Filling the need for trusted information on national health issues…

Trending on kff Open Enrollment Medicare Part D Medicaid Expansion

The large number of uninsured people in the United States has been at the forefront of health policy discussions for decades and has received increased attention with the passage of the Affordable Care Act in 2010 and the implementation of its major coverage expansions in 2014.

How much do you know about the uninsured population and the consequences of not having coverage?

Get Started

1

How many people under 65 in the United States were without coverage in 2014?

32 million people under age 65 were without health insurance coverage in 2014.

2

Following implementation of the Affordable Care Act in January 2014, the uninsured rate:

Following implementation of the Affordable Care Act (ACA) in January 2014, the uninsured rate reached its lowest level in decades.

3

Since the ACA coverage expansions, how do uninsured rates for children compare to those for adults?

Compared to adults, children are less likely to be uninsured.

4

The remaining nonelderly uninsured population is made up predominantly of which of the following:

The remaining nonelderly uninsured population is made up predominantly of people from working families.

5

Most of the uninsured have been without health coverage for how long?

Most of the uninsured have been without health coverage for a year or more.

6

The main reason that people say they are uninsured is:

The main reason that people say they are uninsured is that the cost of coverage is too expensive.

7

Compared to people with health coverage, those who are uninsured are more likely to:

Compared to people with health coverage, those who are uninsured are more likely to forgo health care services when they are sick.

8

When people without insurance need to use health care services:

When people without insurance need to use health care services, they are typically billed for those services.

9

In states that did not expand Medicaid, what coverage options are available for poor uninsured adults?

In states that did not expand Medicaid, poor uninsured adults are likely to fall into a “coverage gap” in which they earn too much to qualify for Medicaid in their state but too little to qualify for subsidies in the Marketplace.

10

True or False: Nearly all of the remaining uninsured population is ineligible for assistance under the Affordable Care Act.

Roughly half of the nonelderly population that remained uninsured as of the beginning of 2015 was eligible for financial assistance under the ACA.

of

Uninsured Quiz

You Answered out of 10 Questions Correctly.

Question

Correct Response

1

How many people under 65 in the United States were without coverage in 2014?

32 million people under age 65 were without health insurance coverage in 2014.

In 2014, 12% of the nonelderly lacked insurance coverage. Over half (56%) received health coverage as a benefit through their own or a family member’s job, 5% purchased coverage on their own through the “non-group” market, and over one in five (22%) were covered by public coverage such as Medicaid or CHIP.

Learn More

2

Following implementation of the Affordable Care Act in January 2014, the uninsured rate:

Following implementation of the Affordable Care Act (ACA) in January 2014, the uninsured rate reached its lowest level in decades.

Corresponding with implementation of the Affordable Care Act, the total number of nonelderly uninsured people nationally dropped from 41.1 million in 2013 to 32.3 million in 2014. Nearly the entire decline in the number of uninsured people occurred among adults.

Learn More

3

Since the ACA coverage expansions, how do uninsured rates for children compare to those for adults?

Compared to adults, children are less likely to be uninsured.

Compared to an uninsured rate of 14% for nonelderly adults, 6% of children were uninsured in 2014. This disparity reflects ongoing differences in eligibility for Medicaid, as well as expanded eligibility for public coverage available to children through the Children’s Health Insurance Program (CHIP). While the ACA has increased Medicaid eligibility levels for adults, they remain below those of children in most states. As of January 2015, the median Medicaid/CHIP income eligibility threshold for children in Medicaid expansion states was 305%, compared to 138% for adults. In non-expansion states, the median was 215% for children, 45% for parents, and childless adults were excluded in all but one non-expansion state.

Learn More

4

The remaining nonelderly uninsured population is made up predominantly of which of the following:

The remaining nonelderly uninsured population is made up predominantly of people from working families.

While undocumented immigrants and “young invincibles” are at increased risk of being uninsured, most of the uninsured—about 85%--are in a family with at least one worker. However, not all employers offer coverage to their employees, and not all employees in firms that provide coverage are eligible. For example, part-time workers may not be eligible for coverage. When offered insurance, most eligible workers choose to take up coverage, though the rising cost of employer-sponsored insurance makes it harder for employees to afford their share of the costs.

