HHS Says More Than 10 Million Uninsured Americans Are Eligible for Obamacare

Go­ing in­to the Af­ford­able Care Act’s third year of open en­roll­ment, the Obama ad­min­is­tra­tion es­tim­ates that 10.5 mil­lion un­in­sured Amer­ic­ans are eli­gible for private health cov­er­age on the in­sur­ance mar­ket­places cre­ated by the law.

The num­ber, based on the gov­ern­ment’s ana­lys­is of Gal­lup sur­vey data and oth­er sources, of­fers a glimpse at how the law has done so far in cov­er­ing the un­in­sured and the work that it still has left to do.

HHS also re­leased new data on the num­ber of people who have gained health cov­er­age at some point since Obama­care’s cov­er­age pro­vi­sions star­ted to take ef­fect: 17.6 mil­lion.

Half of the 10.5 mil­lion eli­gible un­in­sured are between ages 18 and 34, the key young and pre­sum­ably health­i­er demo­graph­ic whose en­roll­ment is ne­ces­sary to keep premi­um in­creases in check. About 40 per­cent of them make an in­come of 250 per­cent of the fed­er­al poverty level or less, mean­ing they qual­i­fy for both the law’s premi­um tax cred­its as well as ad­di­tion­al cost-shar­ing sub­sidies to lower what they pay for health care. About 19 per­cent are His­pan­ic, 14 per­cent are Afric­an-Amer­ic­an, 2 per­cent are Asi­an-Amer­ic­an, and the rest are white.

“This open en­roll­ment is go­ing to be tough­er than last year,” Health and Hu­man Ser­vices Sec­ret­ary Sylvia Math­ews Bur­well said in a speech Tues­day at Howard Uni­versity. “But while our goals may be harder to reach, we’re work­ing smarter to reach them.”

The 10.5 mil­lion fig­ure does not in­clude un­in­sured people who are either eli­gible for Medi­caid in states that ex­pan­ded Medi­caid un­der Obama­care but haven’t signed up or people who are in poverty who would have been eli­gible for ex­pan­ded Medi­caid but live in one of the 20 states that re­fused to ex­pand the pro­gram.

A couple oth­er data points from HHS un­der­score the chal­lenge in sign­ing up the re­main­ing un­in­sured: Al­most 60 per­cent said that they were either con­fused about the law’s tax cred­its or didn’t know they ex­is­ted, and 50 per­cent have less than $100 in sav­ings, sug­gest­ing they could struggle to af­ford cov­er­age even with a nom­in­al premi­um.

“We have a pretty good idea of who the re­main­ing un­in­sured are,” a seni­or HHS of­fi­cial told re­port­ers be­fore Bur­well’s speech.

HHS of­fi­cials laid out some of their ideas for reach­ing those people. The de­part­ment plans to tar­get the un­in­sured in Dal­las, Hou­s­ton, north­ern New Jer­sey, Chica­go, and Miami, which the data show have the highest num­ber of un­in­sured who are eli­gible for mar­ket­place cov­er­age. It plans to use in­form­a­tion it has gathered from last year’s email cam­paign—which the seni­or of­fi­cial said “has been pretty ef­fect­ive in terms of the cost of it and the re­turn on in­vest­ment”—and its mes­saging on af­ford­ab­il­ity to try to re­fine its out­reach this year.

The law also has a big­ger stick to wield in tan­dem with the car­rot of tax sub­sidies for the poor and un­in­sured. The in­di­vidu­al man­date pen­alty in­creases in 2016 to $695 or 2 per­cent of in­come, whichever is great­er, up from $95 or 1 per­cent of in­come back dur­ing the first year of en­roll­ment

“I think you’ll also hear us speak­ing dir­ectly about the per­son­al-re­spons­ib­il­ity fee,” the seni­or HHS of­fi­cial said. “It’s something we’ll be talk­ing about this year, to make sure people un­der­stand that every­body has a re­spons­ib­il­ity to get health in­sur­ance.”