FORT WAYNE, Ind. (AP) – Indiana had a higher percentage of people lacking medical insurance than any neighboring state in 2018.

The U.S. Census Bureau said Thursday that 8.3% of the state’s residents were uninsured last year, while only 5.4% were not covered in Michigan and 5.6% in Kentucky.

Director of the Community Research Institute at Purdue University Fort Wayne Rachel Blakeman says Kentucky and Michigan have been aggressively expanding Medicaid programs.

The Census Bureau said 43.5% of Kentuckians had Medicare or Medicaid last year. the figure for Indiana was 33.8%.

Blakeman says a strong economy has played a big role in lowering uninsured rates as more people are working for employers that provide insurance.

The Journal Gazette reports Ohio and Illinois also had lower uninsured rates than Indiana. Ohio was at 6.5% in 2018 and Illinois was at 7%.