Health Insurance Coverage
In states that have not implemented Medicaid expansion, 18% of the population lacks health insurance, compared to only 10% in states that have expanded Medicaid.
Lack of health insurance coverage by county, 2017-21 (5-yr average)
Percent of population age 19-64
Sources: Census Bureau’s American Community Survey 2017-21 and Kaiser Family Foundation. Note: South Dakota has adopted but not yet implemented Medicaid expansion. Wisconsin has partially expanded Medicaid (under a Medicaid waiver) to include all adults under 100 percent federal poverty level, but did not adopt the ACA expansion.
Americans without health insurance are less likely to get the medical care they need. When they are injured they don’t get the follow-up care prescribed for them, and those that have chronic conditions often go untreated until they appear in emergency rooms. In 2010, the Affordable Care Act began to dramatically reduce the number of uninsured people across the country through Medicaid expansion as well as through new subsidies for health insurance “marketplaces.” Despite substantial new federal subsidies, 11 states (7 of them in the South) have still not adopted Medicaid expansion. In many counties in these non-expansion states, 30, 40, or even 50% of the population is uninsured. Hospitals in communities with high rates of uninsured patients become financially strapped and high uninsurance rates have led to many closures of rural hospitals across the South.1,2 Texas (one of the 11 states that has not adopted Medicaid) had the highest uninsured rate in the U.S. at 24% during 2017-21. Florida, Georgia, and Mississippi also had very high uninsured rates, of 19%, 18%, and 18%, respectively. Those uninsured individuals that do get medical treatment are likely to incur medical debt (Medical Debt).
“Key Facts about the Uninsured Population”. Tolbert, Orgera, and Damico. Kaiser Family Foundation. November, 2020. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/#:~:text=When%20they%20are%20hospitalized%2C%20uninsured,rates%20than%20those%20with%20insurance.&text=Research%20demonstrates%20that%20gaining%20health,effects%20of%20having%20been%20uninsured.
“181 rural hospitals have closed since 2005—see the states that have been impacted”. Givens. Sidecar Health. December, 2021. https://sidecarhealth.com/blog/181-rural-hospitals-have-closed-since-2005-see-the-states-that-have-been-impacted/
