It shouldn’t be a surprise.  Reluctant states that have so far refused to expand Medicaid under the Affordable Care Act are consistently helping far fewer of their uninsured residents obtain health coverage compared to states that have expanded Medicaid.

The latest study from the Urban Institute yesterday found the uninsurance rate for nonelderly adults dropped 6.1 percent in expansion states compared to only 1.7% in states that haven’t expanded.  (Noting the huge discrepancy, Urban authors write: “This represents a decline in the uninsurance rate of 37.7 percent in the expansion states and only 9.0 percent in the nonexpansion states.”)  Here’s the Urban Institute’s chart:

The findings mirror a flood of recent surveys showing a substantial decrease in the overall number of Americans without health insurance.  The Commonwealth Fund showed a drop from a 20% uninsured rate to 15%, RAND showed a decline from 20.5% to 15.8% and Gallup showed a decline from a high of 18% to 13.4%.

This chart from the Gallup survey illustrates the overall decline in the uninsured rate the most clearly:

So, the sharp decline in the numbers of people living without health coverage is unassailable, it’s just distributed very unevenly – reluctant states who haven’t yet expanded Medicaid are missing out on the big nationwide drop.  This is one more reason for states that have been hesitant to expand to reconsider their decisions.

With such good news about how much states benefit from expanding Medicaid, I was struck today at how some news outlets handled the coverage.  There was the talk radio station in San Antonio that trumpeted, “Obamacare Boosted [sic] Texas Uninsured Rate by Less than 2%,” not bothering to mention the huge drop in rates in every single state which – unlike Texas – has expanded Medicaid.

Then there was the strategy of ignoring the good news and, like the public relations people suggest, “pivoting” to another topic, used in this case by the reliable Affordable Care Act critics the “Foundation for Government Accountability”. They have never met a positive statistic about poor families getting health coverage that they couldn’t disagree with.  The national picture on the effects of expanding Medicaid and enrollment is so good, these folks who made the unfortunate prediction last year that “ObamaCare exchanges are on track for monumental failure” were reduced yesterday, after this latest round of solid enrollment news, to criticizing technical points of Medicaid reform plans in states like North Carolina.

Overall the reaction to this data so far from opponents of expanding Medicaid has seemed to be one of silence.  It was tough to see any mention in the flood of news stories on the decline in the rate of people without insurance much of a critical view.  Why? I argued earlier this week that there has been a big change in our national conversation about poor people and health care where serious debate is about how we best cover people, not whether we should leave some people without access to health insurance.  Similarly, I see the silence and obfuscation on these latest overwhelming survey numbers as another important point for states reluctant to expand Medicaid to consider.  In 1770 John Adams noted:  “Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.”  As more states like Indiana, Utah, Pennsylvania and Florida look at the facts around Medicaid expansion, it becomes easier to look for compromise solutions to expanding health coverage for everyone.