Eligible Uninsured African Americans: 6 in 10 Could Receive Health Insurance Marketplace Tax Credits, Medicaid or CHIP. Notes


1 ASPE tabulations from the CY 2011 American Community Survey Public Use Microdata Sample (ACS PUMS) are adjusted to exclude estimated undocumented persons based on ASPE’s TRIM3 microsimulation model. All references to eligible uninsured in this brief use these tabulations. See the methodology section for more information. For more information about eligibility to purchase coverage in the Marketplace, see https://www.healthcare.gov/immigration-status-and-the-marketplace/. The estimates contained in this brief do not take into account certain Marketplace coverage and Medicaid/CHIP eligibility requirements, such as those relating to other minimum essential coverage or tax filing requirements, and thus the populations described in this brief should be construed as “potentially” eligible, subject to these other requirements. Also, the statutory threshold for Medicaid expansion set by the Affordable Care Act is 133 percent of the FPL, not 138 percent of the FPL. This brief refers throughout to 138 percent of the FPL, which is the effective threshold including the 5 percent statutory disregard.

2 For the most up to date information on the demographic characteristics of the uninsured, including by age and gender, see a summary of the Census Bureau’s Current Population Survey released in September 2013 at http://aspe.hhs.gov/health/reports/2013/CPSIssueBrief/ib_cps.cfm.

3 For family income, a “family” is based on the “health insurance unit” (HIU), which includes adults, their spouses, and their dependent children (ages 0-18, plus full-time students under age 23), using ASPE analysis of the ACS PUMS data.

4 Our analysis assumes that the following 25 states plus the District of Columbia expand their Medicaid programs: Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Rhode Island, Vermont, Washington, and West Virginia.

5 The sum of expansion and non-expansion state estimates may not equal the stated total for all states due to rounding.

6 Estimates in this row are for all nonelderly (ages 0 to 64) African American who are U.S. citizens or lawfully residing in the United States.

7 We define Marketplace-tax-credit-eligible individuals in this analysis as uninsured U.S. citizens and others lawfully residing in the area served by the Marketplace who are adults (ages 19 to 64) with family incomes above 138 percent to 400 percent of the FPL in Medicaid expansion states and above 100 percent to 400 percent of the FPL in non-expansion states or who are children (ages 0 to18) with incomes 250 percent to 400 percent of the FPL.

8 We make the simplifying assumption in this analysis that all children with incomes below 250 percent of the FPL would be eligible for Medicaid/CHIP rather than the Marketplace.

9 The sum of expansion and non-expansion state estimates may not equal the stated total for all states due to rounding.

10 In non-expansion states, some eligible uninsured may currently qualify for Medicaid and are not enrolled, and such individuals are not included in our analysis. For expansion states, our estimate of the eligible uninsured who may qualify for Medicaid includes both the current and the newly eligible.

11 The 15-state total is based on the 15 states corresponding to the top 20 MSAs listed in the table, not the 15 states by greatest number of eligible uninsured African Americans.

12 For the purposes of this analysis, a family of four is defined as two 30-year-old adults and two children.

13 Net of tax credits, bronze premiums for a family of four may be below those for a single individual and may be as low as 0. This occurs because the tax credit is calculated as the difference between the cost of the second lowest cost silver plan premium and the maximum payment amount determined by income. Because premiums for older individuals and families are higher than those for younger individuals, tax credits are larger for older individuals and families. Therefore, using tax credits to purchase a bronze plan may yield lower bronze premiums for older individuals.

14 Los Angeles County is split into two rating areas for Marketplace premiums.

15 Information on the lowest-price catastrophic plan in the Baltimore metro area was not readily available.

16 The adjustment methodology is based on imputations of immigrant legal status in ASPE’s TRIM3 microsimulation model (http://trim.urban.org/), according to methods initially developed by Jeffrey Passel and Rebecca Clark.

17 The Integrated Public Use Microdata Series (Version 5.0) was developed by Steven Ruggles, J. Trent Alexander, Katie Genadek, Ronald Goeken, Matthew B. Schroeder, and Matthew Sobek at the University of Minnesota. Available online: https://usa.ipums.org/usa/index.shtml.

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