About a third of the uninsured people who might be eligible to buy subsidized coverage through a health insurance exchange in 2014 have had no recent health or care access problems, researchers say.
The researchers, at the Center for Studying Health System Change (HSC), Washington, come to that conclusion in a paper based on a 2007 coverage survey of about 18,000 U.S. adults, including 4,500 people ages 19 to 64 with family incomes between 138% and 400% of the federal poverty level, and a second survey, on attitudes, conducted from 2005 to 2007.
The second survey sample includes 20,000 adults ages 19 to 64 with family incomes between 138% and 400%of the federal poverty level, and about 3,250 of those people are uninsured 
with no access to employer-sponsored group health coverage, the researchers say.
About 25% of the uninsured participants with incomes between 300% and 400% of the poverty level and 38% of the uninsured participants with incomes between 200% and 300% of poverty level said they have had no recent problems with their health, medical bills or access to health care, and about 31% of uninsured adults ages 27 to 39 said they have had no recent problems with health, medical bills or access to care.
The Affordable Care Act, the federal legislative package that includes the Patient Protection and Affordable Care Act (PPACA), includes provisions that will require states to create a system of state-based health insurance exchanges in 2014. The exchanges are supposed to help individuals and small groups buy standardized, federally subsidized health insurance packages that meet exchange program quality standards.
Some fear that younger, healthier uninsured people with moderately high incomes, will get smaller subsidies because they are closer than other moderate-income people to earning 400%
of the federal poverty level, will avoid buying coverage through the exchange system.
