The Uninsured Part 2

Another provision that will increase the number of insured individuals is that private insurance companies can no longer deny coverage to people based on pre-existing conditions. As of 2010, there were 50.6 million nonelderly people in the United States with a pre-existing health condition of which 8.8 million people were uninsured.[3] Individuals that can afford private insurance will now be eligible to enroll in these programs and cannot be denied coverage. They will also have the access to the marketplace subsidies and Medicaid if eligible.

Image 1

Table 2 shows the uninsured based on income and poverty level. Higher levels of uninsured are seen in lower poverty levels and at lower incomes.
For lower income groups, there are two main parts to the government subsidies that will allow for greater coverage. One is the expansion of Medicaid which is limited to a specific low-income groups. The other is market subsidies for people from 100%-400% above the federal poverty line (or incomes from $11,490 – $45,960). However, states that do not expand their Medicaid eligibility limit will have a coverage gap. The Kaiser Family Foundation estimates that 4.8 million nonelderly adults below the poverty line will remain uninsured. In this group 41% will be from states that are not expanding Medicaid and 79% will be from the south. [4]

The success of this law in the future will depend on the mix of enrollees; mainly if enough healthy people signed up to help offset the costs of sicker patients. It will also depend on the mix of enrollees in each specific state, since there are 51 unique insurance markets (including the District of Columbia). There will be some states that thrive under the ACA and others that will surely struggle, depending on a number of factors, like demographics, political attitudes and the history of their insurance markets before the law.

[3] Kaiser Family Foundation. The Uninsured – Interactive Tool. Accessed April 2014:
[4] Kaiser Family Foundation. Characteristics of Poor Uninsured Adults who Fall into the Coverage Gap. Accessed April 2014:

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