Key Facts about the Uninsured Population

The Affordable Care Act (ACA) led to historic gains in health insurance coverage by extending Medicaid coverage to many low-income individuals and providing Marketplace subsidies for individuals below 400% of poverty. The number of uninsured nonelderly Americans decreased from over 44 million in 2013 (the year before the major coverage provisions went into effect) to just below 27 million in 2016. However, in 2017, the number of uninsured people increased by nearly 700,000 people, the first increase since implementation of the ACA. Ongoing efforts to alter the ACA or to make receipt of Medicaid contingent on work may further erode coverage gains seen under the ACA. This fact sheet describes how coverage has changed in recent years, examines the characteristics of the uninsured population, and summarizes the access and financial implications of not having coverage.

Summary: Key Facts about the Uninsured Population
How many people are uninsured?
In the past, gaps in the public insurance system and lack of access to affordable private coverage left millions without health insurance. Beginning in 2014, the ACA expanded coverage to millions of previously uninsured people through the expansion of Medicaid and the establishment of Health Insurance Marketplaces. Data show substantial gains in public and private insurance coverage and historic decreases in the number of uninsured people under the ACA, with nearly 20 million gaining coverage. However, for the first time since the implementation of the ACA, the number of uninsured increased by more than half a million in 2017.

Why do people remain uninsured?
Even under the ACA, many uninsured people cite the high cost of insurance as the main reason they lack coverage. In 2017, 45% of uninsured adults said that they remained uninsured because the cost of coverage was too high. Many people do not have access to coverage through a job, and some people, particularly poor adults in states that did not expand Medicaid, remain ineligible for financial assistance for coverage. Some people who are eligible for financial assistance under the ACA may not know they can get help, and undocumented immigrants are ineligible for Medicaid or Marketplace coverage.

Who remains uninsured?
Most uninsured people are in low-income families and have at least one worker in the family. Reflecting the more limited availability of public coverage in some states, adults are more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.

How does not having coverage affect health care access?
People without insurance coverage have worse access to care than people who are insured. One in five uninsured adults in 2017 went without needed medical care due to cost. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.

What are the financial implications of being uninsured?
The uninsured often face unaffordable medical bills when they do seek care. In 2017, uninsured nonelderly adults were over twice as likely as their insured counterparts to have had problems paying medical bills in the past 12 months. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.

How many people are uninsured?

In the past, gaps in the public insurance system and lack of access to affordable private coverage left millions without health insurance, and the number of uninsured Americans grew over time, particularly during periods of economic downturns. By 2013, more than 44 million people lacked coverage. Under the ACA, as of 2014, Medicaid coverage has been expanded to nearly all adults with incomes at or below 138% of poverty in states that have expanded their programs, and tax credits are available for people who purchase coverage through a health insurance marketplace. Millions of people have enrolled in these new coverage options, and the uninsured rate dropped to a historic low. Coverage gains were particularly large among low-income adults living in states that expanded Medicaid. Still, millions of people—27.4 million nonelderly individuals in 2017—remain without coverage.1

Key Details:

Figure 1: Number of Uninsured and Uninsured Rate Among the Nonelderly Population, 2008-2017

Figure 2: Change in Uninsured Rate Among the Nonelderly Population by Selected Characteristics, 2013-2016

Figure 3: Change in Uninsured Rate Among the Nonelderly Population by Selected Characteristics and Expansion Status, 2016-2017

Why do people remain uninsured?

Most of the nonelderly in the United States obtain health insurance through an employer, but not all workers are offered employer-sponsored coverage or, if offered, can afford their share of the premiums. Medicaid covers many low-income individuals, and financial assistance for Marketplace coverage is available for many moderate-income people. However, Medicaid eligibility for adults remains limited in some states, and few people can afford to purchase coverage without financial assistance. Some people who are eligible for coverage under the ACA may not know they can get help, and others may still find the cost of coverage prohibitive.

Key Details:

Who remains uninsured?

Most remaining uninsured people are in working families, are in families with low incomes, and are nonelderly adults.17 Reflecting income and the availability of public coverage, people who live in the South or West are more likely to be uninsured. Most who remain uninsured have been without coverage for long periods of time. (See Appendix Table B for detailed data on the uninsured population.)

