Key Facts about the Uninsured Population

Issue Brief
  1. Kaiser Family Foundation analysis of 2018 American Community Survey (ACS), 1-Year Estimates.

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  2. State Health Facts. “Total Monthly Medicaid and CHIP Enrollment.” Kaiser Family Foundation, August 2019, https://www.kff.org/health-reform/state-indicator/total-monthly-medicaid-and-chip-enrollment/.

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  3. State Health Facts. “Marketplace Enrollment, 2014-2019.” Kaiser Family Foundation, https://www.kff.org/health-reform/state-indicator/marketplace-enrollment/.

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  4. Kaiser Family Foundation analysis of 2018 American Community Survey (ACS), 1-Year Estimates.

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  5. The Federal Poverty Level was $20,212 for a family of three in 2018.

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  6. Kaiser Family Foundation analysis of 2018 American Community Survey (ACS), 1-Year Estimates.

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  7. Kaiser Family Foundation analysis of 2018 American Community Survey (ACS), 1-Year Estimates.

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  8. Kaiser Family Foundation analysis of 2018 American Community Survey (ACS), 1-Year Estimates.

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  9. 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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  10. Kaiser Family Foundation analysis of the 2018 National Health Interview Survey.

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  11. Kaiser Family Foundation analysis of the 2018 National Health Interview Survey.

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  12. Kaiser Family Foundation analysis of the 2018 National Health Interview Survey.

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

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  14. Kaiser Family Foundation. 2019 Employer Health Benefits Survey (Washington, DC: Kaiser Family Foundation, October 2019), https://www.kff.org/health-costs/report/2019-employer-health-benefits-survey/.

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  15. Gary Claxton, Bradley Sawyer, and Cynthia Cox, “How affordability of health care varies by income among people with employer coverage,” (Health System Tracker, Peterson-KFF, April 2019), https://www.healthsystemtracker.org/brief/how-affordability-of-health-care-varies-by-income-among-people-with-employer-coverage/.

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  16. 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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  17. Tricia Brooks, Karina Wagnerman, Samantha Artiga, and Elizabeth Cornachione, Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey (Washington, DC: Kaiser Family Foundation, March 2019), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2019-findings-from-a-50-state-survey/.

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  18. 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, March 2019), https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/.

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  19. Health Coverage of Immigrants (Washington, DC: Kaiser Family Foundation, February 2019), https://www.kff.org/disparities-policy/fact-sheet/health-coverage-of-immigrants/.

     

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  20. Ashley Semanskee, Gary Claxton, and Larry Levitt. How Premiums Are Changing in 2018 (Washington, DC: Kaiser Family Foundation, November 2017), https://www.kff.org/health-costs/issue-brief/how-premiums-are-changing-in-2018/.

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  21. Rachel Fehr, Cynthia Cox, and Larry Levitt. Data Note: Changes in Enrollment in the Individual Health Insurance Market through Early 2019 (Washington, DC: Kaiser Family Foundation, August 2019), https://www.kff.org/private-insurance/issue-brief/data-note-changes-in-enrollment-in-the-individual-health-insurance-market-through-early-2019/

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  22. 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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  23. 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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  24. Karen Pollitz, Jennifer Tolbert, and Maria Diaz. Data Note: Limited Navigator Funding for Federal Marketplace States, (Washington, D.C.: Kaiser Family Foundation, November 2019), https://www.kff.org/private-insurance/issue-brief/data-note-further-reductions-in-navigator-funding-for-federal-marketplace-states/.

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  25. Hailun Liang, May A. Beydoun, and Shaker M. Eid, Health Needs, Utilization of Services and Access to Care Among Medicaid and Uninsured Patients with Chronic Disease in Health Centres, Journal of Health Services Research & Policy 24, no. 3 (Jul 2019): 172-181.

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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. Megan B. Cole, Amal N. Trivedi, Brad Wright, and Kathleen Carey, “Health Insurance Coverage and Access to Care for Community Health Center Patients: Evidence Following the Affordable Care Act,” Journal of General Internal Medicine 33, no. 9 (September 2018): 1444-1446.

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  28. Veri Seo, et al., “Access to Care Among Medicaid and Uninsured Patients in Community Health Centers After the Affordable Care Act,” BMC Health Services Research 19, no. 291 (May 2019).

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  29. Kaiser Family Foundation analysis of the 2018 National Health Interview Survey.

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  30. 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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  31. Cesar I. Fernandez-Lazaro, et al., “Medication Adherence and Barriers Among Low-Income, Uninsured Patients with Multiple Chronic Conditions,” Research in Social and Administrative Pharmacy 15, no. 6 (June 2019): 744-753.

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  32. 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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  33. 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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  34. 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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  35. 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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  36. Michael G. Usher, et al., “Insurance Coverage Predicts Mortality in Patients Transferred Between Hospitals: a Cross-Sectional Study,” Journal of General Internal Medicine 33, no. 12 (December 2018): 2078-2084.

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  37. 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, August 2019), https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-august-2019/.

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  38. Aparna Soni, Kosali Simon, John Cawley, and Lindsay Sabik, Effect of Medicaid Expansions of 2014 on Overall and Early-Stage Cancer Diagnoses, American Journal of Public Health epub ahead of print (December 2017), http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2017.304166.

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  39. Sameed Ahmed Khantana et al., Association of Medicaid Expansion with Cardiovascular Mortality, JAMA Cardiology epub ahead of print (June 2019), https://jamanetwork.com/journals/jamacardiology/fullarticle/2734704.

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  40. Jonathan Koma et al., Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-Income Adults, Medical Care 55, no. 12 (December 2017): 1023-1029.

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  41. 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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  42. 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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  43. Margaret B. Greenwood-Ericksen and Keith Kocher, Trends in Emergency Department Use by Rural and Urban Populations in the United States, JAMA Netw Open, April 2019.

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  44. 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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  45. 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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  46. John W. Scott, et al., Cured into Destitution: Catastrophic Health Expenditure Risk Among Uninsured Trauma Patients in the United States, Annals of Surgery 267, no. 6 (June 2018): 1093-1099.

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  47. “Total expenditures in millions by source of payment and insurance coverage, United States, 2017,” Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2017, https://meps.ahrq.gov/mepstrends/hc_use/.

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  48. 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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  49. 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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  50. Rebekah Davis Reed, Costs and Benefits: Price Transparency in Health Care, Journal of Health Care Finance (Spring 2019).

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  51. Kaiser Family Foundation analysis of the 2018 National Health Interview Survey.

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  52. Ashley Kirzinger, Cailey Muñana, Bryan Wu, and Mollyann Brodie, Data Note: American’s Challenges with Health Care Costs, (Washington, D.C.: Kaiser Family Foundation, June 2019), https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/.

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  53. Debt in America: An Interactive Map (Washington, DC, Urban Institute, updated 12/6/17). Accessed November 26, 2019 at https://apps.urban.org/features/debt-interactive-map/?type=medical&variable=perc_debt_med.

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  54. 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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  55. “5 Charts About Americans and Medical Bills,” Kaiser Family Foundation, July 2018, https://www.kff.org/slideshow/5-charts-americans-medical-bills/.

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  56. 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, August 2019), https://www.kff.org/medicaid/issue-brief/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review-august-2019/.

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  57. Ibid.

     

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