Health and Science

Obamacare boosted number of people with health insurance in all states, decreased care cost barriers

Obamacare lowers number of uninsured in every state
Obamacare lowers number of uninsured in every state

A lot of people got health insurance under Obamacare — and they've elected a president who has vowed to take it away.

A new study out Wednesday notes that all 50 states and the District of Columbia saw decreases — often sharp decreases — in their rates of people lacking health insurance after implementation of the Affordable Care Act.

Nine states "experienced 10 to 13 percentage-point reductions in their adult uninsured rate from 2013 to 2015," the Commonwealth Fund report said.

Among those states, California, Kentucky, Oregon, Rhode Island, Washington state and West Virginia cut their uninsured rate by at least half.

The same Commonwealth Fund report also found that in 38 states and in Washington, D.C., the share of adults who reported not going to the doctor because of cost dropped by at least 2 percentage points since the ACA took full effect.

And in 16 states and D.C., there were declines in the percentage of people at risk for poor health outcomes who did not have a routine doctor's visit, the report said.

Kentucky was the state that benefited most in terms of both increases insurance coverage and decreases in cost barriers to health care, the Commonwealth Fund said.

In 2013, before the ACA took effect, Kentucky's uninsured rate was 17 percent — which also happened to be the average uninsured rate nationally.

Two years later, Kentucky's uninsured rate was just 7 percent — a 10 percentage-point drop. The state's uninsured rate by then was 4 full percentage points lower than than the new national average of 11 percent in 2015.

And for low-income adults in Kentucky, the results were even more dramatic: a 25 percentage-point drop in the uninsured rate.

Only 12 percent of Kentuckians reported forgoing health care because of costs by 2015. That compares with 19 percent who said so in 2013, according to the Commonwealth Fund.

Kentucky, however, overwhelmingly supported Obamacare opponent Donald Trump in the presidential election, giving the Republican nominee more than 62 percent of its vote, compared with just 32.7 percent for Democratic candidate Hillary Clinton.

In an article last week, Vox detailed how many people in Kentucky who directly benefited from health insurance coverage expansion under Obamacare voted for Trump — but at the same believed he would make Obamacare work better.

"We all need it," Trump voter Kathy Oller, who helps people enroll in Obamacare, told Vox. "You can't get rid of it."

The Commonwealth Fund report noted that a number of other states, which also had supported Trump in the election, saw declines in their uninsured rates of as much as 7 to 9 percentage points under Obamacare, despite not having expanded their Medicaid programs as the health-care law allows.

Those states included Florida, Georgia, Louisiana, Montana, North Carolina, South Carolina and Texas.

Commonwealth Fund President Dr. David Blumenthal, during a call Tuesday with reporters, was asked why people who may have benefited from insurance coverage and reduced cost concerns under the ACA would have voted for Trump, despite his promise to repeal Obamacare.

"I don't have a degree in psychology, or sociology," said Blumenthal, who is a physician. "I think this is really a perplexing point."

"There is clearly a disconnect between people from benefiting from this particular program and their political viewpoints about what candidate they want to support."

"I don't have a magic answer," Blumenthal said.

He noted that "a large body" of research has shown that having health insurance is linked to also having better health.

Trump, while promising to repeal Obamacare, has vowed to replace it with something better. But it's not clear what that will consist of. And there is disagreement among Republicans in Congress about what, if anything, should replace the ACA.

Susan Hayes, one of the authors of the Commonwealth Fund report, said that given the "historic reduction" in the uninsured rate under Obamacare, "It is important to hold onto these gains."