But states that accepted federal money to expand Medicaid for the poorest adults saw bigger gains in coverage, according to the latest report from the Gallup-Healthways Well-Being Index, which polls a random sampling of adults across the country. The national uninsured rate went from 17.3 percent to 13.8 percent, the lowest in the seven years of the well-being poll.
"Collectively, the uninsured rate in states that have chosen to expand Medicaid and set up their own state exchanges or partnerships in the health insurance marketplace declined significantly more last year than the rate in states that did not take these steps," Gallup reports. "The uninsured rate declined 4.8 points in the 21 states that implemented both of these measures, compared with a 2.7-point drop across the 29 states that have implemented only one or neither of these actions."
North and South Carolina, along with many Republican-led states, neither set up an insurance exchange nor expanded Medicaid.
As Rose Hoban with N.C. Health News recently reported, bankers and business leaders have been receptive to the argument that expansion would bring financial benefits to the state, though the state Chamber of Commerce has taken no position. And a coalition of health and anti-poverty advocates argue that expansion would save lives and create jobs. But state legislative leaders remain wary of the costs and complexities of expansion, and Gov. Pat McCrory has said he'll delay any plans to expand coverage until the U.S. Supreme Court rules on a challenge to the ACA.