The graph below, not surprisingly, shows that the rates are lower for the states that are expanding Medicaid. The rates are also decreasing at a faster rate for Medicaid expanding states (15.4% in Q4 2013 to 12.45% in Q1 2014) compared to those who are not (19.6% in Q4 2013 to 18.1% in Q1 2014)
A harder thing to measure is the number of underinsured under the ACA relative to the time before the law was passed. The way in which the word underinsured is defined makes all the difference. It is much easier just to ask survey respondents whether they have insurance or not that to ask them extensive questions about the type of coverage they have and whether it is adequate for their medical needs.
I have reported extensively on Census Bureau Small Area Health Insurance Estimates (SAHIE) because they provide a more local picture of trends in the uninsured. When they are discordant with uninsured rates, the rates of medical bankruptcies could suggest troubles with underinsurance. Getting access to these statistics is difficult however. PNHP has conducted a study on 2007 data found 62.1% of all bankruptcies were the result of medical expenses but new studies will need to be done to assess the impact of the ACA. States with improved uninsured rates but little change in the number of medical bankruptcies could have issues with underinsurance.
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