State Medicaid Expansion impacyon Health Insurance Coverage at the County Level

Counties and states with large shares of uninsured risk having to contend with a range of health and economic impacts, such as reduced workplace productivity, unsustainable demands on emergency departments, higher tax burdens resulting from uncompensated care costs, and deteriorating health care quality due to reductions in public spending. In 2013, before the implementation of major provisions of the Affordable Care Act, 41 million U.S. adults age 19–64 had no health insurance. Coverage varies considerably by geographic location. For instance, in 2013 county-level coverage rates ranged from a high of 96 percent in Norfolk County, Massachusetts to a low of 57 percent in Willacy County, Texas.