By Pension and Benefits Editorial Staff
States’ progress in expanding health care coverage and access since the Patient Protection and Affordable Care Act (ACA) was enacted has stalled, according to recent research from the Commonwealth Fund. The report, 2019 Scorecard on State Health System Performance, noted that although nearly all states saw widespread reductions in their uninsured rates between 2013 and 2016, progress stalled after 2015. Between 2016 and 2017, more than half of states simply held on to earlier coverage gains among working-age adults. And 16 states, including those that have expanded Medicaid and those that have not, experienced one-percentage-point upticks in their adult uninsured rate.
Health care costs are the primary driving force behind rising premiums, which are an increasing financial burden to working families in all states. Per-enrollee cost growth in employer plans grew at a faster pace than in Medicare from 2013 to 2016 in five of eight regions of the country and in 31 states. Across states, per-enrollee spending growth in employer plans was more variable than in Medicare.
State rankings. Hawaii, Massachusetts, Minnesota, Washington, Connecticut, and Vermont rank at the top of the Commonwealth Fund’s scorecard. The scorecard assesses all 50 states and the District of Columbia on 47 health care measures, covering access, quality, service use and costs of care, health outcomes, and income-based health care disparities. Arkansas, Nevada, Texas, Oklahoma, and Mississippi rank at the bottom in the report.
The Commonwealth Fund found that California had the largest jump in rankings, and Rhode Island improved on the most indicators that are tracked over time. Only Delaware, which fell 17 spots in the rankings, Hawaii, New Mexico, and Wyoming performed worse on more measures than they improved on over a five-year period.
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