Strategic Planning & Timelines

The Affordable Care Act became law more than three years ago, but polls find that the majority of Americans still do not understand the law and how it will affect them. The Marketplaces, run by either states or the federal government, allow people to shop for insurance, find out whether they qualify for federal subsidies, and enroll in a health plan. Educating people about the new Marketplaces, which are now open to consumers, and helping them understand their insurance options will require a massive outreach effort carried out in part by navigators and in-person assisters. The troublesome launch of the Marketplaces, in which most people could not shop online, highlights the importance of consumer assistance in getting people enrolled.

This report examines how many of the uninsured in each state would be eligible for health coverage assistance programs - i.e. Medicaid, the Children's Health Insurance Program and subsidized private coverage through the new health insurance marketplaces - under the Affordable Care Act. The report also estimates the anticipated decrease in the uninsured population under the ACA in each state. Finally, the report examines the share of those remaining uninsured under the ACA in each state who would be eligible for, but not enrolled in, assistance programs.

The Affordable Care Act (ACA) has implications for “boomerang children” and their parents. “Boomerangs,” young adults who (often for financial reasons) move in with their parents, may expose their parents to significant tax penalties, even if the rest of the family has health coverage. This brief summarizes the available demographic information about the boomerang population, and provides an analysis of a common example to illustrate the ACA’s implications to such families.

In states that do not expand Medicaid, nearly five million poor uninsured adults have incomes above Medicaid eligibility levels but below poverty and may fall into a “coverage gap” of earning too much to qualify for Medicaid, but not enough to qualify for Marketplace premium tax credits. Most of these people have very limited coverage options and are likely to remain uninsured. This brief describes the coverage gap and presents estimates of the population that falls into this situation.

This brief estimates the number of uninsured community health center (CHC) patients who would gain coverage under the Affordable Care Act using data from the 2009 HRSA Survey of CHC patients and 2011 Uniform Data System. The authors find that were all states to implement the Affordable Care Act Medicaid expansion, an estimated 5 million uninsured health center patients would be eligible for coverage. However, over one million uninsured patients – 72 percent of whom live in southern states – who would have been eligible for coverage will remain uninsured because of states’ decisions to opt out of the expansion.