The Uninsured: Part 1

A policy analysis of the Affordable Care Act

The Affordable Care Act (ACA) was passed in 2010 and aims to give more Americans access to affordable, quality health insurance, and to reduce the growth in health care spending in the U.S. To achieve this first goal, an individual mandate requires that most Americans get some kind of health insurance by 2014. March 31, 2014 marked the end of the open enrollment period if you want an insurance plan through the federal or state marketplaces. This was also the date to sign up by if you want to avoid the tax penalty if you do not have insurance or an exemption. The ACA estimated 32 million people would gain coverage, out of about 48 million who do not have insurance. Subsidies from the federal government will help pay for health insurance on state-based exchanges starting in 2014 and will allow many low- to moderate-income Americans to get a break on their premiums.

In the first part of our analysis we looked at who the uninsured are and what the demographics of these 48 million Americans look like. Then we explored how the ACA addresses the needs of these specific groups of uninsured people.

Table 1

Table 1 shows a breakdown of the population based on certain characteristics such as age, sex, race, and employment status and then gives the percent distribution based on insurance coverage. The age group that has the highest percent of uninsured are adults aged 18-65. Within this group there are 11 million young adults ages 18 to 29 that lack coverage.[1] More men are uninsured than women. The largest ethnic group that is uninsured are Hispanic and Latinos.

Within the adults that are uninsured, the group of young adults between 19-25 years of age have received the benefits of an additional benefit of the ACA. In one provision young adults can stay on their parent’s private health insurance coverage until the age of 26. This provision reduced the number of adults by an estimated 3 million people.[2]

Even though there is relatively high private coverage for employed individuals, the percent of uninsured employed people is only 0.2% less than the percent of unemployed and uninsured people. This could be due to employed individuals only working part time. Many companies do not offer health benefits to part-time employees. Under the ACA, large employers will have to offer benefits to full-time employees that work 30 or more hours a week. There are 7.6 million part time workers and 3.5 million self-employed workers that do not have health insurance. Depending on their income, Part-time workers and self-employed individuals can gain ACA coverage through Medicaid or Health Insurance Marketplaces.

In our next post, part 2 of The Uninsured, we will discuss a provision to the ACA that will increase the number of insured.

[1] Medical Expenditure Panel Survey: Health insurance coverage of the civilian noninstitutionalized population:Percent by type of coverage and selected population characteristics, United States, first half of 2012

[2] Kaiser Family Foundation. The Uninsured – Interactive Tool. Accessed April 2014: http://kff.org/interactive/the-uninsured-an-interactive-tool/

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