The states that have worked to implement Obamacare’s key provisions have seen a greater drop in their uninsurance rates than the states that have resisted health reform, according to a new Gallup poll released on Wednesday.

Twenty one states and the District of Columbia have agreed to both set up an insurance marketplace and expand Medicaid, the major mechanisms through which Obamacare seeks to extend coverage to additional Americans. Those states have reduced their population of uninsured residents by an average of 2.5 percent so far this year. The 29 states that haven’t taken both of those measures, on the other hand, have seen just a 0.8 drop:


Previous Gallup studies have found that Obamacare is effectively helping lower the number of uninsured across the country. But those gains aren’t necessarily being shared equally across states, as some GOP leaders have continued to resist health reform at any cost.

Some states still haven’t lifted a finger to implement the Affordable Care Act. It’s not hard to see the concrete impact of that policy position. The states that oppose Obamacare have allocated less funding to educate residents about their options under the law, and some have even attempted to undermine the “navigators” who are tasked with helping Americans enroll. That’s ensured that the people who live in red states are much less likely to receive information about health reform, even when they seek assistance at a local clinic.

Unfortunately, those people are also the ones who need health coverage the most. The states that have resisted implementing Obamacare already had higher uninsurance rates to begin with, and are home to people who tend to be poorer and sicker than the residents in other states. Before Obamacare, there were already significant health disparities between different states — but GOP-led resistance to reform threatens to make the issue worse. Thanks to the resistance to Obamacare’s optional Medicaid expansion, about five million of the poorest Americans have been left with no affordable health care options whatsoever.


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