In nearly all states, there were widespread reductions in uninsured rates between 2013 and 2017, in the wake of the ACA’s insurance market reforms and coverage expansions. As more people gained coverage, fewer cited cost as a barrier to receiving needed care. But in most states, progress stalled after 2015. From 2016 to 2017, more than half of states simply held on to earlier gains; 16 states, including those that did and did not expand Medicaid, experienced upticks of 1 percentage point in their adult uninsured rate. One notable exception was Louisiana, where Medicaid expansion took effect in July 2016. Louisiana experienced a 3 percentage-point drop in its adult uninsured rate (from 15% to 12%) from the end of 2016 to the end of 2017. People with low income made the greatest gains. 

Learn more at

Cost barriers to receiving care fell as uninsured rates fell following ACA coverage expansions