As you know, Obamacare was designed to lower uninsured rates and drive America to a fully insured, highly efficient healthcare system. Although the rollout of the law that set such ambitious aims for itself was disappointing, the end result was laudable with 8 million Americans enrolling for insurance coverage. Since the inception of the law, the country was divided into two camps, States which decided to build their own exchanges and States that refused.

Now, it appears that the States that created state-based exchanges are boasting the lowest uninsured rates in the country.

According to a recent survey conducted by Gallup and Healthways, States which embraced Obamacare have experienced substantial drops in the number of uninsured. The leader among these States is Arkansas, which opted for a partnership marketplace, and is showing a drop of 10.1 percentage points in the number of uninsured before and after the rollout of ACA. On second place, Kentucky is standing proud with a drop of 8.5 percentage points in uninsured people. Delaware showed a drop in uninsured from 10.5 percent to 3.3 percent, owing to the Medicaid expansion and the partnership exchange working in the state. Similarly, Washington, Colorado, W. Virginia, Oregon, California and New Mexico showed percentage point drops in the range of 5, while Connecticut showed a 4.9 percentage point change.

The overall change for States which expanded Medicaid and established state exchanges came out as 4 percent, while States that did not participate in either of these showed a change of only 2.2 percent. On the same track, the national uninsured rate is only 13.4 percent now, the lowest since 2008. The combined effect of private health insurance exchanges, Medicaid expansion, and CHIP implementation has contributed 10 million new enrollments to the system.

On the other hand, for States which did not align with the ACA, the change in the number of uninsured was only marginal. Florida, a highly crucial state, has 18.9 percent people uninsured in the state, with 3.2 percent people buying health insurance through Similarly, Texas recorded a 3 percentage point difference, and now has 24 percent population uninsured. Louisiana has a similar story, with 18.4 percent uninsured after a 3.3 percentage point difference due to Obamacare enrollment. Most of these States experienced this slight drop in the number of uninsured due to the availability of subsidized private health insurance available to people earning up to 400% of the federal poverty level.

Even after Obamacare’s solid contribution to lowering the number of uninsured in the country, some States showed an increase in people without health insurance. The biggest increase was shown by Kansas, which exhibited 5.1 percentage point increase in the number of uninsured, finally recoding 17.6 percent uninsured in the state. Iowa now has 10.3 percent uninsured, up from 9.7 percent before the rollout of ACA. Virginia has shown an increase of 0.1 percentage points.

The decisions States made in 2013 had a huge impact on the enrollment numbers of 2014. Now, with the second open enrollment period beginning from 15th November, the count of uninsured might change noticeably. There are some changes in Sate strategies toward Obamacare, such as Idaho going for a state-based health exchange, Massachusetts redesigning its exchange for better performance, and Oregon defecting to the federal marketplace for covering up the mess created by its state exchange. All these changes will influence the national uninsured rate as well as individual state uninsured rate. In effect, States which embraced ACA are reaping benefits of a timely, smart decision to stick with the law while remaining States repent their past moves and look to improve their numbers in the approaching open enrollment period.

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