When the Affordable Care Act was rolled out in 2014, clear trends began to emerge about who has health insurance in America and who doesn’t. The New York Times analyzed the progress of Obamacare using the help of two organizations that are closely monitoring the situation. The original analysis from last year showed the drastic effects that the health law had on reducing the number of uninsured Americans. As the data continues to come in, regional patterns are becoming evident.
Those that are still without insurance are mostly in the South and Southwest, mostly in Republican-voting states. They tend to be from low-income families. These trends seem to show that national health care is still being influenced by state-level politics.
The upper Midwest and Northeast states were early adopters of the Affordable Care Act and immediately acted to expand Medicaid for their citizens. As a result, the rates of those without insurance have fallen into the single digits. Conversely, those states in the South and Southwest that have yet to expand Medicaid are showing the highest rates of uninsured Americans.
According to Ed Coleman, the director of analytics at Enroll America, “This year it’s more of a state-specific story. There was a pronounced drop pretty much everywhere last year, and we don’t see that pattern again this time around.” The states whose politicians have decided to forgo Medicaid expansions are effectively trapping their low-income citizens in a “Medicaid gap”. These families are too poor to qualify for subsidies in the healthcare marketplace, but they’re still unable to get into a government program.
A few Republican-leaning states have expanded their Medicaid programs, though many have not. The trends show that states with Republican leaders continue to have more residents without insurance than Democratic-leaning states. However, these red and blue states have seen very similar rates of decline in uninsured rates since 2013.