Learn More

5

Most of the uninsured have been without health coverage for how long?

Most of the uninsured have been without health coverage for a year or more.

Some uninsured individuals experience relatively brief spells without health insurance due to transitions between coverage. However,  over half of uninsured people have been without coverage for over a year and nearly one in five has never had coverage in his/her lifetime.

Learn More

6

The main reason that people say they are uninsured is:

The main reason that people say they are uninsured is that the cost of coverage is too expensive.

Over half of uninsured people lived in households with annual income below 200% of the federal poverty level, or $38,110 for a family with two adults and one child in 2014. Though the provisions in the ACA aim to make coverage more affordable, almost half of uninsured adults say that the main reason they lack coverage is because it is too expensive. Few uninsured adults say that they are uninsured because they do not need coverage, oppose the ACA, or would rather pay the penalty.

Learn More

7

Compared to people with health coverage, those who are uninsured are more likely to:

Compared to people with health coverage, those who are uninsured are more likely to forgo health care services when they are sick.

Having health insurance makes a difference in whether and when people get medical care. Those without insurance are less likely than those with to receive preventive care, which leads them to be diagnosed at later stages of illness. Among those with health needs, uninsured individuals are less likely to be able to follow recommended care for an illness, receive fewer therapeutic services, and have higher mortality rates than the insured. The uninsured are also less likely to report being in excellent or very good health than the general nonelderly population.

Learn More

8

When people without insurance need to use health care services:

When people without insurance need to use health care services, they are typically billed for those services.

Most uninsured people do not receive health services for free or reduced charge. Rather, they pay out-of-pocket for their care. The share they do not pay, the “uncompensated costs,” are either absorbed by the provider or may be reimbursed by funds appropriated for this purpose, though these funds do not cover all of these costs. Being uninsured has financial consequences. Compared to those with insurance, people without health coverage are more likely to be sent to collection over medical bills or to have to use their savings to pay medical bills.

Learn More

9

In states that did not expand Medicaid, what coverage options are available for poor uninsured adults?

In states that did not expand Medicaid, poor uninsured adults are likely to fall into a “coverage gap” in which they earn too much to qualify for Medicaid in their state but too little to qualify for subsidies in the Marketplace.

Over three million poor adults fell into a coverage gap in the twenty states that had not expanded Medicaid as of 2015. These adults have incomes above Medicaid eligibility limits in their state but below the lower limit for Marketplace premium tax credits, which begin at 100% FPL ($20,090 for a family of three in 2015). Because the ACA envisioned that people below poverty would be eligible for Medicaid, it does not make premium subsidies available to poor people, and Medicaid eligibility for adults in non-expansion states is very low. In non-expansion states, the median income eligibility level for parents is 44% FPL ($8,840 for a family of three in 2015) and 0% for childless adults. People in the coverage gap are concentrated in Southern states, with the largest number of people in the coverage gap in Texas (766,000 people) followed by Florida (567,000), Georgia (305,000), and North Carolina (244,000).

Learn More

10

True or False: Nearly all of the remaining uninsured population is ineligible for assistance under the Affordable Care Act.

Roughly half of the nonelderly population that remained uninsured as of the beginning of 2015 was eligible for financial assistance under the ACA.

Nearly a quarter of the nonelderly uninsured population in 2015 qualified for tax credits (22%), 17% were adults who were eligible for Medicaid and one in ten were children who were eligible for Medicaid or CHIP.  Most uninsured adults did not try and get insurance in 2014, and despite the availability of low-cost or zero premium coverage, a majority of eligible adults still perceive insurance to be too expensive, with many citing confusion about eligibility.

 

The current design of the ACA leaves the other half of the remaining uninsured outside of reach: in 2014 people were ineligible because they had an offer of employer coverage (15%); their incomes were above the threshold to qualify for Marketplace subsidies (12%), due to immigration status (15%), or because they lived in a state that did not expand Medicaid and were in the coverage gap (10%).

 

 

Learn More