Nearly half of nonelderly uninsured patients are eligible for Medicaid or subsidized coverage through the Affordable Care Act (ACA) marketplace, according to a study released Oct. 13 by the Kaiser Family Foundation.
More than a quarter of uninsured patients at the start of 2015 were adults eligible for Medicaid or children eligible for Medicaid or the Children’s Health Insurance Program. One in five of the nonelderly uninsured population were eligible for premium tax credits to purchase coverage through the ACA marketplace.
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For the study, Kaiser researchers analyzed data from the 2015 Current Population Survey Annual Social and Economic Supplement, which provides socioeconomic and demographic information for the United States population and specific subpopulations. Of 32 million uninsured patients at the start of 2015, 16 million (49%) were eligible for state or federal government assistance through Medicaid or the ACA. One in ten (3.1 million) fell into the coverage gap because of their state’s decision not to expand Medicaid, according to the study. About 15% of the uninsured (4.9 million) patients were undocumented immigrants ineligible for ACA coverage under federal law. The remainder of the uninsured were not eligible for assistance under the ACA because they have access to employer coverage or have incomes too high to qualify for Medicaid or marketplace subsidies.
The rate of uninsured patients eligible for either ACA-based coverage or Medicaid varied widely across states. In Nebraska and Texas, 35% of nonelderly uninsured patients were eligible for coverage, while in West Virginia, 75% of uninsured patients were eligible for coverage under Medicaid or the ACA. Five states account for 40% of the uninsured population that could receive Medicaid or subsidized private coverage under the ACA, including California (2 million), Texas (1.5 million), Florida (1 million), New York (865,000), and Pennsylvania (656,000).
The authors concluded that there are still significant opportunities for the government to increase the number of insured patients under the ACA by reaching these eligible patients before the 2016 open enrollment period begins on Nov. 1. However, the authors note that, in many cases, the uninsured will remain uninsured because they are either undocumented or live in states that have not expanded Medicaid.
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