Obamacare's Impact on the Uninsured, State by State

[QueEx]

Obamacare's Impact on the Uninsured, State by State
Where officials wanted it to work, it did
​

Obamacare is already making a big difference in the states that actually embraced it.

States that expanded Medicaid and created their own health insurance exchanges, or worked closely with the federal government to cover more people, have shown the largest drops in their uninsured rates this year, according to a new poll released by Gallup and Healthways on Tuesday.

Leading the pack was Arkansas, where the uninsured rate has fallen by 10.1 percentage points so far this year, and Kentucky, where it has fallen 8.5 percentage points.

Multiple surveys and studies conducted since the first Affordable Care Act sign-up period officially ended on March 31 suggest President Barack Obama's signature health care reform law is succeeding in one of its chief aims: extending coverage to Americans who lacked health insurance.

The Gallup poll underscores the crucial role played by states, which varied in their approach to Obamacare from fully cooperating with its implementation to actively obstructing it. States have the option of establishing their own insurance exchanges, partnering with the federal government or deferring entirely to the Department of Health and Human Services. States also have a choice between accepting federal dollars to make Medicaid available to more of their poorest residents or rejecting the funding.

The results of those decisions are clear. States that welcomed the law saw significant drops in their uninsured rate, according to Gallup. The findings are consistent with other recent research showing the uninsured rate barely moved in states that didn't expand Medicaid.

The uninsured rate fell 10.1 percentage points to 12.4 percent as of June 30 in Arkansas, which broadened Medicaid eligibility through its "private option" plan using private insurance companies and teamed up with the federal government on an insurance exchange. Kentucky, which has its own exchange and expanded Medicaid, saw its uninsured rate drop 8.5 percentage points, to 11.9 percent. And in Delaware, which also expanded Medicaid and has a partnership exchange, the uninsured rate fell from 10.5 percent to 3.3 percent, Gallup found.

Washington state, Colorado, West Virginia, Oregon, California and New Mexico each cut their uninsured rates by at least 5 percentage points, and Connecticut's fell 4.9 percentage points.

Overall, the uninsured rate fell 4 percent in states that expanded Medicaid and either set up an exchange or partnered with the federal government, compared with 2.2 percent in states that did neither, Gallup found.

The nationwide uninsured rate is 13.4 percent, the lowest since 2008, Gallup reported in a separate survey last month. HHS estimates that thanks to Obamacare, more than 10 million more people are now covered by private health insurance, Medicaid or the Children's Health Insurance Program than before.

Even without expanding Medicaid, the uninsured rate still fell at least slightly in most states that didn't help with Obamacare, according to the Gallup poll. This likely is due in large part to the availability of subsidized private health insurance via the exchanges for people earning more than the federal poverty level, which was $11,490 for a single person during the enrollment period for this year.

For instance, several states that had higher-than-average uninsured rates saw declines. In Florida, the share of residents without health coverage declined 3.2 percentage points to 18.9 percent. In Texas, it dropped to 24 percent, a 3-percentage-point difference. And in Louisiana, 18.4 percent of residents are now uninsured, 3.3 percentage points lower than before Obamacare enrollment. Three states actually recorded an increase in the uninsured rate since September: Kansas, by 5.1 percentage points to 17.6 percent, Iowa, by 0.6 percentage points to 10.3 percent, and Virginia, by 0.1 percentage points to 13.4 percent Gallup found.

For 2014 enrollment, 26 states and the District of Columbia adopted the Medicaid expansion, [url="http://kff.org/health-reform/state-indicator/state-decisions-for-creating-health-insurance-exchanges-and-expanding-medicaid/]16 states and the District of Columbia[/url] fully operated exchanges, seven states opted for partnership exchanges and the remainder allowed HHS to run their exchanges. The breakdown of state and federal exchanges may be different for the enrollment period for 2015 health coverage that begins Nov. 15. For example, Idaho plans to switch to a state-run exchange, while Oregon will allow the federal government to handle enrollment.

For its study, Gallup interviewed almost 89,000 adults in all 50 states and the District of Columbia by phone. The margin of error ranges from plus or minus 1 percentage point to 3.5 percentage points in states with small populations, such as Delaware, Hawaii, North Dakota, South Dakota and Wyoming.

​

http://www.huffingtonpost.com/2014/08/05/states-obamacare_n_5650606.html?ncid=txtlnkusaolp00000592

 

[QueEx]

The spread was pretty big. You can see it in the above map, which the
Huffington Post constructed. Arkansas seemed to make the most progress:
In that state, by Gallup's reckoning, the ranks of the uninsured fell by 10.1
percentage points. Nest was Kentucky, at 8.5 percentage points. After
came Delaware, Washington, and Colorado. But in some states, Gallup
found the rate fell by much less or not at all.

