Need another reminder of why Obamacare's impact depends heavily on the state where you live? Gallup has one for you. On Tuesday, the organization published a state-by-state breakdown of how the law has affected the rate of uninsurance, at least according to its polling.
The spread was pretty big. You can see it in the above map, which the Huffington Post constructed. Arkansas seemed to make the most progress: In that state, by Gallup's reckoning, the ranks of the uninsured fell by 10.1 percentage points. Next was Kentucky, at 8.5 percentage points. After that came Delaware, Washington, and Colorado. But in some states, Gallup found, the rate fell by much less or not at all. In Kansas, Gallup determined, the number of people without health insurance actually increased by 5.1 percent.
Yeah, I know. I had the same thought.
Gallup acknowledges a substantial margin of error, of plus or minus 5 percentage points, on its estimates for states with smaller populations. That, along with the truly weird results in places like Kansas, should make you treat the state-specific numbers with caution. In other words, don't take any one figure too literally.
But the numbers do suggest a pattern, one Gallup's own researchers observe. The states that made the most headway covering the uninsured, according to Gallup, are states in which officials decided to build their own insurance marketplaces and to make all low-income people eligible for Medicaid, as the Affordable Care Act originally envisioned.
The Medicaid expansion is obviously the big factor here, because it meant many more people (into the millions, in the largest states) became eligible for government-subsidized insurance. But it's safe to assume that the states that undertook both steps were also the ones that put the most thought and effort into promoting the program.
The conservative state officials who have shunned the Affordable Care Act have their reasons. They think the program costs too much, that the insurance it gives people doesn't do any good, and that it generally messes with the free market. That's their right and, if the polls are to be believed, plenty of their constituents agree. But their decision also has consequences for their states. These Gallup numbers show what those consequences are.