Georgia’s uninsured rate of 13.9 percent in 2015 was the nation’s third-highest, trailing only Texas and Alaska, according to U.S. Census Bureau data released Tuesday.

The rate in Georgia fell from 15.8 percent the previous year.

The number of Georgians without health insurance, 1,388,000, was the fourth-highest total in the nation in 2015. (By contrast, Georgia is the No. 8 state in overall population.)

Georgia was tied with Oklahoma with a 13.9 percent uninsured rate last year.

Nationally, the percentage of Americans who had no health insurance last year fell to 9.1 percent, the report said. The number of people without health insurance declined from 33 million to 29 million over that period, Census officials said.

The gains in insurance coverage are largely attributed to the Affordable Care Act. Among other things, the 2010 law created insurance exchanges to help consumers find and purchase affordable health coverage.

But the health law has taken widespread criticism recently, with the departure of health insurers Aetna and UnitedHealthcare from the insurance exchanges in several states, including Georgia. And insurers remaining in the exchanges have requested high premium increases.

Not unexpectedly, the federal data showed that states that have expanded their Medicaid programs under the ACA had lower rates of people without coverage than states that have not, such as Georgia. Medicaid expansion, which is optional for states, extends the program to more low-income people.

Two Southern states that have adopted Medicaid expansion, Arkansas and Kentucky, had 2015 uninsured rates of 9.5 percent and 6 percent, respectively, the Census figures showed.

States that have held out against Medicaid expansion are generally run by Republicans. Georgia’s Republican governor and legislative leadership have rejected expansion as too expensive. But proponents of such a move, including some members of the GOP, have helped build momentum for the Legislature at least to consider such a plan.

A task force created by the Georgia Chamber of Commerce has proposed three alternatives to standard Medicaid expansion, all of which would increase access to health insurance. (Here’s a recent GHN article on the proposals.)

The state’s high poverty rate “is one of the reasons why Medicaid expansion would have such a large impact on Georgia,” Bill Custer, a health insurance expert at Georgia State University, said Tuesday.

The ACA fueled the decrease in the uninsured rates by adding the exchange coverage and Medicaid expansion, Custer said. The Census data indicate that “we don’t see an erosion of employer-based coverage,” he said.

The national uninsured rate is the lowest in decades, if not ever, Custer said.

Cindy Zeldin of Georgians for a Healthy Future pointed to the impact of expansion on coverage rates. “The success of other states around the country, including Southern states like Kentucky and Arkansas, in driving their uninsured rates down below 10 percent shows that we can do it too.” she said. “Closing the coverage gap in Georgia would help put us on this path.”

Nationally, employer-based insurance covered 55.7 percent of the population for some or all of the calendar year, followed by Medicaid (19.6 percent), Medicare (16.3 percent), direct-purchase (16.3 percent), and military coverage (4.7 percent).

Non-Hispanic whites had the lowest uninsured rate among ethnic demographic categories, at 6.7 percent.

The uninsured rates for African-Americans and Asians were higher than for non-Hispanic whites, at 11.1 percent and 7.5 percent, respectively. Hispanics had the highest uninsured rate in 2015, at 16.2 percent.

The Census also reported that median household income in the United States in 2015 was $56,516, an increase of 5.2 percent from the 2014 median income of $53,718. This is the first annual increase in median household income since 2007, the year before the most recent recession.

The nation’s official poverty rate in 2015 was 13.5 percent, with 43.1 million people in poverty, 3.5 million fewer than in 2014. The 1.2 percentage point decrease in the poverty rate from 2014 to 2015 represents the largest annual percentage point drop in poverty since 1999