2018 MIDTERM ELECTION

Time: D H M S

HHS Sec. Burwell: 10.5M uninsured still eligible for ACA Exchange coverage

In addition to bumping up the HHS Dept's official estimate of how many people have gained healthcare coverage thanks to the ACA, HHS Secretary Burwell also gave the following update about the upcoming 2016 Open Enrollment Period:

Secretary Burwell outlined the following key facts about Marketplace eligible uninsured:

  • About 10.5 million uninsured Americans are eligible for Marketplace coverage in the upcoming open enrollment.
  • While HHS will work to bolster enrollment across the nation, the Department’s top five target areas for outreach are Dallas, Houston, northern New Jersey, Chicago, and Miami – which are home to the highest numbers of uninsured who are eligible for Marketplace coverage.
  • Almost half of the uninsured individuals who are likely eligible for Marketplace plans are between the ages of 18 and 34.
  • Almost 40 percent of the uninsured who qualify for Marketplace plans are living between 139 and 250 percent of the federal poverty level (about $34,000 to $61,000 for a family of four).
  • Approximately one-third of the uninsured who qualify for Marketplace plans are people of color: approximately 19 percent are Hispanic, 14 percent are African American, and 2 percent are Asian American.

Secretary Burwell also described additional takeaways about the uninsured:

  • About half of the uninsured have less than $100 in savings.
  • Nearly three in five of the uninsured are either confused about how the tax credits work or don’t know that they are available.

The first data point is the most relevant to me at ACASignups.net, of course. That's 10.5 million people in addition to the 9.9 million currently enrolled in private ACA exchange policies who a) are not currently covered and b) are eligible to enroll via the exchanges.

Remember, although there's a total of anywhere between 29-33 million people uninsured total in the U.S., about 6.5 million of them can't enroll via the exchanges due to being undocumented immigrants, while another 3.7 million are caught in the "Medicaid Gap" (there's nothing legally preventing them from signing up, but by definition these people can't possibly afford exchange policies since they're very low-income and don't receive any financial assistance to help them).

Remove these folks and you stll have around 8.3 - 12.3 million uninsured people who fall into an unknown category; even if you subtract uninsured expatriots or people living in Puerto Rico, Guam and the other U.S. Territories (none of which have ACA exchanges available), that still seems like an awful lot of people unaccounted for.

On the flip side, it's important to note that the total number of people eligible for the ACA exchanges is actually much higher than 10.5 million, since any U.S. citizen could theoretically enroll as long as they're willing to pay full price and don't have other qualifying coverage already. For instance, the 7 million or so people who are currently enrolled in off-exchange individual policies could, if they wanted to, move over to an exchange-based plan next year (and some of them will likely do so due to their non-ACA compliant policies being discontinued at the end of this year).

The other noteworthy points above relate to enrollment outreach targeting as well as risk pool demographics.

UPDATE: Over at Xpostfactoid, Andrew Sprung has done some additional number-crunching and poses another interesting question: Is the HHS Dept. only targeting 5.5 million subsidy-eligible uninsureds?

UPDATE x2: The other rather depressing tidbit is the last point: Fully 59% of those who are still uninsured don't know about the federal tax credits (or, at best, don't understand how they work).

I'm hoping beyond hope that the "don't understand how they work" part makes up the bulk of this population. If not, then that's potentially as many as 17 million people who still aren't aware that financial assistance is available for those who qualify, even after 5 friggin' years of the ACA sucking the oxygen out of the room. (sigh)