Lemme say this loud & clear: 4.2 MILLION uninsured are eligible for FREE Bronze plans.

I've written a lot about how the clever Silver Loading and Silver Switcharoo pricing workarounds have managed to result in millions of people becoming eligible for dirt-cheap or even free Bronze ACA exchange healthcare policies, or bargain-priced Gold plans for millions more. Last year, in fact, the Kaiser Family Foundation determined that roughly 4.5 million uninsured Americans qualified for FREE Bronze plans nationally.

Well, they've done it again for 2019. The total number eligible for FREE Bronze plans has dropped a bit to 4.2 million, but that's still a TON of people:

In this analysis, we focus specifically on the approximately 15.9 million uninsured people who could be shopping on the Marketplace, regardless of whether or not they are eligible for a subsidy.1 We therefore exclude people who are eligible for Medicaid and those who are undocumented immigrants (who are not permitted to buy Marketplace coverage).

We estimate that 27% of uninsured individuals who could shop on the Marketplace, or 4.2 million people nationwide, are eligible to purchase a bronze plan with $0 premiums after subsidies in 2019. As shown on the map and table below, the availability of free bronze plans varies widely between states, from less than 5% of uninsured potential Marketplace shoppers in Washington and Indiana to more than 45% in Delaware, Iowa, Nebraska, and Utah.

Rather than continuing to go without insurance, the 4.2 million uninsured people eligible for $0 bronze plans would benefit from the financial protection health insurance offers. However, bronze plans have an average deductible of $6,258, and many people eligible for a $0 bronze premium would also be eligible for significant cost-sharing assistance by instead purchasing a silver plan.

Of course, the premium itself isn't the only factor to look at, and to their credit, Kaiser makes sure to stress that for many lower-income people, a CSR Silver plan would actually be a better way to go; the premiums may not be $0, but by paying $20 - $130/month they can wipe out most or nearly all of the deductible:

On average in 2019, benchmark silver plans with cost-sharing reductions (CSR) for single individuals with incomes below 200% of the poverty level can be purchased for roughly $20 to $130 per month after subsidies, depending on an enrollees’ income. Silver CSR plans have average annual deductibles ranging from $239 to $3,169 in 2019, also depending on income, and have reduced copays and coinsurance. It is therefore important for potential enrollees, particularly those with significant health needs, to not only consider the premium, but also the significant cost-sharing assistance that is only available if they enroll in a silver plan.

Kaiser includes a table listing their estimates of how many uninsured people in each state should be eligible for a free Bronze plan.

As for those who think the admittedly sky-high deductibles make even a free policy pointless, that's nonsense. EVERY ACA policy includes the following list of FREE preventative services...and by free, I mean at no cost to the enrollee at all, regardless of the deductible, as long as they're performed by an in-network healthcare provider:

Services for Everyone:

  • Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
  • Alcohol misuse screening and counseling
  • Aspirin use to prevent cardiovascular disease and colorectal cancer for adults 50 to 59 years with a high cardiovascular risk
  • Blood pressure screening
  • Cholesterol screening for adults of certain ages or at higher risk
  • Colorectal cancer screening for adults 50 to 75
  • Depression screening
  • Diabetes (Type 2) screening for adults 40 to 70 years who are overweight or obese
  • Diet counseling for adults at higher risk for chronic disease
  • Falls prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over, living in a community setting
  • Hepatitis B screening for people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence.
  • Hepatitis C screening for adults at increased risk, and one time for everyone born 1945–1965
  • HIV screening for everyone ages 15 to 65, and other ages at increased risk
  • Immunization vaccines for adults — doses, recommended ages, and recommended populations vary: Diphtheria, Hepatitis A, Hepatitis B, Herpes Zoster, Human Papillomavirus (HPV), Influenza (flu shot), Measles, Meningococcal, Mumps, Pertussis, Pneumococcal, Rubella, Tetanus, Varicella (Chickenpox)
  • Lung cancer screening for adults 55-80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
  • Obesity screening and counseling
  • Sexually transmitted infection (STI) prevention counseling for adults at higher risk
  • Statin preventive medication for adults 40 to 75 at high risk
  • Syphilis screening for adults at higher risk
  • Tobacco use screening for all adults and cessation interventions for tobacco users
  • Tuberculosis screening for certain adults without symptoms at high risk