Key Details:

Figure 5: Characteristics of the Nonelderly Uninsured, 2017

Figure 6: Uninsured Rates Among the Nonelderly Population by Selected Characteristics, 2017

How does not having coverage affect health care access?

Health insurance makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy they are. Uninsured adults are far more likely than those with insurance to postpone health care or forgo it altogether. The consequences can be severe, particularly when preventable conditions or chronic diseases go undetected.

Key Details:

What are the financial implications of being uninsured?

The uninsured often face unaffordable medical bills when they do seek care. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.38

Key Details:

Conclusion

Millions of people gained coverage under the ACA, but recent trends in insurance coverage indicate that coverage gains may be eroding. In 2017, 27.4 million people lacked health coverage, up slightly from 2016. Ongoing debate about altering the ACA or limiting Medicaid to populations traditionally served by the program could lead to further loss of coverage. On the other hand, if additional states opt to expand Medicaid as allowed under the ACA, there may be additional coverage gains as low-income individuals gain access to affordable coverage. Going without coverage can have serious health consequences for the uninsured because they receive less preventive care, and delayed care often results in serious illness or other health problems. Being uninsured also can have serious financial consequences. The outcome of ongoing debate over health coverage policy in the United States has substantial implications for people’s coverage, access, and overall health and well-being.

