The uninsured rate declined in 42 states in 2014, and adults in 21 states were less likely to go without care due to cost, according to a new report from the Commonwealth Fund. The share of low-income adults who were uninsured dropped at least three percentage points in every state except Maine, where it fell two percentage points. A separate report also looks at state performance on other indicators related to health care access, quality, costs and outcomes. “These are the most substantial and widespread state improvements in access to care we’ve seen since we created the state scorecard series in 2007,” said Commonwealth Fund President David Blumenthal, M.D. “While there are still wide differences among states, and performance has worsened in some instances, policy changes like those in the Affordable Care Act, incentives to improve health care quality and safety, and provider-led efforts are beginning to bear fruit.”