Certain states are also lagging in health care access. Texas, Nevada and Florida top the nation in uninsured with more than 1 in 5 people living without health insurance, according to 2011 data. Nationwide, the average is closer to 1 in 6 people uninsured.
Massachusetts, which began implementing a statewide health insurance mandate in 2006, has the lowest numbers of uninsured in the nation at 1 in 23 individuals, a scenario that bodes well for the ACA, which was modeled, in part, after the Massachusetts plan.
Some states, like Minnesota, have been doing relatively well all along, and Blewett attributes its success to the state's sound economy with a set of large employers with a tradition of providing comprehensive health coverage, as well as a public health insurance program that covers broad classes of individuals, including homeless men.
Texas, on the other hand, has a very different kind of economy, and a weak public safety net.
“Texas has a lot of small employers, it's a different culture of coverage” said Blewett. “It's very hard for small employers to provide coverage.”