Appendix Table A: Uninsured Rate Among the Nonelderly by State, 2013-2017
2013
Uninsured Rate
2016
Uninsured Rate
2017
Uninsured Rate
Change in
Uninsured Rate
2013-2017
Change in Number of Uninsured
2013-2017
Change in
Uninsured Rate
2016-2017
Change in Number of Uninsured
2016-2017
US Total 16.8% 10.0% 10.2% -6.6% -17,037,000 0.2% 684,800
Expansion States 15.1% 7.7% 7.6% -7.4% -12,070,200 0.0% 4,400
Alaska 20.5% 16.0% 15.5% -4.9% -32,900 -0.5% -4,900
Arizona 20.4% 11.9% 12.0% -8.4% -435,600 0.1% 11,600
Arkansas 19.0% 9.5% 9.6% -9.5% -230,300 0.1% 2,400
California 19.4% 8.4% 8.2% -11.2% -3,619,900 -0.2% -48,700
Colorado 15.8% 8.7% 8.6% -7.2% -306,600 -0.1% -3,400
Connecticut 10.9% 5.7% 6.6% -4.3% -129,900 0.9% 25,600
Delaware 11.8% 6.8% 6.6% -5.2% -38,600 -0.1% -1,000
District of Columbia 7.2% 4.5% 4.1% -3.1% -15,000 -0.4% -1,900
Hawaii 8.2% 4.1% 4.5% -3.7% -41,800 0.4% 3,200
Illinois 14.5% 7.5% 7.9% -6.6% -739,500 0.4% 37,400
Indiana 16.3% 9.4% 9.8% -6.5% -358,700 0.4% 23,300
Iowa 10.3% 4.8% 5.2% -5.1% -129,900 0.4% 9,400
Kentucky 16.8% 6.0% 6.4% -10.4% -380,900 0.4% 14,700
Louisiana 19.2% 11.9% 9.7% -9.6% -375,800 -2.2% -85,600
Maryland 11.5% 7.0% 7.1% -4.4% -220,500 0.1% 6,100
Massachusetts 4.4% 2.9% 3.2% -1.2% -63,200 0.3% 18,900
Michigan 12.9% 6.3% 6.1% -6.9% -571,800 -0.2% -19,400
Minnesota 9.6% 4.9% 5.2% -4.3% -194,900 0.3% 15,000
Montana 19.9% 10.1% 11.0% -8.9% -72,700 0.8% 7,200
Nevada 23.5% 12.8% 12.9% -10.6% -235,000 0.1% 6,100
New Hampshire 12.8% 7.6% 6.8% -6.0% -66,400 -0.8% -9,000
New Jersey 15.4% 8.9% 8.9% -6.5% -488,200 0.0% -1,000
New Mexico 22.3% 10.7% 10.7% -11.6% -205,600 0.1% 1,500
New York 12.5% 7.0% 6.7% -5.8% -961,800 -0.3% -58,600
North Dakota 12.0% 9.1% 8.7% -3.3% -17,500 -0.4% -2,700
Ohio 12.9% 6.6% 6.9% -6.0% -579,800 0.3% 29,100
Oregon 17.5% 7.3% 8.1% -9.4% -296,500 0.8% 28,900
Pennsylvania 11.5% 7.0% 6.6% -4.8% -508,400 -0.3% -35,400
Rhode Island 14.1% 5.0% 5.3% -8.7% -74,700 0.3% 2,900
Vermont 8.3% 4.4% 5.1% -3.2% -17,100 0.7% 3,300
Washington 16.2% 6.9% 7.1% -9.2% -519,300 0.2% 15,800
West Virginia 16.3% 6.0% 7.1% -9.2% -141,400 1.1% 13,600
Non-Expansion States 19.6% 13.8% 14.3% -5.3% -4,966,700 0.6% 680,400
Alabama 16.0% 10.9% 11.3% -4.7% -191,700 0.4% 16,200
Florida 24.4% 15.3% 15.9% -8.5% -1,179,400 0.6% 133,400
Georgia 21.2% 14.8% 15.4% -5.9% -466,400 0.6% 62,800
Idaho 18.6% 12.1% 12.6% -6.0% -73,400 0.6% 10,900
Kansas 14.3% 9.8% 10.0% -4.3% -106,200 0.2% 4,500
Maine 13.4% 9.7% 9.8% -3.7% -41,500 0.0% -200
Mississippi 19.7% 13.8% 14.3% -5.5% -144,000 0.5% 9,200
Missouri 15.3% 10.6% 10.8% -4.5% -228,800 0.2% 6,100
Nebraska 12.4% 10.3% 10.0% -2.4% -35,300 -0.3% -4,500
North Carolina 18.2% 12.3% 12.7% -5.5% -422,500 0.4% 38,500
Oklahoma 20.6% 16.1% 16.4% -4.2% -130,200 0.3% 7,000
South Carolina 18.6% 11.8% 13.4% -5.1% -186,600 1.6% 66,100
South Dakota 14.6% 9.8% 11.0% -3.5% -23,900 1.2% 8,200
Tennessee 16.3% 10.8% 11.1% -5.2% -267,700 0.3% 23,600
Texas 24.6% 18.7% 19.6% -5.0% -879,100 0.9% 275,300
Utah 14.8% 9.4% 10.0% -4.7% -106,300 0.6% 19,800
Virginia 14.2% 10.3% 10.2% -3.9% -266,700 0.0% -400
Wisconsin 10.5% 6.1% 6.1% -4.4% -213,900 -0.1% -3,600
Wyoming 14.7% 12.7% 14.5% -0.1% -3,100 1.8% 7,400
NOTES: Includes nonelderly individuals ages 0-64. Expansion status reflects the implementation of Medicaid expansion as of 2017.
SOURCE: Kaiser Family Foundation analysis of 2013, 2016, and 2017 American Community Survey (ACS), 1-Year Estimates.
Appendix Table B: Characteristics of the Nonelderly Uninsured, 2017
Nonelderly
(millions)
Percent of Nonelderly Uninsured
(millions)
Percent of Uninsured Uninsured
Rate
Total Nonelderly 267.5 100.0% 27.4 100.0% 10.2%
Age
Children – Total 76.1 28.5% 3.8 13.8% 5.0%
Nonelderly Adults – Total 191.4 71.5% 23.6 86.2% 12.3%
Adults 19 – 25 28.3 10.6% 4.2 15.4% 14.8%
Adults 26 – 34 39.1 14.6% 6.1 22.3% 15.6%
Adults 35 – 44 40.5 15.1% 5.5 20.2% 13.6%
Adults 45 – 54 41.8 15.6% 4.5 16.3% 10.7%
Adults 55 – 64 41.6 15.6% 3.3 12.0% 7.9%
Annual Family Income
<$20,000 31.8 11.9% 5.5 20.0% 17.2%
$20,000 – <$40,000 42.8 16.0% 7.4 27.0% 17.3%
$40,000+ 192.9 72.1% 14.5 53.0% 7.5%
Family Poverty Level
<100% 30.4 11.4% 5.0 18.4% 16.6%
100% – <200% 45.3 16.9% 7.8 28.5% 17.2%
200% – <400% 81.9 30.6% 9.6 35.2% 11.7%
400%+ 109.9 41.1% 4.9 18.0% 4.5%
Household Type
1 Parent with Children 19.0 7.1% 1.3 4.9% 7.1%
2 Parents with Children 84.2 31.5% 6.0 22.0% 7.2%
Multigenerational 18.7 7.0% 2.2 7.9% 11.6%
Adults Living Alone or with Other Adults 111.7 41.8% 13.2 48.3% 11.8%
Other 33.9 12.7% 4.6 16.9% 13.6%
Family Work Status
2+ Full-time 101.8 38.1% 8.6 31.5% 8.5%
1 Full-time 119.3 44.6% 12.4 45.3% 10.4%
Only Part-time 19.5 7.3% 2.8 10.4% 14.6%
Non-workers 26.9 10.1% 3.5 12.8% 13.0%
Race/Ethnicity
White 154.3 57.7% 11.3 41.3% 7.3%
Black 34.0 12.7% 3.8 13.8% 11.1%
Hispanic 53.5 20.0% 10.1 36.9% 18.9%
Asian/N. Hawaiian and Pacific Islander 15.9 5.9% 1.1 4.2% 7.2%
American Indian/Alaska Native 1.8 0.7% 0.4 1.5% 22.0%
Two or More Races 8.0 3.0% 0.6 2.3% 7.9%
Citizenship
U.S. Citizen – Native 230.6 86.2% 18.9 69.2% 8.2%
U.S. Citizen – Naturalized 16.7 6.2% 1.7 6.1% 10.0%
Non-U.S. Citizen, Residents for <5 Years 6.4 2.4% 1.7 6.4% 27.2%
Non-U.S. Citizen, Residents for 5+ Years 13.9 5.2% 5.0 18.3% 36.0%
NOTES: Includes nonelderly individuals ages 0-64. The U.S. Census Bureau’s poverty threshold for a family with two adults and one child was $19,730 in 2017. Parent includes any person with a dependent child. Multigenerational/other families with children include families with at least three generations in a household, plus families in which adults are caring for children other than their own. Part-time workers were defined as working <35 hours per week. Respondents who identify as mixed race who do not also identify as Hispanic fall intot he “Two or More Races” category. All individuals who identify as Hispanic ethnicity fall into the Hispanic category regardless of race.
SOURCE: Kaiser Family Foundation analysis of 2017 American Community Survey (ACS), 1-Year Estimates.
Endnotes
  1. Kaiser Family Foundation analysis of 2017 American Community Survey (ACS), 1-Year Estimates.

