Poll: Obama health law is a tale of 2 Americas

By From page A9 | August 06, 2014

WASHINGTON — President Barack Obama’s health care law has become a tale of two Americas.

States that fully embraced the law’s coverage expansion are experiencing a significant drop in the number of uninsured residents, according to a major new survey released Tuesday. States whose leaders still object to “Obamacare” are seeing much less change.

The Gallup-Healthways Well-Being Index found an overall drop of 4 percentage points in the share of uninsured residents for states accepting the law’s core coverage provisions. Those are states that expanded their Medicaid programs and also built or took an active role managing new online insurance markets.

The drop was about half that level — 2.2 percentage points — in states that took neither of those steps, or just one of them.

“Those states that implement the law’s major mechanisms are seeing a significantly greater decline in their uninsured rates,” said Dan Witters, research director for the poll.

Medicaid expansion mainly helps low-income uninsured adults in states accepting it. Insurance exchanges operate in every state, offering taxpayer-subsidized private coverage to people who have no health plan on the job.

Leading the nation were two southern states where the law has found political support. Arkansas saw a drop of about 10 percentage points in its share of uninsured residents, from 22.5 percent in 2013, to 12.4 percent by the middle of this year. Kentucky experienced a drop of nearly 9 percentage points, from 20.4 percent of its residents uninsured in 2013, to 11.9 percent.

Although the poll’s margin of sampling error is higher for smaller states, Witters said Gallup has a high level of confidence that the numbers represent real changes.

The poll found contrasts among states that share a border, but have taken different paths politically on the health care law.

— While Arkansas had the 10-point decline in its uninsured rate, the drop in Tennessee was just 2.4 percentage points.

— The uninsured rate in West Virginia fell 5.7 points after the state agreed to Medicaid expansion, but there was no change for neighboring Virginia, where Democratic Gov. Terry McAuliffe has been blocked by a Republican-led legislature.

— Colorado’s uninsured rated dropped 6 percentage points with Medicaid expansion and a state-run exchange, while Utah’s didn’t budge. That state has a federally-run exchange and is still weighing whether to expand Medicaid.

It’s unclear if emerging disparities among neighboring states will start to shift the hardened lines in the political debate over health care. Americans remain divided over Obama’s signature program, with opponents clearly outnumbering supporters.

Robert Blendon, a public opinion analyst at the Harvard School of Public Health, said immediate shifts are unlikely. That’s because negative views about the law are driven by people who already had insurance. They worry that the coverage expansion will raise their premiums or compromise the quality of care they receive.

“Why isn’t the bill more popular?” asked Blendon. “Rightly or wrongly, people who are not directly aided by it are worried.”

The Gallup survey found some coverage gains in several major states opposing the law that were also the focus of sign-up campaigns by the Obama administration and its supporters. Texas saw a drop of 3 percentage points in its uninsured rate, while Florida saw a slightly higher decline.

Some blue states that already had high levels of insurance coverage made little headway. The poll found hardly any change in Massachusetts and Vermont.

In deeply red Kansas, the uninsured rate actually went up by 5 percentage points this year. Witters said Gallup is taking a closer look at that finding, and it’s not clear if it represents an anomaly.

The Gallup-Healthways survey is important because it combines the quick turnaround of media polls with extensive outreach usually seen in government research. Pollsters interview 500 people a day, 350 days a year.

The 2013 margin of sampling error for most states is plus or minus 1 to 2 percentage points, but it is as high as plus or minus 3.5 points for states with smaller population sizes, such as Wyoming, North Dakota, South Dakota, Delaware, and Hawaii. For midyear 2014 results, the error range increases to as high as plus or minus 5.0 points for these smallest states.


Gallup-Healthways Well-Being Index – http://tinyurl.com/n8rrex7


The Associated Press

The Associated Press


Discussion | 9 comments

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  • 2realAugust 06, 2014 - 6:26 am


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  • rlw895August 06, 2014 - 7:28 am

    Maybe Tennessee is hoping all the people who benefit from expanded Medicaid will move to Arkansas and Kentucky.

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  • rlw895August 06, 2014 - 7:35 am

    Before there was data, opponents argued ObamaCare would increase the number of uninsureds, remember? That was to kill it in the cradle. But the lie didn't work. They've come up with new arguments. Are they any better? What they haven't come up with is a congress that will make the law better instead of voting to repeal it.

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  • Larry WAugust 06, 2014 - 8:07 am

    Rlw. It's simple. Great if others are paying your way and not so good when you are forced to pay for others care.

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  • rlw895August 06, 2014 - 10:44 am

    Taxation "forces" us to do all sorts of things we may not agree with. It's part of being an American. I understand, but it's not a very good argument for opposing ObamaCare. I came to oppose the war in Iraq, but I didn't use the argument that I opposed it because I was being forced to pay for it. Try again.

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  • Larry WAugust 06, 2014 - 12:13 pm

    We all pay taxes on things that we dislike but the people who seem to be the most in favor of the new health law are the ones who are not paying their cost. I already pay enough in taxes and am not looking forward to seeing them increase to cover the costs that will follow. I also don't like people's private health information made available to the government.

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  • JBDragonAugust 06, 2014 - 1:03 pm

    The Government can't run anything right, but magically they can with Heath care? I mean really? Heath care will be going down the crapper in a few years, only the money starts to run out.

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  • Mr. PracticalAugust 06, 2014 - 6:31 pm

    I'm not convinced the numbers include those that enrolled but didn't pay and/or those that received cancellations and still haven't procured new insurance. Regardless, the increases are due to expanded Medicaid and not exchange success. The preliminary rates for next year were released and the average increase is 18 percent, mostly due to not enrolling enough of the young, health and profitable risks. Now the adverse selection begins. When rates increase, they will lose more of the young and healthy. The sick and older risks will stay on at any cost. That results in larger losses the next year. Keep in mind that the rates are artificial because of the re-insurance and risk corridor scheme that are bailing out the carriers for their loses. That stops in 2017 and then the real fun begins. November will be interesting when the 2015 rates are released and the disruption due to the employer mandate start to become more evident.

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  • rlw895August 17, 2014 - 3:00 pm

    Mr.P: Let's come back to this when we have more numbers, but I believe the rates for Covered California are already out and the average increase is like 4%.

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