Oct. 16, 2015: Analysis: Nearly Half of Uninsured are Eligible for Medicaid or Subsidized ACA Coverage


Nearly half of the 32.3 million nonelderly people in the United States without health insurance at the beginning of 2015 are eligible for Medicaid or subsidized coverage through an Affordable Care Act marketplace, says a new Kaiser Family Foundation analysis.

On a state level, the share of the uninsured population eligible for those two forms of insurance-related financial assistance ranges from 35 percent in Nebraska and Texas to 75 percent in West Virginia, according to the analysis, which uses data from the 2015 Current Population Survey Annual Social and Economic Supplement and other sources.

Of New Jersey’s 940,000 uninsured, 36 percent are Medicaid eligible and 14 percent are tax credit eligible for coverage.

Five states, including some with the largest populations, account for approximately 40 percent of the uninsured population that could receive Medicaid or subsidized private coverage under the ACA. Among these are California with 2.1 million uninsured eligible for assistance; Texas with 1.5 million eligible; Florida with 1.1 million eligible; New York with 865,000 eligible; and Pennsylvania with 656,000 eligible.

Ten percent (3.1 million) of the nonelderly uninsured, fall into a coverage gap in which they earn too much to be eligible for Medicaid but not enough to qualify for financial assistance through an ACA marketplace. The gap exists in the 20 states that have opted not to expand Medicaid.

The analysis is based on an eligibility model developed by Kaiser researchers and provides state-level data on people without insurance who are eligible for Medicaid or subsidized ACA coverage and on those who are ineligible.