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  2. Kaiser Family Foundation analysis of 2013 and 2016 American Community Survey (ACS), 1-Year Estimates.

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  3. Kaiser Family Foundation analysis of 2017 American Community Survey (ACS), 1-Year Estimates.

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  4. Rachel Garfield, Anthony Damico, Kendal Orgera, Gary Claxton, and Larry Levitt, Estimates of Eligibility for ACA Coverage among the Uninsured in 2016 (Washington, DC:  Kaiser Family Foundation, June 2018), https://www.kff.org/uninsured/issue-brief/estimates-of-eligibility-for-aca-coverage-among-the-uninsured-in-2016/.

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  5. Ashley Kirzinger, Liz Hamel, Cailey Muñana, and Mollyann Brodie. Kaiser Health Tracking Poll – March 2018: Non-Group Enrollees, (Washington, D.C.: Kaiser Family Foundation, April 2018), https://www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-march-2018-non-group-enrollees/.

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  6. Karen Pollitz, Jennifer Tolbert, and Ashley Semanskee. 2016 Survey of Health Insurance Marketplace Assister Programs and Brokers (Washington, DC: Kaiser Family Foundation, June 2016), http://www.kff.org/health-reform/report/2016-survey-of-health-insurance-marketplace-assister-programs-and-brokers/

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  7. Karen Pollitz, Jennifer Tolbert, and Maria Diaz. Data Note: Further Reductions in Navigator Funding for Federal Marketplace States, (Washington, D.C.: Kaiser Family Foundation, September 2018), https://www.kff.org/health-reform/issue-brief/data-note-further-reductions-in-navigator-funding-for-federal-marketplace-states/.

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  8. Kaiser Family Foundation analysis of the 2017 National Health Interview Survey.

