Fifty-Six Percent of the Uninsured Could Pay $100 or Less per Month for Coverage in 2014. Limitations


There are several limitations to this analysis. First, while we did take into account family size, we made some simplifying assumptions. When determining whether a family could purchase coverage for $100 or less per person per month, we used the income ceiling for a family of four for all families with four or more members. Similarly, we applied a limit of $200 in premiums per family to all families with two or more uninsured adults. These two assumptions have opposite effects on our estimate, and we believe the combined effect of these assumptions is likely small.

Second, we assume that the weighted average silver and bronze premiums from the 17 states that have published their Marketplace premium rates to date are representative of the entire country, and that the age weights used are appropriate for the low-income uninsured. It is possible that the average adult in the income ranges specified in Table 1 is younger than specified in our weighted average, which means our estimate may overstate the number of individuals who will be able to purchase a bronze plan for $100 or less.

Lastly, we omit the eligible uninsured living in non-Medicaid expansion states with family incomes of below 100 percent of the FPL from our analysis of those eligible for Marketplace coverage for $100 or less per person. These low-income individuals are exempt from the individual mandate on the basis of hardship.  While technically eligible to purchase coverage on the Marketplace, they would not qualify for tax credits to subsidize their Marketplace coverage and would probably not be able to afford full-price premiums. We do, however, include this group as eligible for Medicaid in our discussion of the scenario in which all states expand Medicaid coverage.

Table 2. Eligible Uninsured Who Could Purchase Marketplace Coverage for $100 or Less after Tax Credits or Enroll in Medicaid or CHIP
    State Medicaid Expansion Status*
  Total** Non-Expansion Expansion
Total Eligible Uninsured 41,341,000 23,179,000 18,163,000
Number of States (includes D.C.) 51 26 25
Marketplace Eligible*** 21,945,000 13,280,000 8,665,000
     Tax credit eligible 18,586,000 11,549,000 7,037,000
     Not tax credit eligible 3,359,000 1,731,000 1,628,000
Silver plan for $100 or less 6,425,000 4,583,000 1,843,000
Bronze plan only for $100 or less**** 4,343,000 2,386,000 1,957,000
Bronze or silver plan for $100 or less 10,769,000 6,969,000 3,800,000
Percent of Marketplace eligible* who could purchase coverage for $100 or less 49.1% 52.5% 43.9%
Medicaid and CHIP      
Total 12,431,000 2,369,000 10,062,000
     Children less than 250% FPL 3,971,000 2,369,000 1,603,000
     Adults 138% FPL or less 8,459,000   8,459,000
Number of eligible uninsured who may obtain coverage for $100 or less through Marketplaces, or enroll in Medicaid or CHIP


23,199,000 9,338,000 13,862,000
Percent of eligible uninsured who may obtain coverage for $100 or less through Marketplaces, or enroll in Medicaid or CHIP


56.1% 40.3% 76.3%

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

** Totals may not sum due to rounding.

*** Individuals with family incomes below 100% are not counted among the Marketplace eligible for the purpose of this analysis.

**** This is in addition to those who may be able to pay $100 or less per person per month for the second lowest-cost silver plan.


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