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The 5 States With the Biggest Drop in Uninsured Rates

They all have at least one thing in common.

Health Overhaul Hispanics
(AP/Gerry Broome)
There are now 8.8 million fewer people living without health insurance in the U.S, according to data the Census Bureau released Wednesday. The new estimates for 2014, when the primary provisions of the Affordable Care Act (ACA) became effective, indicate the largest single-year drop to date.

States that opted to expand Medicaid saw the biggest declines in the number of uninsured people. If the uninsured rate had improved everywhere in the country at the same rate as in expansion states, 2.6 million more Americans would have attained health insurance last year, according to the Center for Budget on Policy and Priorities.

Here's a look at the five states with the most dramatic decrease in uninsured residents.

Kentucky: -5.8 percentage points

  • Uninsured in 2013: 14.3 percent
  • Uninsured in 2014: 8.5 percent
Kentucky was not only one of two Southern states that opted to expand Medicaid, but it also has a popular state exchange website. Observers credit Kynect with insuring 15 percent of the state’s population, and it's even popular among those who opposed the ACA rollout. Senate Majority Leader Mitch McConnell was vocal about repealing Obamacare, but still acknowledged how popular Kynect was with Kentucky residents. 

Nevada: -5.5 percentage points

  • Uninsured in 2013: 20.7 percent
  • Uninsured in 2014: 15.2 percent
Kentucky may have been one of the first in the South to expand Medicaid, but Nevada was the very first state with a Republican governor to do so. The state runs a federally-supported state-based marketplace, the Nevada Health Link. But despite the drop in uninsured people, Nevada still has one of the highest rates of uninsured people in the country.

West Virginia: -5.4 percentage points

  • Uninsured in 2013: 14 percent
  • Uninsured in 2014: 8.6 percent
West Virginia, along with Kentucky, was the other Southern states to take part in Medicaid expansion. By expanding Medicaid, the state was able to offer cover an additional 91,500 resident -- 20 percent of the population.

Oregon: -4.9 percentage points

  • Uninsured in 2013: 14.7 percent
  • Uninsured in 2014: 9.7 percent
Oregon expanded Medicaid, and launched, a state-based marketplace. However, it hasn’t all been good news. Riddled with technical and functionality difficulties, the state scrapped and fell back to the federal exchange. Despite the hiccup, the ACA still remains popular in the state, with 240,000 people enrolling.

Washington: -4.7 percentage points

  • Uninsured in 2013: 14 percent
  • Uninsured in 2014: 9.2 percent
Washington also embraced Medicaid expansion and created its own state exchange website. But unlike Oregon, Washington’s Healthplanfinder has been a success. Similar to Kentucky’s Kynect, Healthplanfinder has run smoothly since the beginning and is popular among residents.

“We know that other states have had substantially more challenges … but I think what we’ve learned is, once you get the software systems, hallelujah, it works, and we’ve been getting numbers that are sustainable in the long term,” Gov. Jay Inslee said in a 2014 interview with Politico.

Changes in State Uninsured Rates

The following map shows percentage-point changes in the share of each state's population without health insurance, according to the 2014 American Community Survey.

Correction: A previous version of this story inaccurately stated Nevada, Oregon and Washington's uninsured rate in 2014 as the insured rate.

Mattie covers all things health for Governing.

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