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  9. Kaiser Family Foundation analysis of the March 2018 Current Population Survey, Annual Social and Economic Supplement.

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  10. Kaiser Family Foundation analysis of the March 2018 Current Population Survey, Annual Social and Economic Supplement.

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  11. Kaiser Family Foundation. 2018 Employer Health Benefits Survey (Washington, DC: Kaiser Family Foundation, October 2018), https://www.kff.org/health-costs/report/2018-employer-health-benefits-survey/.

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  12. State Health Facts. “Status of State Action on the Medicaid Expansion Decision.” Kaiser Family Foundation, 2018, https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/.

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  13. Idaho, Nebraska, and Utah had ballot initiatives in the 2018 midterm elections on Medicaid expansion where each state voted to expand. Montana voters also had a ballot initiative that voted down the extension of Medicaid expansion, which is planned to end on June 30, 2019.

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  14. Tricia Brooks, Karina Wagnerman, Samantha Artiga, and Elizabeth Cornachione, Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2018: Findings from a 50-State Survey (Washington, DC: Kaiser Family Foundation, January 2018), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-renewal-and-cost-sharing-policies-as-of-january-2018-findings-from-a-50-state-survey/.

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  15. Rachel Garfield, Anthony Damico, and Kendal Orgera, The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid (Washington, DC: Kaiser Family Foundation, June 2018), https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/.

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  16. Health Coverage of Immigrants (Washington, DC: Kaiser Family Foundation, December 2017), https://www.kff.org/disparities-policy/fact-sheet/health-coverage-of-immigrants/.

     

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  17. Kaiser Family Foundation analysis of 2017 American Community Survey (ACS), 1-Year Estimates.

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  18. $19,730 for a family of three in 2017.

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  19. Kaiser Family Foundation analysis of 2017 American Community Survey (ACS), 1-Year Estimates.

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  20. Kaiser Family Foundation analysis of 2017 American Community Survey (ACS), 1-Year Estimates.

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  21. Kaiser Family Foundation analysis of 2017 American Community Survey (ACS), 1-Year Estimates.

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  22. Kaiser Family Foundation analysis of 2017 American Community Survey (ACS), 1-Year Estimates.

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  23. Health Coverage of Immigrants (Washington, DC: Kaiser Family Foundation, December 2017), https://www.kff.org/disparities-policy/fact-sheet/health-coverage-of-immigrants/.

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  24.  Kaiser Family Foundation analysis of the 2017 National Health Interview Survey.

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  25. Jack Hadley, “Insurance Coverage, Medical Care Use, and Short-term Health Changes Following an Unintentional Injury or the Onset of a Chronic Condition.” JAMA 297, no. 10 (March 2007):1073-84.

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  26. Stacey McMorrow, Genevieve M. Kenney, and Dana Goin,“Determinants of Receipt of Recommended Preventive Services: Implications for the Affordable Care Act,” American Journal of Public Health 104, no. 12 (Dec 2014): 2392-9.

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  27. Kaiser Family Foundation analysis of the 2017 National Health Interview Survey.

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  28. Jack Hadley, “Insurance Coverage, Medical Care Use, and Short-term Health Changes Following an Unintentional Injury or the Onset of a Chronic Condition,” JAMA 297, no. 10 (March 2007): 1073-84.

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  29. Marco A Castaneda and Meryem Saygili, “The health conditions and the health care consumption of the uninsured,” Health Economics Review (2016).

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  30. Steffie Woolhandler, et al., “The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?” Annals of Internal Medicine 167 (June 2017): 424-431.

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  31. Destini A Smith, et al., “The effect of health insurance coverage and the doctor-patient relationship on health care utilization in high poverty neighborhoods.” Preventive Medicine Reports 7 (2017): 158-161.

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  32. Andrea S. Christopher, et al., “Access to Care and Chronic Disease Outcomes Among Medicaid-Insured Persons Versus the Uninsured,” American Journal of Public Health 106, no. 1 (January 2016): 63-69.

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  33. Amy Finkelstein, et. al, “The Oregon Health Insurance Experiment: Evidence from the First Year” (National Bureau of Economic Research, July 2011), http://www.nber.org/papers/w17190.