In Kansas, the Gallup determined, the number of people without health
insurance actually increased by 5.1 percent.



​

 

[QueEx]

Arkansas, Kentucky Report
Sharpest Drops in Uninsured Rate​

Medicaid expansion, state exchanges linked to faster reduction in uninsured rate​

Gallup
by Dan Witters
August 5, 2014


WASHINGTON, D.C. -- Arkansas and Kentucky lead all other states in the sharpest reductions in their uninsured rate among adult residents since the healthcare law's requirement to have insurance took effect at the beginning of the year. Delaware, Washington, and Colorado round out the top five. All 10 states that report the largest declines in uninsured rates expanded Medicaid and established a state-based marketplace exchange or state-federal partnership.

As Gallup previously reported, the states that chose to expand Medicaid and set up their own health exchanges had a lower uninsured rate to begin with: 16.1% compared with 18.7% for the remaining states -- a difference of 2.6 percentage points. The already notable gap between the two groups of states widened through the first quarter to 4.3 points, as states that have implemented these core mechanisms of the Affordable Care Act reduced their uninsured rates three times more than states that did not implement these core mechanisms.

These data, collected as part of the Gallup-Healthways Well-Being Index, are based on respondents' self-reports of health insurance status based on the question, "Do you have health insurance coverage?"

Uninsured Rates Continue to Drop More in States Embracing Multiple Parts of Health Law

The uninsured rate in the states that have chosen to expand Medicaid and set up their own state exchange in the health insurance marketplace has declined significantly more in the first half of 2014 than in the remaining states that have not done so. The uninsured rate declined 4.0 points in the 21 states that have implemented both of these measures, compared with a 2.2-point drop across the 29 states that have implemented only one or neither of these actions.

Some states have chosen to implement state-federal "partnership" exchanges, where states run certain functions and make key decisions based on local market and demographic conditions. For the purposes of this analysis, these partnerships are included with the state exchanges. New Hampshire, which manages a state-based exchange but has only recently voted to expand Medicaid, is not included, as its eligible residents were not privy to expanded Medicaid through the first six months of 2014. Four states -- North Dakota, New Jersey, Ohio, and Arizona -- have decided to expand Medicaid without also administering a state-based exchange or partnership, while several others continue to debate its expansion. The District of Columbia, which has expanded Medicaid and has implemented a locally managed exchange, is not included in this analysis.


Implications

While a majority of Americans continue to disapprove of the Affordable Care Act, the uninsured rate is declining, as the law intended. Nationally, 17.3% of U.S. adults reported being without health insurance in 2013, a rate that had slowly increased from 14.8% in 2008. The uninsured rate peaked at 18.0% in the third quarter of 2013 -- the three months immediately preceding the opening of the healthcare exchanges -- and has since declined to 13.4% in the second quarter of 2014, the lowest quarterly rate in more than six years of Gallup-Healthways Well-Being Index trending.

At the state level, those that have implemented two of the law's core mechanisms -- Medicaid expansion and state health exchanges -- are seeing a substantially larger drop in the uninsured rate than states that did not take both of these actions. Consequently, the gap in uninsured that existed between the two groups in 2013 has now nearly doubled through the first half of 2014.

Many states continue to debate implementing these actions. New Hampshire recently became the 26th state (plus the District of Columbia) to expand Medicaid, which takes effect this summer. Utah, a conservative state with a Republican governor, Gary Herbert, continues negotiation with the Centers for Medicare and Medicaid Services to have revised, more flexible terms than what is detailed in the Affordable Care Act. Utah expanding Medicaid could serve as a blue print for other red states to follow, as could similar scenarios playing out in Indiana and Pennsylvania.

Other states, in turn, are debating dropping their state-based exchanges and moving to the federal exchange because of technological issues or unexpected cost-related challenges. Oregon has recently voted to move from a state-based to a federal-based exchange, while Maryland is modifying its troubled website to model Connecticut's. Officials from the states of Massachusetts and Hawaii -- both of which had comparatively low uninsured rates to begin with but show little or no change since 2013 -- are also considering switching to the federal exchange, indicating that locally managed exchanges are not necessarily optimal for insurance sign-ups in some states.

