The Obamacare that's working best is public Medicaid expansion, not private insurance

Center on Budget & Policy Priorities - Since  the major coverage provisions of the Affordable Care Act  took effect in  2014, insurance coverage rates have improved  across the country, but  the gains  are far greater  in  the  states that have expanded Medicaid . As a result, hospitals in expansion states  are treating fewer uninsured patients, and  the amount of  uncompensated care they  are providing is  declining steeply.

Moreover, contrary to critics ’ claims that Medicaid expansion is  financially  unsustainable for states , there is increasing evidence that  expansion has saved states money, and  these savings  are expected to grow  over time. 

The Medicaid expansion has had an especially dramatic impact in Arkansas and Kentucky, which both had high uninsurance rates and limited Medicaid eligibility for non-elderly adults before  health  reform.  Both states’ uninsurance rates have fallen by half in  just over  a year, and  the expansion is expected to  save each state more than $100 million by the time their current state fiscal years end on June 30 .

Meanwhile, the states that have not expanded Medicaid are falling further behind. In the non-expansion states, large numbers of low - income people  remain uninsured and without access to  affordable health coverage.  These individuals are caught in a “coverage gap ” because their incomes  are too high for Medicaid but too low for subsidies to purchase coverage in the marketplace.  Hospitals in these states continue to provide large amounts of uncompensated care, and  the states  are missing  the opportunity to  leverage  billions  of dollars  in new federal funding  through the Medicaid expansion.