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The CHCF Blog

ACA's Impact: Fewer Uninsured in Most Congressional Districts

Lacey Hartman, Senior Research Fellow, State Health Access Data Assistance Center
Lacey Hartman
Lacey Hartman

A new analysis by the State Health Access Data Assistance Center (SHADAC) provides information about the impacts of the Affordable Care Act (ACA) on the uninsured by all 435 congressional districts in the 50 states. The analysis, funded by the California Health Care Foundation, includes detailed infographics and data tables illustrating changes in the number and rate (percentage) of uninsured between 2013 and 2015 across all congressional districts and for a range of demographic groups within each district, including: race/ethnicity, income, citizenship, educational attainment, and employment status.

Impacts of the Affordable Care Act on Insurance Coverage by Congressional District

All but five of the nation's congressional districts experienced a statistically significant decline in the uninsured rate between 2013 and 2015. However, there was considerable variation in the magnitude of these declines. The decline in the uninsured ranged from 14.5 percentage points in the 34th District of California to slightly less than one percentage point in the 3rd District of Massachusetts. There was also variation in the ACA impact on the uninsured for subgroups within individual congressional districts. For example, in many districts, people with lower incomes and less education saw the biggest drop in their uninsured rate under the ACA. The infographics provide intuitive "at a glance" visualizations of these important differences.

Percentage Change in Uninsured and Rate of Uninsured Among the Employed

Health care continues to be an extremely political and divisive issue. Understanding the impacts of the ACA at the congressional district level is important for policymakers, the media, and other stakeholders engaged in the debate. This analysis can be used to understand trends within individual states as well as to provide insights into how coverage rates for specific groups within individual congressional districts — racial and ethnic minorities, low income populations, etc. — have changed under the ACA.

For more on the impact in California, see ACA 411.

About Lacey

Lacey Hartman is a senior research fellow at the State Health Access Data Assistance Center (SHADAC), where she leads a range of projects aimed at helping states use data to inform policy. Lacey previously worked as the research and policy director at Portico Healthnet and as a senior research economist in the Health Economics Program at the Minnesota Department of Health. She holds a master's degree in public policy from the University of Minnesota and a bachelor's in women's studies and political science from Macalester College in St. Paul.