States With Both Medicaid Expansion and State
Exchanges Report Biggest Drop in Uninsured Rate

<iframe width="560" height="315" src="//www.youtube.com/embed/AtjQ49ovfSI" frameborder="0" allowfullscreen></iframe>
​

​

http://www.gallup.com/poll/174290/arkansas-kentucky-report-sharpest-drops-uninsured-rate.aspx#1

 

[QueEx]

State-By-State

​

 

[Upgrade Dave]

The other half of the story is in states where the uninsured rate has risen, the Republicans blame it on Obamacare.

Go figure.

http://talkingpointsmemo.com/livewire/phil-bryant-uninsured-mississippi-blame-obama-expand-medicaid


MS Gov Blames Obama For Jump In Uninsured After Refusing To Expand Medicaid


ByDaniel StraussPublishedJuly 28, 2014, 10:50 AM EDT 21026 views






Mississippi Gov. Phil Bryant (R) blamed President Barack Obama for a reported increase in uninsured Mississipians. The problem is, Bryant didn't acknowledge that he's been a staunch opponent of expanding Medicaid under Obamacare and refused to encourage enrolling in private coverage through Healthcare.gov.


Bryant directed his blame at Obama in response to a question about a WalletHub study that showed an increase in the percentage of uninsured Mississippians. The study found that the uninsured rate increased by 3.34 percentage points to 21.46 percent of Mississippi's population, according to the Northeast Mississippi Daily Journal.

"If statistics show that the ill-conceived and so-called Affordable Care Act is resulting in higher rates of uninsured people in Mississippi, I'd say that's yet another example of a broken promise from Barack Obama," Bryant said.

An estimated 137,800 people in Mississippi were left uncovered by health insurance because the state did not expand Medicaid.

Mississippi Democrats pounced on Bryant's comments.

"It is sad how many out there need health care who are not getting it. I hear from them every day. We ought to be ashamed of ourselves for not taking the federal money to expand Medicaid," state Rep. Steve Holland (D) said.

 

[QueEx]

The other half of the story is in states where the uninsured rate has risen, the Republicans blame it on Obamacare.

Go figure.

. . . casting blame and failing and refusing to:

. . . acknowledge that he's been a staunch opponent of expanding Medicaid under Obamacare and refused to encourage enrolling in private coverage through Healthcare.gov.

​

. . . HypoFuckinCrits.

 

[thoughtone]

. . . casting blame and failing and refusing to:

. . . HypoFuckinCrits.

...but there will be a significant amount of conservatives, republicans, libertarians, capitalists, et al, that will return those "HypoFuckinCrits" to office.

...Go figure.

 

[QueEx]

...but there will be a significant amount of conservatives, republicans, libertarians, capitalists, et al, that will return those "HypoFuckinCrits" to office.

...Go figure.

In a lot of congressional districts though, because some people maybe stayed home during midterm elections past (i.e., 2006), the hypofuckincrits have rigged the numbers (through careful redistricting) so that many of them are in safe districts where voter turn-out of "non-crazies" is no longer of any real moment . . .

 

[Upgrade Dave]

In a lot of congressional districts though, because some people maybe stayed home during midterm elections past (i.e., 2006), the hypofuckincrits have rigged the numbers (through careful redistricting) so that many of them are in safe districts where voter turn-out of "non-crazies" is no longer of any real moment . . .

On this they've had cooperation on the state level from Democrats who are more interested in gaining some small measure of personal power than the general well being of their constituents.

 

[thoughtone]

In a lot of congressional districts though, because some people maybe stayed home during midterm elections past (i.e., 2006), the hypofuckincrits have rigged the numbers (through careful redistricting) so that many of them are in safe districts where voter turn-out of "non-crazies" is no longer of any real moment . . .

However, whether Dem or GOP, voting for the "crazies" actually casts judgement on the intelligence on the voters of these safe districts.

 

[QueEx]

On this they've had cooperation on the state level from Democrats who are more interested in gaining some small measure of personal power than the general well being of their constituents.

Precisely.

 

[thoughtone]

source: TPM

Yet Another GOP State Is Moving To Expand Medicaid Under Obamcare

n a growing trend, Tennessee looks like it will be the next Republican-led state to move toward expanding Medicaid under Obamacare.

The Tennessean reported that Gov. Bill Haslam (R) said Thursday that Tennessee would aim to submit a Medicaid expansion plan to the Department of Health and Human Services "some time this fall." The program would cover more than 150,000 low-income residents in the state.

Like 24 other states, almost all of them with statehouses controlled by Republicans, Tennessee declined to expand Medicaid in the initial rollout of Obamacare last year, leaving tens of thousands of people uninsured. Since then two of those states have changed course and embraced Medicaid expansion, and another three states have expressed an interest in doing so. Tennessee now joins the latter group.

