Connecticut remains a national leader in implementing the Affordable Care Act and helping its citizens gain access to health insurance.

The state’s health insurance exchange, Access Health CT, recently reported that 116,019 state residents signed up for private insurance utilizing the exchange during the latest open enrollment period, Nov. 1 through Feb. 1. Another 41,000 applied for Medicaid.

The number is more impressive given that U.S. Census figures released last October showed that only 3.8 percent of state residents did not have health insurance, among the lowest uninsured rates in the country. Contrast that with Texas, dead last with 25 percent of its population still without access to health insurance, according to the Texas Medical Association.

Also encouraging is that the sign-up effort reached young adults, with Access Health CT reporting that the customers signing up were 3.5 years younger on average than a year ago.

Access Health did a great job reaching deep into communities, including working with churches, community centers and other grassroots organizations to reach people not accessed through traditional marketing efforts. The sign-ups surpassed the goal of 105,000 to 115,000.

The ACA has its problems. Many are forced to settle for “bronze plans” to make their premiums affordable. They face high deductibles that make it difficult to pay medical bills out of pocket when health problems arise. Also, assessing health insurance options remains overly complex. And for adults, the exchange plans do not offer access to dental coverage.

However, the program has been successful in reducing the number of insured. Before the ACA in 2009, about 48.6 million, nearly 16 percent of the American population, was uninsured. A 2015 study by the CDC using Census data showed the total uninsured rate at 9.2 percent and declining.

Millions of more Americans would have health insurance if all states had cooperated with the new law as did Connecticut. Instead 19 states, predominately in the South, have refused to expand Medicaid under the act. The ACA had intended to provide Medicaid eligibility to all low-income individuals with incomes at or below 138 percent of poverty level, about $28,000 for a family of three.

According to the Kaiser Family Foundation, nearly 3 million adult poor are being denied health insurance due to these callous policies, 89 percent of them in the South, more than a quarter of them in Texas and 20 percent in Florida.

These states are run by Republicans. Their to-hell-with-the-poor policies are shameful.