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  34. Larisa Antonisse, Rachel Garfield, Robin Rudowitz, and Samantha Artiga, The Effects of Medicaid Expansion on the ACA: Updated Findings From a Literature Review (Washington, D.C.: Kaiser Family Foundation, March 2018), https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/.

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  35. Sara Rosenbaum, Jennifer Tolbert, Jessica Sharac, Peter Shin, Rachel Gunsalus, and Julia Zur, Community Health Centers: Growing Important in a Changing Health Care System, (Washington, DC: Kaiser Family Foundation, March 2018), https://www.kff.org/medicaid/issue-brief/community-health-centers-growing-importance-in-a-changing-health-care-system/.

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  36. Allen Dobson, Joan DaVanzo, Randy Haught, and Phap-Hoa Luu, Comparing the Affordable Care Act’s Financial Impact on Safety-Net Hospitals in States That Expanded Medicaid and Those That Did Not, (New York, NY: The Commonweath Fund, November 2017), https://www.commonwealthfund.org/publications/issue-briefs/2017/nov/comparing-affordable-care-acts-financial-impact-safety-net.

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  37. Jane Wishner, et al., A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies (Washington, DC: The Urban Institute and Kaiser Family Foundation, July 2016), https://www.kff.org/report-section/a-look-at-rural-hospital-closures-and-implications-for-access-to-care-three-case-studies-issue-brief/.

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  38. Sherry Glied and Richard Kronick, The Value of Health Insurance: Few of the Uninsured Have Adequate Resources to Pay Potential Hospital Bills (Washington, DC: Office of Assistant Secretary for Planning and Evaluation, HHS, May 2011), http://aspe.hhs.gov/health/reports/2011/ValueofInsurance/rb.pdf

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  39. Philippe Gwet, Jerrod Anderson, and Steven Machlin, “Out-of-Pocket Health Care Expenses in the U.S. Civilian Noninstitutionalized Population by Age and Insurance Coverage, 2014,” Agency for Healthcare Research and Quality (AHRQ), Statistical Brief #495, https://meps.ahrq.gov/data_files/publications/st495/stat495.shtml.

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  40. Tim Xu, Angela Park, Ge Bai, Sarah Joo, Susan Hutfless, Ambar Mehta, Gerard Anderson, and Martin Makary, “Variation in Emergency Department vs Internal Medicine Excess Charges in the United States,” JAMA Intern Med. 177(8): 1130-1145 (June 2017), https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2629494%20 

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  41. Stacie Dusetzina, Ethan Basch, and Nancy Keating, “For Uninsured Cancer Patients, Outpatient Charges Can Be Costly, Putting Treatments out of Reach,” Health Affairs 34, no. 4 (April 2015): 584-591, http://content.healthaffairs.org/content/34/4/584.abstract

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  42. Kaiser Family Foundation analysis of the 2017 National Health Interview Survey.

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  43. Liz Hamel, Mira Norton, Karen Pollitz, Larry Levitt, Gary Claxton, and Mollyann Brodie, The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times Medical Bills Survey, (Washington, D.C.: Kaiser Family Foundation, Jan 2016),  https://www.kff.org/health-costs/report/the-burden-of-medical-debt-results-from-the-kaiser-family-foundationnew-york-times-medical-bills-survey/.

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  44. Consumer Financial Protection Bureau, “Consumer Experiences with Debt Collection: Findings from the CFPB’s Survey of Consumer Views on Debt.” (Consumer Financial Protection Bureau: January 2017),

    https://www.consumerfinance.gov/data-research/research-reports/consumer-experiences-debt-collection-findings-cfpbs-survey-consumer-views-debt/.

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  45. Liz Hamel, Mira Norton, Karen Pollitz, Larry Levitt, Gary Claxton, and Mollyann Brodie, The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times Medical Bills Survey (Washington, D.C.: Kaiser Family Foundation, January 2016), https://www.kff.org/report-section/the-burden-of-medical-debt-section-1-who-has-medical-bill-problems-and-what-are-the-contributing-factors/.

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  46. Larisa Antonisse, Rachel Garfield, Robin Rudowitz, and Samantha Artiga, The Effects of Medicaid Expansion on the ACA: Updated Findings From a Literature Review (Washington, D.C.: Kaiser Family Foundation, March 2018), https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-march-2018/.

     

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  47. Ibid.

     

     

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