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Government Help Fueling Highest Growth in Healthcare Coverage in States Rejecting Medicaid Expansion

FILE – The HealthCare.gov website is photographed in Washington, Wednesday, Oct. 31, 2018.
(AP Photo/Pablo Martinez Monsivais, File)
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FILE – The HealthCare.gov website is photographed in Washington, Wednesday, Oct. 31, 2018.

Total enrollment in the U.S. nearly doubled since 2020, reaching a record 21 million people.

Texas and Louisiana are among the states in the South, which had the highest growth in health insurance. It came through the Affordable Care Act Marketplace over the past several years. It is the coverage plan widely referred to as “Obamacare.” That’s according to a new health policy research report. As Drew Hawkins with the Gulf States Newsroom reports, total enrollment in the U.S. nearly doubled since 2020, reaching a record 21 million people. The surge is because in many cases insurance premiums are now cheaper or even free, in large part due to subsidies introduced by the Biden Administration in response to the pandemic. The states that saw the highest increases have not adopted Medicaid expansion, like Texas and Mississippi.

Note: Medicaid expansion status as of 2024.
Note: Medicaid expansion status as of 2024.

“To me that really underscores that people want health insurance, but they need that health insurance to be affordable,” said Cynthia Cox , a vice president at the Kaiser Family Foundation and a co-author of the report. “In the last few years," Cox Concludes, "these enhanced subsidies have made that coverage much more affordable and much more attractive for people.”
The subsidies that can make insurance cheaper are set to expire next year. If they aren’t renewed by Congress, they could drive up the cost of premiums and could lead to people dropping coverage.
The Gulf States Newsroom is a partnership among public radio stations in Alabama, Louisiana & Mississippi.

Originally from the Pacific Northwest, and a graduate of the University of Washington, Jeff began his on-air broadcasting career 33 years ago in the Black Hills of South Dakota as a general assignment reporter.
Drew Hawkins is the health equity reporter for the Gulf States Newsroom, a collaboration among public radio stations in Louisiana (WWNO and WRKF), Alabama (WBHM) and Mississippi (MPB-Mississippi Public Broadcasting) and NPR.