Despite Health Reform, 32.3 Million Are Uninsured

A full 32.3 million non-elderly people do not have health insurance despite the costly health reform act and the individual mandate tax penalty, new analysis shows.

Nearly half of the 32.3 million uninsured, or 15.7 million, are still not getting health insurance through the Affordable Care Act or Medicaid, new state-by-state analysis by the Kaiser Family Foundation reveals. More than a quarter of the uninsured are either eligible adults or children.

While “millions of people have enrolled in these new coverage options,” Kaiser found “millions of others are still uninsured.” The findings indicate that hospitals will continue to be under pressure from the uninsured. The analysis, based on government data, found that as of early 2015, Texas, California, and Florida had the most uninsured, in that order.

Kaiser’s findings come as the five Democrat presidential contenders barely mentioned health reform at the first Democrat presidential debate in Las Vegas, even though all five supported it. On Tuesday, GOP presidential candidate Jeb Bush unveiled his healthcare reform plan, vowing to abolish and replace the Affordable Care Act to "stop the damage Washington central planners have caused for decades."

Kaiser found that 4.4 million Texans were still uninsured, even though 11% could get Medicaid and 23% were eligible for tax credits on the Affordable Care Act’s exchanges.

California has 3.8 million uninsured, even though nearly four out of ten were eligible for Medicaid and more than one out of seven could get tax credits to buy health insurance on the Affordable Care Act’s exchanges.

A full 2.78 million Floridians still didn’t have insurance, even though more than one out of ten were qualified for Medicaid and nearly a third, 30%, were eligible for tax credits to buy health insurance on the health reform exchanges.

Kaiser published its analysis less than a month before Obamacare’s third open enrollment period is set to launch Nov. 1. The White House continues to say it will zero in on areas with high rates of uninsured individuals.

“We believe we can continue to connect people with the coverage they need and further decrease the number of Americans without health insurance,” Health Secretary Sylvia Burwell said last September.

The lack of coverage comes despite the fact that the health reform act expanded Medicaid “to nearly all nonelderly adults with incomes at or below 138% of the federal poverty level,” Kaiser says.

It added that “30 states and D.C. had expanded Medicaid eligibility” under health reform after the Supreme Court ruled in June 2012 that Medicaid expansion was optional for the states.

“One in ten uninsured people (3.1 million) fall into the coverage gap due to their state’s decision not to expand Medicaid, and 15% of the uninsured (4.9 million) are undocumented immigrants who are ineligible for ACA coverage under federal law,” Kaiser says, noting, “A quarter of the remaining uninsured population is outside the reach of the ACA due to either their immigration status or their state’s decision not to expand Medicaid.”

The balance of the uninsured generally earn too much income to qualify either for Medicaid or for the tax credits to buy subsidized coverage on the health exchanges.

The poor showing is also an indication people are not buying health insurance on the Obamacare exchanges, despite the fact they can get federal tax credits to do so. Obamacare’s high out of pocket costs and deductibles have been to blame for the reason why people aren’t signing up—and for delays in getting health care.