While a broad array of factors contribute to the relatively high chronic disease rates and poor health outcomes in the South, a first step in addressing these disparities is ensuring that individuals have health coverage that enables them to access preventive and primary care and ongoing treatment to meet their health needs. Health insurance coverage facilitates timely access to health services, and being uninsured affects people’s ability to obtain needed medical care as well as their financial security. Compared to individuals in other regions, Southerners are more likely to be uninsured. Further, within the South, people of color are more likely than Whites to be uninsured. Coverage rates in the South vary by state, however, reflecting variation in demographics and the availability of health coverage options.
The Affordable Care Act has the potential to extend health coverage to many currently uninsured Southerners through an expansion of Medicaid to low-income individuals and the creation of new health insurance Marketplaces with financial assistance to help moderate-income individuals purchase private coverage. Because many southern states are not implementing the Medicaid expansion, many uninsured adults in the South will not gain a new coverage option. However, nearly half of uninsured individuals are eligible for some financial assistance to obtain coverage in 2014, largely through the Marketplace, and millions of eligible individuals have already enrolled.