Trump has said, the Affordable Care Act’s health insurance marketplaces are not uniformly failing. Instead, they have succeeded in some states, while failing in others largely because of political and policy decisions made in each state. The New York Times article looks at the exchanges in New Mexico and Oklahoma, both Republican states. New Mexico, a state that embraced the law, has seen a healthy and successful marketplace. Oklahoma, on the other hand, resisted the law at every turn, and now sees a failing marketplace.
New Mexico expanded Medicaid as soon as the law allowed and has four insurers selling plans. The marketplace is overseen by the state and outreach is conducted to draw in potential customers, all moves likely to have helped attract healthier customers. The uninsured rate in 2015 was 10.9 percent.
Oklahoma, since the law’s passage, has fought against it. The state challenged the law’s subsidies in a lawsuit, refused to expand Medicaid and refused to set up its own state-run insurance exchange. Instead, their marketplace is run by the federal government. Only one health insurer is left selling coverage through the federal marketplace and the uninsured rate in 2015 was 13.9 percent.