Topeka ? The percentage of people in Kansas without health insurance has fallen at a much slower rate than the nation as a whole, new Census Bureau figures show, reflecting the fact that Kansas has refused to expand its Medicaid program or actively promote other parts of the Obama administration’s signature health care law.

The report, released Tuesday, shows that since 2013, the year before major parts of the law took effect, Kansas had a lower uninsured rate than the rest of the nation: 12.3 percent in Kansas compared with 14.5 percent nationally.

By 2016, however, the rate in Kansas had fallen only 3.5 percentage points, while the national uninsured rate fell nearly 6 percentage points. That means Kansas now has a higher uninsured rate, 8.7 percent, than the national average, 8.6 percent.

“Largely Kansas’ slide compared to other states is due to the lack of Medicaid expansion, but it also reflects the state’s generally negative attitude towards the ACA as a whole,” Robert St. Peter, president and CEO of the Kansas Health Institute, said in an email.

“For example,” he said, “the level of outreach and enrollment to let people know that they may be able to buy affordable, private insurance on the marketplace. Or that even without expansion, they or their children might already be eligible for Medicaid or CHIP. To the extent states failed to do that, it undoubtedly led to fewer persons being insured, especially among working families that are low or middle income.”

St. Peter said it is also possible that there was less of an increase in private insurance coverage in Kansas than there was nationwide.

Republican Gov. Sam Brownback was a U.S. senator at the time the Affordable Care Act was passed in 2010, and he has been a staunch opponent of it. He was elected governor later that same year and has consistently opposed allowing the state to take part in one of the ACA’s key components, making anyone with incomes below 138 percent of the federal poverty level eligible for Medicaid, now known in Kansas as KanCare.

During the 2017 legislative session, Kansas lawmakers passed a Medicaid expansion bill by a wide margin, but Brownback vetoed it, and an effort to override that veto fell short in the House.

The new report also shows that from 2015 to 2016, the uninsured rate in Kansas fell only 0.4 percentage points, a change that was considered not statistically significant because of the margin of error involved in the survey. The U.S. uninsured rate fell 0.8 percentage points over the year, which was considered statistically significant.

The report was part of the American Community Survey, a joint project between the Census Bureau and the Bureau of Labor Statistics.

Additional details from the survey, including breakdowns by metropolitan areas, are scheduled for release Thursday.