Services for pregnant women or women who may become pregnant:

  • Anemia screening on a routine basis
  • Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
  • Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.” Learn more about contraceptive coverage.
  • Folic acid supplements for women who may become pregnant
  • Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  • Gonorrhea screening for all women at higher risk
  • Hepatitis B screening for pregnant women at their first prenatal visit
  • Preeclampsia prevention and screening for pregnant women with high blood pressure
  • Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  • Syphilis screening
  • Expanded tobacco intervention and counseling for pregnant tobacco users
  • Urinary tract or other infection screening

Other covered preventive services for women:

  • Breast cancer genetic test counseling (BRCA) for women at higher risk
  • Breast cancer mammography screenings every 1 to 2 years for women over 40
  • Breast cancer chemoprevention counseling for women at higher risk
  • Cervical cancer screening
  • Pap test (also called a Pap smear) every 3 years for women 21 to 65
  • Human Papillomavirus (HPV) DNA test with the combination of a Pap smear every 5 years for women 30 to 65 who don’t want a Pap smear every 3 years
  • Chlamydia infection screening for younger women and other women at higher risk
  • Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and who haven’t been diagnosed with type 2 diabetes before
  • Domestic and interpersonal violence screening and counseling for all women
  • Gonorrhea screening for all women at higher risk
  • HIV screening and counseling for sexually active women
  • Osteoporosis screening for women over age 60 depending on risk factors
  • Rh incompatibility screening follow-up testing for women at higher risk
  • Sexually transmitted infections counseling for sexually active women
  • Syphilis screening for women at increased risk
  • Tobacco use screening and interventions
  • Urinary incontinence screening for women yearly
  • Well-woman visits to get recommended services for women under 65

Coverage for children’s preventive health services:

  • Alcohol, tobacco, and drug use assessments for adolescents
  • Autism screening for children at 18 and 24 months
  • Behavioral assessments for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Bilirubin concentration screening for newborns
  • Blood pressure screening for children ages: 0 to 11 months, 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Blood screening for newborns
  • Cervical dysplasia screening for sexually active females
  • Depression screening for adolescents beginning routinely at age 12
  • Developmental screening for children under age 3
  • Dyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Fluoride chemoprevention supplements for children without fluoride in their water source
  • Fluoride varnish for all infants and children as soon as teeth are present
  • Gonorrhea preventive medication for the eyes of all newborns
  • Hearing screening for all newborns; and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years
  • Height, weight and body mass index (BMI) measurements for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Hematocrit or hemoglobin screening for all children
  • Hemoglobinopathies or sickle cell screening for newborns
  • Hepatitis B screening for adolescents at high risk, including adolescents from countries with 2% or more Hepatitis B prevalence, and U.S.-born adolescents not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence: 11–17 years
  • HIV screening for adolescents at higher risk
  • Hypothyroidism screening for newborns
  • Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary: Diphtheria, Tetanus, Pertussis (Whooping Cough), Haemophilus influenza type b, Hepatitis A, Hepatitis B, Human Papillomavirus (HPV), Inactivated Poliovirus, Influenza (flu shot), Measles, Meningococcal, Pneumococcal, Rotavirus, Varicella (Chickenpox)
  • Iron supplements for children ages 6 to 12 months at risk for anemia
  • Lead screening for children at risk of exposure
  • Maternal depression screening for mothers of infants at 1, 2, 4, and 6-month visits
  • Medical history for all children throughout development ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Obesity screening and counseling
  • Oral health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years
  • Phenylketonuria (PKU) screening for newborns
  • Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
  • Tuberculin testing for children at higher risk of tuberculosis ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Vision screening for all children