Another major study highlights the benefits the Affordable Care Act has conferred on millions of America’s poor.
A study published in JAMA Internal Medicine compared two states with high levels of poverty that chose to embrace the Medicaid expansion offered by the ACA, Kentucky and Arkansas, with Texas, which has staunchly opposed the Obama administration’s offer to pay 90 percent of the cost of making all of its residents between 100 percent and 133 percent of the federal poverty line eligible for Medicaid.
Before the ACA, Arkansas and Kentucky had the two highest uninsured rates in the country. But despite their Republican tendencies, both of the states had Democratic governors who embraced the Medicaid changes and significantly drove down the uninsured rate.
The drop was particularly pronounced among low-income citizens of both states. In 2013, more than 40 percent of low-income residents in Arkansas and Kentucky lacked insurance. Two years after implementation of the law, the uninsured rate was roughly 14 percent in Arkansas and 9 percent in Kentucky.
“The effects of expanding coverage will be an unfolding story over time,” Dr. Benjamin Sommers, the lead study author, told the Los Angeles Times.
In Texas, the uninsured rate among the poor now stands at 32 percent. The Lone Star State is also the only state with an overall uninsured rate north of 20 percent.
While the percentage of low income residents in Arkansas and Kentucky who reported having a physical in the past year increased significantly since the ACA implementation, the percentage who reported doing so in Texas actually fell.
While residents of states that rejected the Medicaid expansion can still take advantage of the insurance marketplaces set up in each state, many of the poorest among them do not qualify for marketplace subsidies that those of slightly higher incomes can.
When originally written, the ACA mandated that states expand Medicaid, but that provision of the law that was struck down by the Supreme Court in 2012, leaving Republican-run states to display their opposition to Obamacare by refusing to participate in the new program, 90 percent of which would be funded by the federal government in the long term.
An increasing number of Republican states have defected from the anti-Obamacare cause, or at least an increasing number are willing to take what they can get from the law. Alaska, Louisiana, Indiana, Pennsylvania, Montana, Michigan, and New Hampshire have reversed their positions on the Medicaid expansion.