Nearly 5 in 10 Uninsured Single Young Adults Eligible for the Health Insurance Marketplace Could Pay $50 or Less Per month for Coverage in 2014. Methodology


This analysis is based on ASPE analysis of household composition and income from the 2011 American Community Survey Public Use Microdata Sample (ACS PUMS). ASPE tabulations from the ACS PUMS have been adjusted to exclude estimated undocumented persons.21

To calculate the premium tax credit, the Affordable Care Act specifies that an individual or family with a particular income will pay a fixed amount for the second lowest-cost silver plan available in the Marketplace in their local area. This fixed amount is the same in every state except Alaska and Hawaii, without regard to age or the actual premiums in the Marketplace. For example, the law specifies that an individual earning 150 percent of the Federal Poverty Level (FPL), or $17,235 per year, will pay no more than 4 percent of their income ($57 per month) for the second lowest-cost silver plan. Their tax credit will cover the difference between $57 and the monthly cost of the second lowest-cost silver plan available to them. Table 4 below shows the percent of income and maximum payment associated with various incomes for single individuals.

Table 3: Maximum monthly health insurance premiums for the second lowest-cost silver plan for a single adult, by income

Single Adult Income

Percent of the Federal Poverty Level

Percent of Income Paid toward Second Lowest-Cost Silver Plan

Maximum Monthly Premium Payment for Second Lowest-Cost Silver Plan




























No Limit

To calculate bronze premiums after tax credits, this analysis uses data submitted by the 34 states with a Federally-facilitated or State Partnership Marketplace. State-based Marketplaces are not included because we do not have complete data on premiums for catastrophic, bronze and silver plans in every rating region for every State-based Marketplace. Because rates vary by rating region within a state, we did not substitute average rates or rates from the most populous rating region.

To determine the number of uninsured young adults eligible for tax credits sufficient to reduce bronze premiums to $100 or less (or $50 or less), we calculated the percent of the FPL at which the total tax credit would be sufficient to reduce bronze premiums below the threshold in a given rating region for a given age. For example, we calculated the FPL at which a 22-year-old in Miami, Florida, would receive a tax credit sufficient to lower her bronze premium to $100 or less. We repeated this analysis for every combination of rating region and age within the 34 states.23 This analysis includes only single individuals, not families, for simplicity. For families, the net bronze premium after tax credits depends on the rating area, age of each family member, family size, and the total number of family members uninsured.

We limited our analysis to young adults in single-person households, where a household is a “health insurance unit” (HIU). We defined HIUs to include adults, plus their spouses and dependent children (ages 0-18, as well as full time students under 23) living in the household.24 For example, two 22-year-old roommates who are sharing an apartment and are not married to each other would be counted as two separate, single-person HIUs. A married couple living together in a home is categorized as a two-member HIU. We estimate that 63.7 percent of uninsured young adults nationwide live in a single-person HIU.

Using the 2011 ACS PUMS, we estimated the number and percent of U.S. citizens and legal residents ( “eligible uninsured”) between the ages of 18 and 34 in single-person HIUs whose income may qualify them for tax credits that would enable them to purchase coverage for $100 or less per person (after applying their tax credits) on the Marketplace. We also estimated the number and percent of eligible uninsured single young adults who will have access to a catastrophic plan for $100 or less, regardless of income.

The number of young adults potentially eligible for the Marketplaces is calculated as the number of uninsured young adults who have incomes above 138 percent of the FPL in Medicaid expansion states or above 100 percent of the FPL in non-expansion states. The number of individuals potentially eligible to receive a tax credit that would reduce their Marketplace premium to $100 or less per person is calculated based on a combination of age, income, and geographic location. These estimates do not take into account the tax credit eligibility requirements relating to other minimum essential coverage or tax filing requirements.

To take into account variation in premiums by rating area, we computed the maximum income as a percentage of the FPL at which an individual could obtain $100 coverage in every combination of rating area and age. We then applied these thresholds to ACS data. The smallest geographic unit available in the annual ACS PUMS is the public-use microdata area (PUMA), which cannot be directly translated to either counties or rating areas. We therefore assigned PUMA populations to counties based on the distribution of the population using a data crosswalk from the Missouri Census Data Center.25 This method assumes that the geographic distribution of uninsured young adults is proportional to the distribution of the overall population. For individuals who resided in a PUMA covering multiple counties, we adjusted the ACS PUMS survey weight to assign individuals to the relevant counties. After counties were assigned, we determined each individual’s rating area of residence.26

In states likely to expand Medicaid, we estimate the number of individuals who may obtain Medicaid coverage starting in 2014 as the number of eligible uninsured with an income at or below 138 percent of the FPL.

View full report


"rb_uninsuredyoungadults.pdf" (pdf, 82.5Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®