The Patient Protection and Affordable Care Act's health insurance mandate has been in effect for years now, and brought low-cost coverage to millions of Americans who would have had trouble obtaining it before. However, that comes with a major caveat: The vast majority of those who have become covered as a result of the law are located mainly in the northern half of the country.
New analysis shows that the vast majority of people who are still going without some sort of health insurance - whether through an employer, on their own, via the federal exchanges, or government programs like Medicaid and Medicare - are mainly located in a belt stretching from the Southeast to the Southwest, but also up into the more northern Mountain states, according to a report from the New York Times. Experts say this shouldn't come as much of a shock, because the states where lack of insurance - particularly among low-income consumers - is still a major issue also tend to be those where Republican-run state governments did not set up their own exchanges or expand Medicaid to cover more people.
A broader trend
Indeed, some of these trends suggest that what really hampers enrollment is simply the lack of expanded Medicaid programs, the report said. For example, Mississippi has held fast when it comes to keeping that program closed, and as a result, insurance rates have actually worsened there for 2015 when compared with last year. Meanwhile, Pennsylvania and Indiana, which did not expand Medicaid for 2014 but did this year, have seen huge declines in uninsurance rates as a result in less than a year.
Ed Coleman, the director of data and analytics for Enroll America, which helped compile the data in the study, told the newspaper that this comes as little surprise, the report said. While rates of uninsurance declined more or less across the board between 2013 and 2014, the state-by-state trends seen this year were far more predictable because of the lack of Medicaid expansion.
Indeed, in 19 states where Medicaid was not broadened, some 3 million Americans are stuck between making too much to qualify for Medicaid, but not enough to be able to buy coverage on the federal exchanges, the report said. In many of these places, about 1 in 6 people simply do not have any health insurance at all, constituting a major problem not only for them personally, but also the health care ecosystem in those areas and, to a lesser extent, nationwide.
However, the data may not be entirely accurate when it comes to regions of the country that are largely rural, or have large populations of Hispanic or Native American tax payers, the report said. States like Alaska, New Mexico, Texas, and Arizona have some potentially erroneous reported data that could sort itself out for 2016.
This is an issue in which health insurers have a vested interest. The more that can be done to reduce rates of uninsurance in places where it still reigns, the better off the entire healthcare ecosystem is likely to be.