About 75% of uninsured U.S. residents could end up buying health coverage in 2014, consultants say.

The consultants, at Oliver Wyman, a unit of Marsh & McLennan Companies Inc., New York (NYSE:MMC), write about the uninsured as a market in a report based on a recent survey of about 800 U.S. adults who have no major medical coverage.

Opponents of the Patient Protection and Affordable Care Act of 2010 (PPACA) are still trying to block implementation of part or all of the act. If the act takes effect as written and works as drafters expect, then, starting in 2014, low-income consumers will have an easier time qualifying for free health coverage. Middle-income consumers will be able to use a new system of tax credit subsidies to buy coverage through health insurance exchanges on guaranteed issue, mostly community-reated basis.

Some consumers who decide to go without coverage are supposed to pay a modest tax penalty.

The consultants found that 76% of all uninsured people they surveyed said they would rather buy coverage than pay the penalty. Because the subsidies are higher for lower-income people, lower-income participants were more likely to say they would be willing to make the payments needed to buy coverage under the new rules.

The percentage of participants who said they would not buy coverage was just 18% for participants earning 100% to 133% of the federal poverty level, or $22,000 to $29,000 for a family of four, and 34% for participants earning between 300% and 400% of the federal poverty level.

The consultants divided the participants into three major categories: struggling people who are not interested in health insurance; middle-income people who already have chronic health problems, or risk factors that could lead to health problems; and “Engaged to Save” consumers, or cash-strapped healthy people who are interested in health insurance but extremely price sensitive.

The struggling consumers “just want basic protection against disaster,” the consultants say.

The middle-income uninsured people with health problems seem to be willing to pay more to get time-saving services such as access to same-day appointments and 24-hour access to care.

The “Engaged to Save” consumers “want to minimize out-of-pocket costs and are willing to make tradeoffs to reduce their costs,” the consultants say. “For example, they are willing to maintain a healthy body weight or quit smoking if it will save them on premiums.”

- Allison Bell

Other uninsured coverage from National Underwriter Life & Health: