Analysis: Texas has highest rate of uninsured post-ACA, Massachusetts the lowest

Though there are plenty of reports that chronicle how the Affordable Care Act has lowered the overall number of uninsured Americans, a new analysis breaks down the data state-by-state to show how the healthcare reform law has affected regions differently.

The analysis, from financial website WalletHub, found that Texas had the highest rate of uninsured individuals--19.06 percent--in 2014, once the ACA had been fully enacted. Massachusetts had the lowest, at 3.28 percent.

Massachusetts also had the smallest difference between the insured rate of low-income and high-income households, while Texas ranked last with the largest difference. Oregon, meanwhile, experienced the largest absolute difference in its public health insurance rate from 2010 to 2014, while Texas had the largest absolute difference in its private health insurance rate.

As previous research has revealed, states that expanded Medicaid had lower average uninsured rates--in this case 9.35 percent for expansion states and 12.74 percent for non-expansion states in 2014. The analysis also compared "red" to "blue" states based on their 2012 presidential election voting records, finding that predominantly Republican states had a higher average rank of uninsured than mainly Democratic states.

To further drill down the effects of the ACA, WalletHub asked several experts how they think the law has affected the rate of uninsured as well as their assessments of the ACA's present and future.

Kenneth E. Thorpe, who chairs Emory University's Department of Health Policy and Management, said he believes that as financial penalties for not getting coverage increase over time, the number of uninsured individuals will continue to decline.

And Jennifer L. Kohn, an assistant economics and business studies professors at Drew University, said she's worried about what will happen to premiums when the ACA's risk corridor provisions expire next year. In addition, she says, "while consumers want low premiums, the bottom line of medical spending continues to go up, threatening the financial solvency of some of the insurers."

To learn more:
- check out the analysis

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