to be able to find help to sign up for coverage.

Overall, the new findings from Gallup mirror other studies conducted in the final stages of the Affordable Care Act’s first open enrollment period. Gallups’s own survey last month yielded similar findings, though the uninsured rate has dropped significantly just in the past four weeks. A recent report from The Health Reform Monitoring Survey showed a drop to 15.2% in the first quarter of 2014, and a RAND Corporation survey released early last month found the uninsured rate dropped almost 5 percentage points. Subsequent figures from the Congressional Budget Office showed a drop to 16%. The CBO said it expects the uninsured rate to fall even farther in the coming years.

If Republicans stopped obstructing progress in implementing the health care law, these numbers would even better. As of April 1, about 4.5 million low-income Americans who were in need of coverage have gained access to public health insurance through the Affordable Care Act’s Medicaid expansion — but if all states had expanded Medicaid, this number would top 10 million. 

While the GOP is using the Affordable Care Act to make a political statement, millions of Americans are paying the price –and the consequences couldn’t be more severe. According to a recent Harvard study, over 700,000 residents of states that did not implement the Medicaid expansion will be denied appropriate treatment for depression, over 420,000 will not have access to necessary diabetes medications, and almost 700,000 women will not be able to get recommended pap smears and mammograms. The same study also found that an estimated 17,000 people will die directly as a result of the GOP’s refusal to expand Medicaid.

Despite these staggering figures, Republicans are still committed to denying health insurance to millions of Americans.


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