Last week the Centers for Disease Control and Prevention (CDC) released new data that show health insurance coverage holding steady with Medicaid expansion states doing better than states holding out from expansion. The national uninsured rate dropped slightly during the first quarter of this year, falling to 8.8 percent from 9.1 percent for all of 2017. The CDC data is based on a survey. It found that for non-elderly adults, the uninsured rate stood at 12.5 percent a slight decrease from 2017. Seventy percent of those with coverage had private plans while 19.2 percent were enrolled in government programs.

The children’s uninsured rates remained low at 4.6 percent, a slight decrease from the 2017 5 percent uninsured. Public programs, mainly CHIP and Medicaid account for 41.9 percent covered by health insurance, continuing a long history of success for the CHIP and Medicaid programs.

The numbers also provide evidence that the ACA, despite the many political hurdles created has reduced the uninsured number significantly from 50 million uninsured in 2010—before implementation to 28.3 million in 2018. The data also suggests there is an easy route to improving those numbers by getting the approximate 18 non-Medicaid expansion states to expand. There are significant differences in coverage gains between states that have adopted the ACA’s Medicaid expansion and those that held out. In expansion states, the uninsured rate has fallen from 18.4 percent in 2013 to 8.7 percent this year. In non-expansion states, the uninsured rate has dropped from 22.7 percent in 2013 to 17.5 percent this year.

The state of Virginia is expanding its Medicaid program after last fall’s election and another has the voter go ahead or mandate to join that action. In late August Maine’s Supreme Court ordered Governor Paul LePage to submit a plan to the federal government to expand Medicaid. The Governor has done everything in his power to block implementation of a state voter ballot initiative that had 59 percent of voters approving Maine’s extension of Medicaid under the ACA. Although LePage must begin the formal process of expanding Medicaid, the court sent the case back to lower court to address other issues raised in the lawsuit against the Governor. The expansion of Medicaid would allow 80,000 low-income Maine adults to access Medicaid benefits. Governor LePage is out office next year by term limit but he said he’d rather go to jail than implement the expansion.

Due to the Maine ballot initiative other state voters are attempting to get the same expanded health care. Utah will have a ballot question this year on the expansion. And last week, on August 28, a Nebraska court dismissed an effort to block a ballot initiative to expand Medicaid under the ACA. A Nebraska expansion would also allow a projected 90,000 adults to access Medicaid coverage.