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Uninsured Rate Rises in 17 States

By Jack O'Brien  
   May 10, 2018

While several states saw a statistical increase in the uninsured rate, no state saw a significant decrease in the uninsured rate.

The uninsured rate rose in 17 states last year, with five states posting an increase of at least 3 percentage points, a Gallup-Sharecare study released Wednesday found.

During the fourth quarter of 2017, the national uninsured rate was 12.2%, an increase of 1.3 percentage points year-over-year. This is still well below the uninsured rate peak of 18% in the third quarter of 2013, just before the marketplace exchanges opened under the Affordable Care Act on October 1, 2013.

The study attributed the rise in the uninsured rate to increases of insurance premiums for popular ACA plans, which likely drove enrollees with higher incomes out of the marketplace. Insurers have also exited the ACA exchanges due to declining enrollment, shortened enrollment periods, and reduction in public marketing by the federal government.

Gallup points to the Trump administration's decision to halt the cost-sharing reduction payments and attempts by Congress to repeal and replace the ACA as potential drivers for a higher uninsured rate in the future.

The data, based on the Gallup-Sharecare Well-Being Index, was collected via daily surveys throughout 2017.

Below are a few highlights from the study:

  • Among states that adopted Medicaid expansion under the ACA, those that saw the biggest increase in their uninsured populations were Hawaii, Iowa, New Mexico, and West Virginia.

  • Oregon, which also adopted Medicaid expansion, had the biggest decrease in its uninsured population at 0.8 percentage points,.

  • Massachusetts had the lowest uninsured rate at 4%, extending a record that began in 2008.

  • Texas had the highest uninsured rate at 22.5%, extending a record that began in 2008.

  • Five states had an uninsured rate below 7% in 2017, down from 10 states in 2016.

  • Marketplace enrollment peaked at 12.7 million people in 2016, before declining by 3.9% and 3.7% during the 2017 and 2018 enrollment periods, respectively.

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


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