Gallup has released its latest results from its survey of how the Affordable Care Act (ACA) is faring nationwide, and it shows rather stunning (though in most cases likely unsurprising to health policy analysts) results of how this grand policy change is rolling out state by state.  Their main finding is that in states that implemented most of the features of the ACA the drop in the uninsured rate (which was already lower in the states that chose to implement the core mechanisms of the ACA) widened in those states.

As shown in the table below, the states that implemented these core features of the ACA (Medicaid expansion and state-based marketplace) started with lower uninsured rates (16.1% compared to 18.7%) but the drop in the uninsured rate in the states implemented both core mechanisms was 4.0 percentage points, while it was only 2.2 in the states not expanding Medicaid nor using a state-based marketplace.  So the gap in the uninsured rate between those states has widened from 2.6 percentage points to 4.4 points after the ACA.



Looked at state by state the changes are rather remarkable.  Some states are seeing very large drops in the uninsured (Arkansas -10%, Kentucky -8.5% for example), while some states are not seeing much change at all (or even an increase.

In Missouri -- a state that chose neither to expand Medicaid nor implement the state-based marketplace -- the uninsured rate has barely changed at all, from 15.2% to 15.1%, according to the Gallup survey.  See the table below.