CHA News Article

Issue Brief Estimates Eligibility for ACA Coverage Among the Uninsured

The Kaiser Family Foundation (KFF) has released an analysis that provides national and state-by-state estimates of eligibility for Affordable Care Act (ACA) coverage options among those who remain uninsured. The estimates are based on KFF analysis of the 2015 Current Population Survey, combined with other data sources, and apply to coverage and eligibility as of early 2015, prior to the end of the 2015 marketplace open enrollment period. KFF estimates there 3.84 million uninsured in California. Of these, 1.42 million are Medicaid-eligible; 623,000 are eligible for tax credits; and 1.79 million are ineligible for financial assistance due to income, employer-sponsored insurance (ESI) or citizenship status.

According to the report, as of the beginning of 2015, nationally 32.3 million nonelderly people lacked health coverage. KFF estimates that nearly half (15.7 million, or 49 percent) of this population is eligible for financial assistance to gain coverage through either Medicaid or subsidized marketplace coverage. More than a quarter are either adults eligible for Medicaid (5.4 million, or 17 percent) or children eligible for Medicaid or the Children’s Health Insurance Program (3.2 million, or 10 percent). The Medicaid-eligible include those who were previously eligible as well as those newly eligible under the ACA. About one in five (7.1 million, or 22 percent) of the nonelderly uninsured is eligible for premium tax credits to purchase coverage through the marketplace. One in ten uninsured people (3.1 million) falls into the coverage gap due to their state’s decision not to expand Medicaid, and 15 percent of the uninsured (4.9 million) are undocumented immigrants who are ineligible for ACA coverage under federal law. The remainder of the uninsured either has an ESI offer (4.9 million, or 15 percent) or has an income above the limit for premium tax credits but could purchase unsubsidized marketplace coverage (3.7 million, or 12 percent). KFF states that it cannot determine from available survey data if the ESI offers would be considered affordable under the law, which would make the individual ineligible for a marketplace premium subsidy.

The full report is available on the KFF website at