States Who Embraced the ACA are Having more Success

The Medicaid Gap

Starving the Beast and HealthCare Reform

Although it won’t come as a surprise to many, it is worth noting:

States who embraced the ACA’s main coverage provisions (especially Medicaid expansion) are having more success.

This is to say, the states that rejected Medicaid expansion for their poorest (19 or the 20 states who rejected Medicaid expansion are “red states”, the other is Maine) and those states that erected barriers to enrollment and refused to move health plans into the Obamacare marketplaces (again, mostly red states)… are now faced with poorer, sicker customers than they otherwise might have had… and this is driving up the price of coverage in their regions.

This downward spiral could have been prevented, but some argue that it was no accident.

Rather, some are of the opinion that the rejection of key aspects of the ACA is just part of a tactic called starving the beast (in this metaphor the ACA is the beast and the Republican party are the one’s stabbing it with their Steely knives by “breaking” and “defunding” key provisions). Ideology aside, the worst of all the effects is “the Medicaid Gap” in which millions of our nations poorest are stuck.

Eight of the nine states where consumer choices will be most limited in 2017 have rejected Medicaid expansion and taken other steps that have weakened their marketplaces, data show. These include Alabama, Alaska, Florida, Mississippi, Missouri, North Carolina, Oklahoma and Tennessee, all of which will have only one insurer in most counties next year, according to the Kaiser analysis. See the study: Analysis of 2017 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces. See an article on the study: The states with the biggest Obamacare struggles spent years undermining the law.

TIP: With the above said, some very pro-ACA states are also struggling and data is still somewhat anecdotal at this point (as open enrollment 2017 hasn’t happened yet). This is to say, while the data hints that rejecting the program doesn’t help, it doesn’t paint a simple picture (rather it strongly hints at a complex one that can’t by any stretch be a sole fault of the GOP).

All the above said, the story is nothing new (see 2014’s Gallup: Obamacare working better in states that embraced the law, or 2014’s Five states with ObamaCare success, or 2015’s Two Red States That Embraced Obamacare Have Seen Their Uninsured Rates Plummet Faster Than Anywhere), but its good to retell at regular intervals, less the GOP trick their poorest into being against the ACA due to their health struggles (as some claim IS the intention).

Medicaid Gap: Last Week Tonight with John Oliver (HBO). Here is a clip explaining the general problem.

Full Show – 3/9/11. ‘Starve the Beast’ Strategy Killing Democracy. The main GOP strategy for any type of welfare is to “starve the beast”, the term was coined in the Reagan Era, yadda, yadda, here we are. There isn’t one clip that explains the term, but this one explains the concept from a very liberal standpoint (as you can imagine the GOP doesn’t talk about this as much, although CATO does here for a counterpoint).

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of,, and other websites. He has been in the health insurance and healthcare information field since 2012. is a...

Leave a comment

We'll never share your email with anyone else.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Advertise these facts and SELL it.

ObamaCareFacts is a free informational site. It's privately owned, and is not owned, operated, or endorsed by the US federal government or state governments. Our contributors have over a decade of experience writing about health insurance. However, we do not offer professional official legal, tax, or medical advice. See: Legal Information and Cookie Policy. For more on our company, learn About or Contact us.