The Impact of Obamacare, in Four Maps

Three years into the Affordable Care Act, there remain places where many people still lack health insurance. But their share keeps shrinking.

 .. Over all, the gains are substantial: a seven-percentage-point drop in the uninsured rate for adults. But there remain troublesome regional patterns. Many people in the South and the Southwest still don’t have a reliable way to pay for health care, according to the new, detailed numbers from a pair of groups closely tracking enrollment efforts. Those patterns aren’t an accident. As our maps show, many of the places with high uninsured rates had poor coverage before the Affordable Care Act passed. They tend to be states with widespread poverty and limited social safety nets. Look at Mississippi and Texas, for example.

.. West Virginia started near the bottom of the pack in 2013. It had high rates of uninsurance and poverty, and ranked low on measures of public health. But state officials, health care providers and local advocacy groups embraced the Affordable Care Act wholeheartedly — and avoided the word Obamacare. The state didn’t just expand Medicaid, but also took extra efforts to identify residents who were likely to be eligible for new insurance, sought them out, and made it easier for them to sign up

.. In areas with large populations of Native Americans, the uninsured rate does not fully capture the population’s access to health care, since tribal members often get care from the Indian Health Service instead of traditional health insurance.