The national health uninsured rate decreased more than 3.5 percentage points to 14.22% following the Jan. 1 implementation of the Affordable Care Act (ACA), according to WalletHub, a financial social network, in its 2014 Health Insurance Coverage Report. Using data from the Kaiser Family Foundation, which details the number of private health plan enrollees under ACA who previously lacked health insurance–and therefore gained coverage–WalletHub compared state insurance rates pre- and post-ACA.

WalletHub combines this data with the number of new Medicaid recipients and private plan enrolless under ACA to offer an initial project of uninsured rates for 43 states and the District of Columbia. Data is not available for Connecticut, Delaware, Maine, Michigan, New Hampshire, North Dakota and Vermont.

Among the findings, states that expanded Medicaid have an average uninsured rate of 10.22%, compared to 15.87% for states that did not expand Medicaid. “Blue” states have fewer uninsured residents with an average rank of 15.9, compared to 28.52 for “red” states.

West Virginia and Oregon experienced the greatest decline in the uninsured rate–more than 10 percentage points for both states. With fewer uninsured individuals pre-ACA, nearly 1 in 100 Massachusettes residents remain uninsured. But on the opposite end of the spectrum, 1 in 4 Texas lack health insurance.

States with lowest uninsured rates post-ACA implementation

10. Kentucky

Uninsured rate pre-ACA: 17.3%
Projected uninsured rate post-ACA: 8.95%
Difference: -8.35%

The Bluegrass State has the fourth highest drop in the rate of uninsured adults and the ranks third in new Medicaid enrollees per capita.

9. Washington

Uninsured rate pre-ACA: 16.01%
Projected uninsured rate post-ACA: 8.27%
Difference: -7.73%

Washington has the fifth highest drop in the rate of uninsured adults and the most new Medicaid enrollees per capita.

8. Iowa

Uninsured rate pre-ACA: 11.58%
Projected uninsured rate post-ACA: 7.47%
Difference: -4.11%

The Hawkeye State has the fourth lowest number of net new private insurance enrollees per capita.

7. Minnesota

Uninsured rate pre-ACA: 10.07%
Projected uninsured rate post-ACA: 6.61%
Difference: -3.47%

After Massachusetts and Hawaii, Minnesota has the third lowest number of net new private insurance enrollees per capita.

6. West Virginia

Uninsured rate pre-ACA: 17.34%
Projected uninsured rate post-ACA: 6.59%
Difference: -10.74%

The Mountain State is projected to see the biggest drop in uninsured adults. It also has the most new Medicaid enrollees per capita, but also the fewest net new private insurance enrollees per capita.

Next page: States with the lowest uninsured rate, ranks 1-5.

States with lowest uninsured rate post-ACA implementation

5. Oregon

Uninsured rate pre-ACA: 16.91%
Projected uninsured rate post-ACA: 6.38%
Difference: -10.54%

Only West Virginia has a greater drop in the rate of uninsured adults. Oregon also comes in second to the Mountain State for its high number of new Medicaid enrollees per capita.

4. Hawaii

Uninsured rate pre-ACA: 9.11%
Projected uninsured rate post-ACA: 6.35%
Difference: -2.75%

The Aloha State's low uninsured rate is not due to its new enrollees in private insurance, as it ranks second to last. Massachusetts, which underwent health reform in 2006, is the only state to rank lower.

3. District of Columbia

Uninsured rate pre-ACA: 9.09%
Projected uninsured rate post-ACA: 6.29%
Difference: -2.8%

Of the 21 states that expanded Medicaid, the District ranked second to last in new Medicaid enrollees per capita. Only Illinois had fewer.

2. Rhode Island

Uninsured rate pre-ACA: 14.34%
Projected uninsured rate post-ACA: 5.6%
Difference: -8.73%

Rhode Island has the third highest rate drop in uninsured adults, second to West Virginia and Oregon. It also has the fourth highest new Medicaid enrollees per capita

1. Massachusetts

Uninsured rate pre-ACA: 4.35%
Projected uninsured rate post-ACA: 1.2%
Difference: -3.16%

Massachusetts passed a healthcare reform law in 2006, which explains why the state has the fewest net new private insurance enrollees per capita.

Next page: States with the highest uninsured rates post-ACA

States with highest uninsured rate post-ACA

10. Georgia
Uninsured rate pre-ACA: 21.66%
Projected uninsured rate post-ACA: 18.16%
Difference: -3.5%

9. Wyoming
Uninsured rate pre-ACA: 18.92%
Projected uninsured rate post-ACA: 18.29%
Difference: -0.63%

Wyoming has the third lowest drop in adult uninsured rates post-ACA.

8. Oklahoma
Uninsured rate pre-ACA: 19.76%
Projected uninsured rate post-ACA: 18.33%
Difference: -1.43%

7. Alaska
Uninsured rate pre-ACA: 20.48%
Projected uninsured rate post-ACA: 18.96%
Difference: -1.52%

6. Nevada
Uninsured rate pre-ACA: 26.52%
Projected uninsured rate post-ACA: 19.58%
Difference: -6.94%

Next page: States with the highest uninsured rates post-ACA, ranks 1-5

States with highest uninsured rates post-ACA

5. New Mexico
Uninsured rate pre-ACA: 24.29%
Projected uninsured rate post-ACA: 19.59%
Difference: -4.69%

4. Florida
Uninsured rate pre-ACA: 24.73%
Projected uninsured rate post-ACA: 19.61%
Difference: -5.12%

3. Louisiana
Uninsured rate pre-ACA: 22.41%
Projected uninsured rate post-ACA: 20.91%
Difference: -1.5%

2. Mississippi
Uninsured rate pre-ACA: 18.11%
Projected uninsured rate post-ACA: 21.46%
Difference: 3.34%

Mississippi is the only state to experience an increase in its uninsured rate post-ACA.

1. Texas
Uninsured rate pre-ACA: 26.8%
Projected uninsured rate post-ACA: 24.81%
Difference: -1.99%

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