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States Where Obama Polls Badly Make Strides Rolling Out Health Law

By John Reichard, CQ HealthBeat Editor

August 7, 2014 -- Arkansas and Kentucky saw the biggest drops among states in their uninsured rates since a health law requirement took effect Jan. 1 that Americans carry health insurance, according to the Gallup polling organization.

West Virginia—another state where President Barack Obama has low approval ratings—ranked fifth among states in coverage expansion.

The results suggest that Obama's low popularity scores in some places aren't stopping his signature policy achievement from having an effect.

"While a majority of Americans continue to disapproved of the Affordable Care Act, the uninsured rate is declining, as the law intended," Gallup reported. Nationally, 18 percent of U.S. adults reported being uninsured in the third quarter of 2013, but that figure dropped to 13.4 percent in the second quarter of 2014.

Gallup assessed rates of uninsurance by polling individuals on whether or not they had coverage.

States that voted overwhelmingly against Obama in the last election—no county in West Virginia, for example, went for him—were among the most cooperative implementing coverage goals of his health law.

Kentucky established its own state insurance exchange to offer private insurance coverage options. Arkansas and West Virginia have "partnership" exchanges, splitting functions with the federal website, and, in the words of Gallup, "make key decisions based on local market and demographic conditions." Each state also expanded its Medicaid program.

The 29 states that were neither involved in creating exchanges nor in expanding Medicaid, or that took only one of those steps, saw only a 2.2 percentage point drop in their uninsured rate, while the 21 states that did both saw a decline almost twice as great—4 percentage points.

A total of 22.5 percent of Arkansas residents were uninsured in 2013, a proportion that dropped to 12.4 percent by mid-2014. Rounding out the top 10 were Kentucky, which went from 20.4 percent to 11.9 percent; Delaware, 10.5 to 3.3; Washington, 16.8 to 10.7; Colorado, 17 to 11; West Virginia, 17.6 to 11.9; Oregon, 19.4 to 14; California, 21.6 to 16.3; New Mexico, 20.2 to 15.2; and Connecticut, 12.3 to 7.4.

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