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Portfolio > Economy & Markets > Fixed Income

High-income uninsured people: 4.4 million are still out there

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Sellers of individual health coverage may still have 33 million uninsured U.S. residents to pursue, and 4.4 million of those uninsured people may be in families with income over the 400 percent of the federal poverty level (FPL).

Linda Blumberg and other analysts at the Urban Institute have included those figures in a report on the remaining uninsured Americans. The report was sponsored by the Robert Wood Johnson Foundation.

See also: High-income uninsured market shrinks

About 4.1 million of the remaining high-income uninsured people are citizens, are permanent residents, or can show that they are in the United States legally with some other kind of immigration status. People in the latter category make up about 15 percent of all of the remaining uninsured people who are in the country legally.

About 300,000 of the remaining high-income uninsured people cannot prove that they are in the country legally. And only 5.8 percent of the undocumented uninsured people have a family income over 400 percent of the FPL.

The uninsured rate is 4.6 percent for high-income uninsured people who are in the country legally and 16 percent for high-income uninsured people who are undocumented.

About 7 million of the uninsured people who are in the country legally and 975,000 of the undocumented uninsured people have a family income that ranges from 201 percent to 399 percent of the FPL.

Blumberg and her colleagues based their numbers on an analysis of Census Bureau data.

The Patient Protection and Affordable Care Act of 2010 (PPACA) now requires many people to show that they have a minimum level of health coverage or pay an “individual shared responsibility” penalty. PPACA also provides rich subsidies for people with incomes from 100 percent of the FPL (or 138 percent in some states) to 250 percent of the FPL for people who buy qualified health plan (QHP) coverage from a PPACA exchange. The law also provides some subsidies for people with family incomes from 250 percent to 400 percent of the FPL who buy QHP coverage.

However, the law does not provide exchange plan subsidies for people with income over 400 percent of the FPL. Uninsured people in that income category who are in the country legally have to comply with one of the following: they have to show that they have minimum essential coverage (MEC), show that they qualify for an exemption from the MEC requirement, or pay the shared responsibility penalty.

People who are in the country illegally cannot buy coverage from the PPACA exchange, but they are not affected by the shared responsibility penalty system.

See also:

High-income Americans get covered

Private health insurers struggle to reach high earners

 

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