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The large number of uninsured people in the United States has been at the forefront of health policy discussion for decades, and in recent years has received increased attention with the passage of the health reform law in 2010.

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

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1

How many Americans were without health insurance coverage in 2011?

2

Compared to adults, children are:

3

Most uninsured people are not covered by employer-based coverage because:

4

Medicaid currently fills in gaps in the availability of health insurance by:

5

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

6

Most uninsured people go without coverage because:

7

The Affordable Care Act seeks to make coverage available to those currently uninsured by:

8

The nonelderly uninsured population is predominantly which of the following:

9

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

10

When people without insurance need to use health care services:

of

Uninsured Quiz

You Answered out of 10 Questions Correctly.

Question

Correct Response

1

How many Americans were without health insurance coverage in 2011?

48 million Americans were without health insurance coverage in 2011.

In 2011, 18% of the nonelderly lacked insurance coverage. Over half of the nonelderly (56%) received health coverage as a benefit through either their own or a family member’s job, about 6% purchased coverage on their own through the “non-group” market, and nearly 20% were covered by public coverage such as Medicaid or CHIP. Nearly all of the elderly are covered through the Medicare program.

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2

Compared to adults, children are:

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

Compared to an uninsured rate of 21% for adults, 10% of children are currently uninsured.  Between 2007 and 2010, the recent recession and ongoing weak job market led to a steep rise in the number of uninsured adults. This trend was driven by a decline in employer-sponsored coverage that resulted from the high jobless rate. At the same time, Medicaid and CHIP expanded to cover more children and the uninsured rate for children actually decreased. In 2011, the uninsured rate for both children and adults decreased slightly.

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3

Most uninsured people are not covered by employer-based coverage because:

Most uninsured people are not covered by employer-based coverage because their employer does not offer coverage.

Most of uninsured people—about 78%—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. 

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4

Medicaid currently fills in gaps in the availability of health insurance by:

Medicaid currently fills in gaps in the availability of health insurance by covering certain groups of low-income people

Medicaid is the nation’s health program for low-income people.  Currently, to qualify for Medicaid, a person must be both low-income and fall into one of the covered eligibility groups, which generally include children, their parents, pregnant women, individuals with disabilities, and the elderly.  In most states, adults without dependent children are ineligible for Medicaid, regardless of how low their income is.  The Affordable Care Act enables states to expand their Medicaid programs to all individuals up to 138% of poverty ($26,344 for a family of three in 2012) as of 2014, with substantial federal funding for this expansion.  

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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, seven out of ten uninsured people have been without coverage for more than a year, and approximately half have been without coverage for more than three years.

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6

Most uninsured people go without coverage because:

Most uninsured people go without coverage because they cannot afford coverage.

Two out of three uninsured nonelderly people lived in households with annual income below 200% of the federal poverty level, or $38,180 for a family of three in 2012. At the same time, the average cost of a private health insurance plan for a family was nearly $16,000 a year, an amount that is unaffordable for most uninsured families.  When asked about health insurance, most of uninsured people report that they would like coverage but indicate that they cannot afford to pay the price of coverage.  Less than a third of uninsured adults feel that they are “too healthy to need insurance coverage.”  In fact, uninsured people are disproportionately likely to be in fair or poor (versus excellent, very good, or good) health, and nearly half of uninsured adults have a chronic health condition.   

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7

The Affordable Care Act seeks to make coverage available to those currently uninsured by:

The Affordable Care Act seeks to make coverage available to those currently uninsured by expanding Medicaid eligibility and providing subsidies to assist with the purchase of private insurance.

The major coverage provisions of the Affordable Care Act are expected to extend coverage to close to half of the population that was previously uninsured by 2016, or approximately 26 million people. These provisions include the expansion of Medicaid to include both parents and childless adults with incomes up to 138% of the poverty line. If all states implement the Medicaid expansion, eligibility would increase in nearly 40 states for parents and in nearly every state for other adults. In addition, many newly insured individuals will receive coverage as a result of the establishment of Health Insurance Exchanges, with federal subsidies to help low and moderate income people to purchase insurance. Those who remain uninsured after health reform implementation include poor people in states that do not expand Medicaid, individuals who may not qualify for assistance (such as those who are not in the United States legally), as well as other individuals who may be exempt from the law’s requirement that all individuals get coverage. These individuals will still need to rely on the nation’s health care safety net of public hospitals and clinics that provide care to the uninsured population.

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8

The nonelderly uninsured population is predominantly which of the following:

The nonelderly uninsured population is predominantly people from working families.

Approximately two-thirds of uninsured people are in families with one or more full-time workers. Another 16% of the uninsured individuals are from families with part-time workers. Though non-citizens (legal and undocumented) are approximately three times more likely to be uninsured than citizens, they account for 20% of the uninsured population. In 2011, less than one in five of the uninsured population consisted of young adults (19-25 years). In addition, beginning in September 2010, the Affordable Care Act allowed young adults to stay on their parent’s private health insurance until age 26. This provision is one reason that coverage rates have improved among young adults in recent years.

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9

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.

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10

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 of 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 consequences for one’s financial status.  Versus 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. 

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