Southern states are disproportionately represented among non-expansion states, with Arkansas and Kentucky as exceptions. As a result, the share of the uninsured residing in southern states grew from 41.5% to 48.9% between September 2013 and June 2014.
Nationally, the uninsured rate dropped from 17.9% in the third quarter of 2013 to 13.9% in the second quarter of this year, according to the Urban Institute. That represents a decrease of roughly 8 million in the number of uninsured non-elderly adults. The findings track recent survey results from Gallup, which showed the uninsured rate has dropped from 17.1% to 13.4% since the fourth quarter of 2013.
For Medicaid expansion states, the uninsured rate among non-elderly adults dropped from 15.1% to 10.1%, according to the Urban Institute survey. But for non-expansion states, the decrease was just two percentage points, from 20.3% to 18.3%.
At the same time, the share of uninsured individuals who reported Spanish as their primary language grew from 17.0% to 19.9%, and the percentage of uninsured high-school dropouts increased from 23.8% to 28.1%.
Affordability was the most common reason cited by survey respondents for not getting coverage, with 59.5% indicating that healthcare insurance was too expensive. But ignorance about the availability of subsidies may have led some people to wrongly conclude they couldn't afford coverage. Only 38.2% of survey respondents said they were familiar with subsidies that could offset premiums and out-of-pocket costs.
Stephen Zuckerman, co-director of the Health Policy Center, argued that signing up the uninsured will become more difficult in future open-enrollment periods because those who really wanted coverage are now insured.
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