The NCSL Blog


By Ashley Noble

States have made significant improvements in health systems performance over the past couple of years, according to a new report from The Commonwealth Fund (CWF), "Aiming Higher: Results from a Scorecard on State Health System Performance, 2015 Edition."

Doctor with patientThe greatest number of improvements related to access and affordability were observed in California, Florida, Montana, Oklahoma, Oregon and Rhode Island. Other highlights in the report, which uses a set of 42 performance indicators for 2013 and 2014, include the following:

  • Roughly 84 percent of adults ages 19-64 were covered under a public or private health insurance plan in 2014. This represents a 4 percentage point increase from 2013 average rates of insurance coverage for the same age group. Ten states and the District of Columbia have achieved coverage rates of working-age adults of 90 percent or higher. In 2013, only four states had achieved that coverage level.
  • The number of children in the U.S. without health insurance declined by 2 percentage points from 2013 to 2014. Approximately 6 percent of children in the U.S. were uninsured in 2014.
  • Twenty-two states increased rates of recommended vaccinations by at least 3 percentage points in children ranging in age from 19 months to 35 months.
  • States continue to address health disparities in access to care and health care outcomes among different populations. Seven states—Arizona, California, Florida, Illinois, New York, North Carolina and Oklahoma—improved in eight of 13 indicators of racial/ethnic disparities evaluated by the Commonwealth Fund.

The report also points to areas where states have work to do to improve their health systems.

  • Nine states experienced increases in the numbers of adults who did not see a dentist in the previous year.
  • Fifteen states and the District of Columbia experienced declines of at least 3 percentage points in the number of children younger than 3 who received all of the vaccines recommended for their age group.
  • Eleven states experienced increases of 2 percentage points or more in the share of adults who meet the criteria for obesity.

See state-specific report data on this interactive map

Map of adults with health coverage

Ashley Noble is a policy specialist in NCSL's Health program.

Email Ashley

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.