The Affordable Care Act was signed into law six years ago this month. The uninsured rate is now 11.9%, the lowest ever recorded. Approximately 17 million more Americans have health insurance today than before the law was passed. Hospitals across the nation have saved tens of billions of dollars on uncompensated care.

Despite this progress, over 5 million Americans remain unable to access health insurance because they fall into the “coverage gap.” These individuals make too much income to qualify for Medicaid, but too little to be eligible for the tax credits that make private health insurance affordable.

While 80% of this group live with incomes below the Federal Poverty Level, over 70% have at least one full-time worker in their family. Nearly one-third of these households carry medical debt, the primary cause of bankruptcy in the nation.

Everyone stuck in the “coverage gap” lives in one of 18 states; the other 32 states have expanded Medicaid.

It’s clear the Affordable Care Act has made a positive difference. But challenges remain. A minority of states have stubbornly chosen to leave hard-working residents without access to health care. Those elected leaders have sacrificed the health of their constituents in pursuit of individual political goals.

Legislation is under consideration in the 18 states yet to expand health care access. If you live in one of those states, take this opportunity to tell your representative where you stand. Let’s work together to make the “coverage gap” a thing of the past.

By Johnathan Hladik

Center for Rural Affairs