The Uninsured at the Starting Line: Findings from the 2013 Kaiser Survey of Low-Income Americans and the ACA

Rachel Garfield, Rachel Licata, and Katherine Young
Published: Feb 06, 2014

Table A1: Demographics of Adults, by Insurance Coverage
	Uninsured	Insured
	Uninsured	Employer	Nongroup	Medicaid
Income
< 138% FPL	53%	11%*	14%*	78%*
139-399% FPL	39%	36%	44%	20%*
>400% FPL	8%	53%*	42%*	—
Family Work Status
Working Family	66%	91%*	79%*	30%*
Non-Working Family	34%	9%*	21%*	70%*
Age
19-25	17%	14%	—	14%
26-34	27%	19%*	18%	26%
35-44	24%	23%	13%*	16%*
45-64	33%	44%*	58%*	44%*
Health Status
Ongoing Health Condition	30%	32%	32%	60%*
No Ongoing Health Condition	69%	67%	67%	39%*
Fair or Poor Health Status
Excellent/Very Good/Good	68%	88%*	86%*	54%*
Fair or Poor	32%	12%*	14%*	45%*
Race
White, Non Hispanic	49%	70%*	75%*	52%
Hispanic	30%	11%*	9%*	18%*
Black, Non-Hispanic	12%	10%	—	20%*
Asian/Pacific Islander	2%	4%	—	—
American Indian Alaska Native	—	1%	—	—
Other/DK, Non-Hispanic	6%	5%	—	5%
Citizenship
Citizen	81%	96%*	97%*	93%*
Non-Citizen	19%	4%*	—	7%*
Notes: Don’t Know and Refused responses not shown. Excludes people covered by other sources, such as Medicare, VA/CHAMPUS, or other state programs. NA: Not applicable “–“: Estimates with relative standard errors greater than 30% or cell sizes below 50 are not provided. * Estimate statistically significantly different from uninsured estimate at the 95% confidence level.Source: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A2: History of Uninsurance and Attempts to Gain Coverage Among Currently Uninsured Adults, by Income
	All	By Income
	All	<138% FPL	139-400% FPL	>400% FPL
Length of Time Uninsured
< 3 months	9%	7%	9%	—
3 Months to Less than a Year	10%	9%	13%	—
1 Year to 5 years	34%	33%	35%	—
5 Years or More	29%	31%	27%	—
Have Never Had Coverage	18%	20%	16%	—
Attempts to Gain Coverage
Applied for Medicaid in past 5 years	31%	38%	27%^{^}	—
Applied for Medicaid but did not enroll	22%	27%	18%^{^}	—
Applied for Medicaid but told ineligible	19%	25%	15%^{^}	—

Tried to purchase nongroup coverage in past 5 years	22%	20%	22%	—
Tried to purchase nongroup coverage but did not purchase policy	17%	15%	17%	—
Tried to purchase nongroup coverage but too expensive	13%	14%	13%	—
Notes: Don’t Know and Refused responses not shown. Excludes people covered by other sources, such as Medicare, VA/CHAMPUS, or other state programs. NA: Not applicable “–“: Estimates with relative standard errors greater than 30% or cell sizes below 50 are not provided. ^{^} Estimate statistically significantly different from <138% FPL estimate at the 95% confidence level. Source: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A3: Ease of Applying for Medicaid, Among Adults who Have Applied, by Income
	All	By Income
	All	<138% FPL	139-400% FPL	>400% FPL
Share reporting step was somewhat or very easy:
Finding out how to apply	75%	76%	74%	—
Filling in requested information	74%	74%	74%	—
Assembling the required paperwork	62%	63%	59%	—
Submitting the application	78%	78%	78%	—
Share reporting all steps were somewhat or very easy	50%	49%	51%	—
Note: Includes adults who either are currently covered by Medicaid or report that they have applied for the program within the past 5 years. “–“: Estimates with relative standard errors greater than 30% or cell sizes below 50 are not provided. Source: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A4: Reasons for and Problems with Choosing Health Plan, Among Adults who Had and Made a Choice, by Income
	All	By Income
	All	<138% FPL	139-400% FPL	>400% FPL
Share who chose plan primarily because:
Your costs under the plan were low	29%	21%	30%^{^}	31%^{^}
The selection of health care providers was broad or included your doctor	22%	27%	20%	21%
The plan covered a wide range of benefits or a specific benefit that you need	32%	31%	30%	34%
Friends or family recommended the plan	6%	7%	8%	—
Other members of your family were already enrolled in this plan	4%	5%	3%	—
Some other reason	6%	7%	8%	5%
Share of Insured Adults Reporting:
Difficulty comparing services covered under each plan	24%	29%	28%	19%^{^}
Difficulty comparing what costs would be under each plan	17%	17%	20%	16%
Difficulty comparing the doctors, hospitals, and other health care providers you could see under each plan	24%	25%	24%	24%
At least one aspect of plan choice to be difficult	36%	41%	40%	32%
Note: Includes insured adults who had a choice of plans and reported that they made the choice themselves. Excludes those who responded Don’t Know or Refused. “–“: Estimates with relative standard errors greater than 30% or cell sizes below 50 are not provided. ^{^} Estimate statistically significantly different from <138% FPL estimate at the 95% confidence level. Source: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A5: Problems with Health Coverage among Insured Adults, by Income and Coverage
	Insured
	Employer	Nongroup	Medicaid
Rate Health Coverage as “Not so good” or “Poor”
All	11%	26%*	16%*
By Income
<138% FPL	16%	—	16%
139-400% FPL	11%	18%	—
>400% FPL	9%	—	—
Needed Service Not Covered by Plan
All	13%	27%*	26%*
By Income
<138% FPL	18%	—	26%
139-400% FPL	16%	27%	25%
>400% FPL	11%	—	—
Plan Would Not Pay for Service You Thought Was Covered
All	21%	34%*	34%*
By Income
<138% FPL	29%	—	32%
139-400% FPL	24%	32%	39%
>400% FPL	18%	—	—
Costs You Had to Pay for a Service Were Higher Than Expected
All	38%	48%*	22%*
By Income
<138% FPL	36%	—	21%*
139-400% FPL	38%	48%	—
>400% FPL	38%	54%*	—
Notes: Excludes people covered by other sources, such as Medicare, VA/CHAMPUS, or other state programs. “–“: Estimates with relative standard errors greater than 30% or cell sizes below 50 are not provided. * Estimate statistically significantly different from employer estimate at the 95% confidence level. Source: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Table A6: Knowledge of Coverage Pathways available under the ACA, by Income and Coverage
	Uninsured^{^}	Insured
	Uninsured^{^}	Employer	Nongroup	Medicaid
Know “only a little” or “nothing at all” about their state’s Medicaid program
All	70%	69%	73%*	46%*
By Income
<138% FPL	70%	64%	65%	46%*
139-400% FPL	67%	71%	75%	47%*
>400% FPL	84%	68%*	73%	—
Know “only a little” or “nothing at all” about the new Marketplaces
All	82%	63%*	70%*	79%
By Income
<138% FPL	86%	77%*	69%*	78%
139-400% FPL	80%	71%*	78%	84%
>400% FPL	73%	55%	62%	—
Notes: Excludes people covered by other sources, such as Medicare, VA/CHAMPUS, or other state programs. ^{^}Uninsured excludes undocumented immigrants. “–“: Estimates with relative standard errors greater than 30% or cell sizes below 50 are not provided. * Estimate statistically significantly different from uninsured estimate at the 95% confidence level. Source: 2013 Kaiser Survey of Low-Income Americans and the ACA.

Methods