Tennessee and HHS have had some informal negotiations, including meetings between Haslam and then-HHS Secretary Kathleen Sebelius, over the last few years. Haslam said on Thursday that he recently spoke by phone with Sebelius's successor, Sylvia Mathews Burwell, and that he hoped to set up a meeting with Burwell soon, according to The Tennessean.

Haslam has floated a "private option" plan, using Medicaid dollars to pay for private coverage, as has been done in Arkansas and Iowa. Other pieces of the Tennessee plan could include co-payments and incentives for healthy behavior, based on the governor's past public comments.

Such a modified Medicaid expansion would require approval from HHS. The agency has already shown willingness to accept alternative plans and approved Thursday a proposal from Pennsylvania with some similar features.

 

[QueEx]

​

 

[QueEx]

Nearly half of uninsured are eligible for subsidized health coverage​

32.3 million Americans lack health insurance

They’re disproportionately young, poor adults who’re unsure about health coverage​

WASHINGTON — Nearly half of the 32.3 million Americans without health insurance are eligible for Medicaid or federally-subsidized marketplace coverage, according to a new analysis by the Kaiser Family Foundation.

And of these 15.7 million uninsured Americans eligible for assistance, roughly 40 percent reside in just five states: California, Texas, Florida, New York and Pennsylvania.

With the 2016 marketplace enrollment period set to begin on November 1, the Obama administration and its legions of outreach and enrollment workers are focused on finding these uninsured people and getting them into coverage.

Enrollment efforts will target the remaining uninsured in cities like Dallas, Houston, Chicago and Miami, as well as in northern New Jersey.

The Affordable Care Act requires that most Americans get health insurance for 2016 or pay the higher fine of either 2.5 percent of annual household income or $695 per uninsured person. The penalty is $347.50 for uninsured children under age 18.

Of the nation’s 32 million-plus uninsured, about 7.1 million – or 22 percent – qualify for premium tax credits that help offset the cost of marketplace coverage. Meanwhile, 5.4 million, or 17 percent, are eligible for coverage through Medicaid, the state-federal health program for low-income Americans.

Another ten percent, or 3.2 million, qualify for coverage through the Children’s Health Insurance Program. An additional 3.1 million lack coverage because they fall into the “coverage gap” – meaning they don’t earn enough to get premium tax credits, but earn too much to qualify for Medicaid in states that didn’t expand income eligibility for the program.

By virtue of a U.S. Supreme Court decision, the Affordable Care Act gives states the option of extending Medicaid coverage to working-age adults who earn at or below 138 percent of the federal poverty level – $27,724 for a family of three.

The non-expansion states with the most people in the coverage gap are: Texas, 766,000; Florida, 567,000; Georgia, 305,000; and North Carolina, 244,000.

In the 30 states and the District of Columbia which expanded Medicaid eligibility, 40 percent of the non-elderly uninsured is eligible for the program, compared to just 13 percent in the 20 states that did not expand Medicaid, the Kaiser analysis found.

The rest of the nation’s 32.3 million uninsured are 4.9 million undocumented immigrants who are ineligible for the Affordable Care Act, another 4.9 million people who haven’t signed up for job-based coverage and 3.7 million who earn too much to qualify for premium tax credits and must purchase unsubsidized marketplace coverage.

Last month, Health and Human Services Secretary Sylvia Burwell estimated there were 10.5 million uninsured Americans still eligible for marketplace coverage.

Nearly half of them are young adults between ages 18 and 34.

About 40 percent of the remaining uninsured who qualify for marketplace plans are low- to moderate-income workers, earning about $30,000 to $60,000 for a family of four. About half have less than $100 in savings, which means they may have difficulty paying for coverage.

And nearly 60 percent don't know about or how to access the tax credits that can help them pay for marketplace insurance.


Tony Pugh: 202-383-6013, @TonyPughDC​

Read more here: http://www.mcclatchydc.com/news/health-care/article38864331.html#storylink=cpy

 

[Politic Negro]

 

[COINTELPRO]

It was a disaster for me, my insurance premiums skyrocketed 800%. There was also a huge deductible increase. This is why we need a meritocracy in government rather than people throwing around credentials.

I am feeling HSA and getting laws changed delinking from HDHP which would allow you to build up even more money. The fact that you can invest like a 401k and grow the balance significantly and take it out just before retirement is great. Coupled with Medicare expansion, a small incremental change would have worked best, rather than overhauling everything.