Half of the Americans who remain uninsured several years into Obamacare are eligible for government assistance in buying coverage, a new survey shows.
In less than three weeks, the Obama administration will embark on the third enrollment period under the 2010 Affordable Care Act, where it faces the ongoing challenge of persuading those who have resisted obtaining health coverage to buy it. About 32 million people, or about 11 percent of the U.S. population, are still uninsured.
Of those, 49 percent are eligible for Medicaid, the federal insurance program for the poor, or for federal subsidies to help pay for private plans purchased in new online marketplaces, according to a Kaiser Family Foundation analysis released Tuesday.
In one sense, that’s good news for healthcare advocates trying to help the uninsured enroll, because it indicates many who otherwise might struggle to afford health coverage can qualify for assistance. But experts broadly acknowledge that the remaining uninsured are the hardest population to reach, since they have resisted buying coverage or are unaware of the opportunity to buy it over the two enrollment periods.
“There are still substantial opportunities to increase coverage by reaching those who are eligible for help under the ACA, but the breakdown of who the remaining uninsured are suggests that many may be difficult to reach and will still remain uninsured,” the Kaiser analysts wrote.
Uninsured people whose incomes are low enough to qualify for assistance aren’t spread equally throughout the country. Five states, some of them with the largest populations, account for about 40 percent of them. They include California, Texas, Florida, New York and Pennsylvania. The Department of Health and Human Services has said it plans to focus enrollment efforts in some of those states.
And because eligiblity for Medicaid and subsidies depends on a person’s income, some states have many more eligible residents than others. In Nebraska, just 35 percent of the uninsured population are eligible for assistance, while 75 percent of the uninsured in West Virginia qualify.
And then there’s the problem known as the “coverage gap.” After the Supreme Court gave states the option of expanding Medicaid, 20 Republican-led states chose not to, leaving some of their residents with incomes too high to qualify for Medicaid but too low to qualify for subsidies.
Texas has the most people in the coverage gap with 766,000, followed by Florida with 567,000 people, Georgia with 305,000 people and North Carolina with 244,000 people. Those who fall into the coverage gap are deemed unable to afford coverage and are excused from the individual mandate to buy it.
