With health insurance open enrollment season on the horizon, we here at QuoteWizard wanted to see which states have made the biggest improvements in reducing uninsured rates. Since the inception of the Affordable Care Act (ACA) in 2010, there have been major improvements to the uninsured rate. From 2010 to 2019 there was a 37% decrease in uninsured Americans, totaling 17.5 million people nationally. The good news is all 50 states saw some level of improvement to their uninsured rates. However, not all states experienced significant increases as some did.
Key findings:
- A repeal of the ACA could leave over 21 million people uninsured with 12 million losing Medicaid coverage.
- Nationwide, the number of uninsured people has decreased by 37% (17.5 million people) from 2010 to 2019.
- Medicaid expansion under the Affordable Care Act led to an increase of 23% (12.1 million people) in the number of people enrolled in Medicaid from 2010 to 2019.
- Rhode Island, Kentucky and West Virginia saw the greatest improvement in uninsured rates from 2010 to 2019.
- South Dakota, Texas and Wyoming saw the least improvement in uninsured rates from 2008 to 2017.
- 39 states have adopted Medicaid expansion, leading to the overall improved uninsured rates across the nation.
The driving force behind the drop in uninsured rates is likely the expansion of Medicaid under the Affordable Care Act. ACA laws increased eligibility for adults with incomes below 138% of the federal poverty level to be covered under Medicaid. While the ACA increased eligibility for Medicaid, many states have not adopted Medicaid expansion. Currently, there are 39 states that have adopted some form of Medicaid expansion. It’s those states who have adopted Medicaid expansion that saw the greatest decrease in uninsured people from 2010 to 2019. Among the top 25 states to decrease their rate of uninsured from 2010 to 2019, all 25 states have adopted Medicaid expansion. As the ACA faces a legal battle in the Supreme Court the insurance status of millions hangs in the balance of a court decision. If the ACA were to be repealed an estimated 21 million people could be left uninsured and over 12 million people could lose Medicaid coverage.
To rank states with the largest decrease in uninsured people, we analyzed Kaiser Family Foundation data on health insurance coverage of adults from 2010 to 2019. States are ranked from 1 being the greatest decrease of uninsured to 50 being the lowest decrease of uninsured. We also included the rate of Medicaid increases over the same time period to reflect how the expansion of Medicaid impacts uninsured rates.
| Rank | State | 2010 Uninsured | 2019 Uninsured | % Decrease in Uninsured | % Increase in Medicaid |
|---|---|---|---|---|---|
| 1 | Rhode Island | 122,300 | 43,400 | -64.51% | 21% |
| 2 | Kentucky | 644,500 | 275,700 | -57.22% | 26% |
| 3 | West Virginia | 262,500 | 114,500 | -56.38% | 27% |
| 4 | New York | 2,258,800 | 1,000,100 | -55.72% | 26% |
| 5 | California | 6,781,300 | 3,005,400 | -55.68% | 25% |
| 6 | Oregon | 645,800 | 293,500 | -54.55% | 21% |
| 7 | Michigan | 1,201,600 | 561,600 | -53.26% | 22% |
| 8 | New Mexico | 403,800 | 200,500 | -50.35% | 33% |
| 9 | Louisiana | 782,900 | 400,200 | -48.88% | 29% |
| 10 | Illinois | 1,757,900 | 905,900 | -48.47% | 18% |
| 11 | Washington | 936,900 | 488,900 | -47.82% | 20% |
| 12 | Iowa | 275,600 | 144,400 | -47.61% | 20% |
| 13 | Montana | 162,800 | 86,600 | -46.81% | 21% |
| 14 | Arkansas | 495,800 | 265,800 | -46.39% | 26% |
| 15 | Maryland | 640,100 | 347,100 | -45.77% | 19% |
| 16 | Hawaii | 100,400 | 54,500 | -45.72% | 18% |
| 17 | Ohio | 1,384,900 | 760,000 | -45.12% | 20% |
| 18 | Colorado | 776,700 | 436,700 | -43.77% | 17% |
| 19 | Pennsylvania | 1,256,400 | 709,100 | -43.56% | 20% |
| 20 | Vermont | 47,000 | 26,600 | -43.40% | 24% |
| 21 | Minnesota | 464,400 | 265,000 | -42.94% | 17% |
| 22 | Nevada | 600,100 | 349,000 | -41.84% | 18% |
| 23 | New Hampshire | 143,500 | 84,600 | -41.05% | 13% |
| 24 | New Jersey | 1,145,200 | 690,300 | -39.72% | 17% |
| 25 | Indiana | 942,400 | 570,100 | -39.51% | 18% |
| 26 | Wisconsin | 530,500 | 327,000 | -38.36% | 16% |
| 27 | Alaska | 124,100 | 80,500 | -35.13% | 21% |
| 28 | Connecticut | 313,800 | 204,500 | -34.83% | 22% |
| 29 | Virginia | 994,400 | 654,900 | -34.14% | 14% |
| 30 | Idaho | 274,900 | 183,600 | -33.21% | 16% |
| 31 | Alabama | 686,800 | 460,400 | -32.96% | 20% |
| 32 | South Carolina | 790,900 | 539,300 | -31.81% | 19% |
| 33 | Kansas | 378,700 | 259,300 | -31.53% | 14% |
| 34 | Florida | 3,924,000 | 2,757,000 | -29.74% | 17% |
| 35 | Nebraska | 210,000 | 148,300 | -29.38% | 13% |
| 36 | Mississippi | 519,100 | 370,300 | -28.66% | 24% |
| 37 | Delaware | 87,200 | 62,500 | -28.33% | 20% |
| 38 | Utah | 422,200 | 303,700 | -28.07% | 9% |
| 39 | Massachusetts | 277,100 | 202,300 | -26.99% | 22% |
| 40 | North Carolina | 1,569,300 | 1,159,300 | -26.13% | 18% |
| 41 | Georgia | 1,863,200 | 1,379,000 | -25.99% | 17% |
| 42 | Arizona | 1,061,900 | 789,100 | -25.69% | 21% |
| 43 | Tennessee | 893,100 | 676,800 | -24.22% | 20% |
| 44 | Maine | 138,500 | 105,000 | -24.19% | 20% |
| 45 | Missouri | 771,400 | 600,100 | -22.21% | 14% |
| 46 | Oklahoma | 699,400 | 571,000 | -18.36% | 17% |
| 47 | North Dakota | 64,900 | 54,000 | -16.80% | 12% |
| 48 | Wyoming | 80,800 | 69,000 | -14.60% | 12% |
| 49 | South Dakota | 93,600 | 81,500 | -12.93% | 13% |
| 50 | Texas | 5,864,200 | 5,207,000 | -11.21% | 16% |
Methodology
QuoteWizard analyzed health insurance coverage rates in all 50 states to see which states had the greatest improvement in uninsured rates. To get health insurance improvement rates, we compared uninsured rates from 2010 versus 2019 to find which states saw the greatest rate of improvement. States ranked 1 to 50, with 1 being the greatest improvement in uninsured rates and 50 being the lowest rate of improvement. We paired Medicaid increases from 2008 versus 2017 to show a correlation between states that participated in Medicaid expansion and those that saw a greater improvement in uninsured rates.
References:
QuoteWizard.com LLC has made every effort to ensure that the information on this site is correct, but we cannot guarantee that it is free of inaccuracies, errors, or omissions. All content and services provided on or through this site are provided "as is" and "as available" for use. QuoteWizard.com LLC makes no representations or warranties of any kind, express or implied, as to the operation of this site or to the information, content, materials, or products included on this site. You expressly agree that your use of this site is at your sole risk.