CHA News Article

Report Profiles Adults Who Remained Uninsured at the End of 2014

The Kaiser Family Foundation has released a report titled Adults who Remained Uninsured at the End of 2014, based on its 2014 survey of low-income Americans and the Affordable Care Act (ACA). The report profiles the nonelderly adult population that remained uninsured as of fall 2014. Based on the survey findings, approximately 11 million nonelderly adults were newly insured, meaning they reported that they obtained health coverage in 2014 and were uninsured before that coverage started. However, a large share, about 30 million people, reported that they were uninsured as of the date of the survey. Some are ineligible for ACA coverage, either because of their immigration status or because their state did not expand Medicaid, while others may be eligible but aren’t aware of the new coverage options, or have had difficulty navigating the enrollment process.

Still others may have opted not to enroll in coverage for a variety of reasons, such as affordability or personal preferences. The report describes the characteristics of this population, examines why they lack insurance coverage and reasons for not enrolling, and provides information on the coverage options available to the remaining uninsured and their plans for obtaining coverage in 2015.

Key report findings reveal:

Understanding Who Remains Uninsured

  • The remaining uninsured are no more likely to be “young invincibles” than those who gained coverage in 2014.
  • More than half of the remaining uninsured population have family income at or below 138 percent of poverty, the income range for the Medicaid expansion.
  • A majority of the remaining uninsured are in a family with at least one worker.
  • Access to employer-based coverage is limited among uninsured adults.
  • Coverage transitions remain a challenge to continuous coverage.
  • Uninsured adults are more likely than those with coverage to say their health is fair or poor, but are less likely to have a diagnosed medical condition.
  • Hispanics are disproportionately represented among the remaining uninsured population.
  • Adults who remain uninsured are more likely than those with coverage to have uninsured children.

Connecting the Eligible Uninsured to Coverage

  • About half of adults who remained uninsured at the end of 2014 are likely eligible for assistance under the ACA.
  • Cost remains a major barrier to coverage.
  • Despite the availability of low-cost or zero premium coverage, a majority of eligible adults still perceive insurance to be too expensive.
  • Most adults who were uninsured in fall 2014 had not tried to get ACA coverage.
  • Gaps in eligibility or confusion about eligibility are evident among the uninsured who sought ACA coverage.
  • Many uninsured adults who applied for ACA coverage say the coverage offered was unaffordable.
  • While most uninsured adults did not cite application problems as the main reason for not enrolling in ACA coverage, many did encounter difficulties with the application process.
  • Among those who tried to get ACA coverage, most reported trying multiple avenues, and most tried to get coverage directly from the state or federal government.
  • Even among those likely eligible, few uninsured adults have plans to obtain ACA coverage.

The full report is attached.