Three out of four uninsured U.S. residents live in states that have not made any significant progress in establishing health insurance exchanges under the federal health reform law, according to an analysis by the Associated Press and coverage estimates from the Urban Institute, the AP/Yahoo News reports.
The Urban Institute's research was funded by the Robert Wood Johnson Foundation (Alonso-Zaldivar, AP/Yahoo News, 1/22).
According to the analysis:
- 13 states and the District of Columbia have set up an insurance exchange;
- 17 states have made significant progress on setting up an exchange;
- 16 states have made unclear progress; and
- Four states -- Arkansas, Florida, Louisiana and New Hampshire -- have made no significant progress (AP/San Francisco Chronicle, 1/22).
Uninsured residents of the 20 states that have made little or no progress make up 42% of the nation's total uninsured population, or 21 million of 50 million total, according to estimates by the Urban Institute.
Figures Could Mean Coverage Disparities Between States
According to the AP/Yahoo News, the figures could mean disparities between states in expanding health insurance coverage beginning in 2014, when the health reform law is scheduled to be fully implemented.
In California, there are about 7.5 million residents without coverage. According to the Urban Institute, about 2.9 million Californians stand to gain coverage under the reform law.
Diana Dooley -- secretary of California's Health and Human Services Agency -- said, "It's a very heavy lift," adding, "Coverage is certainly important, but it's not the only part. It is very complex."
Urban Institute researcher Matthew Buettgens said, "There will be something there, but if it doesn't mesh with the state's culture and if the state is not really supporting it, that certainly won't help it succeed."
However, Obama administration officials say that there will not be any disparities between states because the federal government has pledged to run exchanges for states that do not have infrastructure in place by Jan. 1, 2013.
Steve Larsen, director of HHS' Center for Consumer Information and Insurance Oversight, said, "The fact of states moving at different rates does not create disparities for a particular state's uninsured population."
Critics doubt that the federal government will be ready to handle the complexities of setting up statewide exchanges (AP/Yahoo News, 1/22).