This week, Gallup released the results of a two-year survey on the nation’s uninsured and the results have stunning implications for the South. Arkansas and Kentucky now lead the nation in having the largest reductions in the number of adults without health insurance: Arkansas dropped its uninsured rate from 22.5 percent to just 9.1 percent and Kentucky dropped its rate from 20.4 percent to 9 percent.

According to the data, the drastic drop in uninsured rates can be attributed to the fact that both states have embraced ACA implementation by setting up state-based or partnership Marketplaces and insuring more people through Medicaid ─ something no other Southern state can boast. We’ve already seen budget savings and job creation from their coverage expansions, and Medicaid is reimbursing hospitals in Arkansas and Kentucky for services they otherwise would have to swallow as uncompensated care. For the first time in a long time, the South is now at the top of a list on a health measure. While that is a positive step forward, many other Southern states still linger at the bottom – something advocates living in those states often bemoan.

Texas illustrates this sentiment perfectly as the only state in the country with an uninsured rate of more than 20 percent. The Lone Star State’s refusal to close the coverage gap is a significant factor in such a high rate. That is not to say that Texas hasn’t made progress in reducing their uninsured rate (6.2 percent reduction) by enrolling millions in Marketplace plans, but there are still more than 1 million Texans in the coverage gap. That is why Arkansas and Kentucky have shot to the top of the charts. Their Medicaid enrollment numbers show when more people have an opportunity to gain insurance through the program, they will enroll and enjoy the peace of mind and financial security of having coverage. Though those who oppose closing the coverage gap have been critical of higher-than-expected Medicaid enrollment figures, this surge in enrollment shows a pent up demand for coverage. Being able to help low-income workers, people without children, or those with a substance use disorder who previously couldn’t access coverage not only impacts the health and well-being of that individual, but also their community and their state.

With so many Southerners in the coverage gap, I’d wager the national uninsurance rate would fall much further if more states in the region increased access to coverage through Medicaid. In fact, more Southern states than ever would have the opportunity to lead the country in ensuring people had access to coverage. According to the Kaiser Family Foundation, in our 12 Southern Health Partner states there are approximately 3.2 million people in the coverage gap out of a possible 3.7 million nationwide. In total, an astounding 86 percent of people in the coverage gap are in the South alone. Imagine what the nation’s uninsured rate would look like if those states moved forward with closing the coverage gap. Even more importantly, think about what that would mean to the individuals gaining access to affordable coverage as well as to local communities and state economies. 

Amanda Ptashkin
Project Manager
Southern Health Partners