The problems in the Affordable Care Act private exchange market may have hammered moderately broke U.S. adults this year.

The U.S. Center for Disease Control and Prevention has come out with new tables that break out the uninsured rate numbers by age and income group. One tables shows what happened to adults ages 18 to 64.

For all adults in that age group, the total uninsured rate fell to 12.1% during the first three months of 2017, from 12.4% in the first quarter of 2016.

(Related: Uninsured Rate Rises for Poor Children and Job Hunters )

This is how the uninsured rate data looked when CDC analysts reported separate uninsured rates for each income group:

  • Iincome under 100% of the federal poverty level, or $24,600 for a family of four in most of the country: The uninsured rate fell to 22.6%, from 24.7%.

  • Income from 100% to 138% of the federal poverty level: The uninsured rate fell to 23.9%, from 24.7%.

  • Iincome from 138% to 250% of the federal poverty level: The uninsured rate rose to 21.3%, from 19.1%.

  • Income from 250% to 400% of the federal poverty level: The uninsured rate rose to 12.3%, from 9.7%.

  • Income over 400% of the federal poverty level: The uninsured rate fell to 3.5%, from 3.7%.

The CDC analysts based the uninsured rate numbers on results from the National Health Interview Survey. A copy of the full results is available here.

Adults in each income group face different types of decisions about whether to buy major medical coverage.

Income Group Differences

Most people with income income under 100% of the federal poverty level, and many people with income under 138% of the federal poverty level, can qualify for Medicaid.

Hospital (Photo: Thinkstock)

(Photo: Thinkstock)

Most people with income from 138% to 250% of the federal poverty level can qualify for both ACA premium tax credit subsidies and for ACA cost-sharing reduction subsidies, which help low-income people pay their deductibles and coinsurance bills.

Most people with income from 250% to 400% of the federal poverty qualify only for a modest amount of ACA premium tax credit help.

People with income over 400% of the federal poverty level qualify for now ACA exchange plan subsidies. They may have to pay the penalty that the ACA imposes on many people who fail to own what the ACA classifies as solid major medical coverage, or minimum essential coverage, for enough of the year.

The CDC analysts did not talk about whether changes in the ACA exchange market explained the increase in the uninsured rate for people with income from 138% to 400% of the federal poverty level.

The CDC tables do show that the percentage of people with income from 250% to 400% of the federal poverty level who had private coverage fell to 77.8% in early 2017, from 79% a year earlier.

Another hint is that the uninsured rate for most adult age groups stayed about the same. The uninsured rate for adults ages 19 to 25 rose to 14.9%, from 14.7%.

ACA Exchange Plan Use

The analysts found that the total number of adults ages 18 to 64 with exchange plan coverage increased to 9.4 million, from 9.2 million.

The number of children with exchange plan coverage fell to 1.4 million, from 1.9 million.

The analysts did not break the exchange plan use numbers down by income, and they did not give figures on use of individual health coverage purchased outside of the ACA exchange system.

Growing Gaps in Coverage

The analysts reported that the percentage of private coverage users with high deductibles has increased this year, in spite of some talk about the possibility that the shift toward higher out-of-pocket costs might be slowing.

The percentage of people under age 65 who had private health coverage, and who used some kind of high-deductible plan, increased to 42.3% this year, from 39.4% in early 2016.

The percentage with a high deductible and no health savings account or health reimbursement arrangement, who might be especially receptive to hearing about supplemental health insurance products such as critical illness insurance and hospital indemnity insurance, increased to 25.3%, from 23.9%.

The analysts note that they adjust the cut-off they use to decide whether a consumer has a high-deductible plan for inflation. The current threshold is $1,300 for self-only coverage and $2,600 for family coverage.

—-Read CDC: Medical Bills Still Haunt Near-Poor Consumers on ThinkAdvisor.


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