Many Uninsured Passing Up Subsidized Coverage

Oct. 14--Two thirds of the nearly 1 million Pennsylvanians without health insurance are eligible for Medicaid or subsidized Affordable Care Act coverage, according to a study published Tuesday.

Pennsylvania is among five states that account for approximately 40 percent of the uninsured population nationally that could receive Medicaid or subsidized private coverage. The others are California, Texas, Florida and New York.

The findings from the nonprofit Kaiser Family Foundation come three weeks before start of the third open enrollment period since the ACA's passage.

Before the health law, many people who wanted coverage had limited options because insurers could reject them or charge them higher rates for pre-existing conditions.

Under the law, nearly eight in 10 consumers in Pennsylvania and the 36 other states using the federal HealthCare.gov online marketplace have had the option of getting covered for as little as $100 a month or less after financial assistance that lowered the cost of their monthly premiums. The average tax credit in Pennsylvania during the last open enrollment was $230 per month, according to the U.S. Department of Health and Human Services.

Nationwide, nearly half of the 32 million non-elderly people in the United States without health insurance at the beginning of 2015 are eligible for Medicaid or subsidized coverage through an ACA marketplace, according to Kaiser, which based its analysis on the 2015 Current Population Survey, combined with other data sources.

Ten percent of the uninsured fall into a coverage gap in which they earn too much to be eligible for Medicaid but not enough to qualify for financial assistance through an ACA marketplace, Kaiser said. The rest of the uninsured were ineligible for financial assistance because either they qualify for employer-based insurance, they earn too much or they are illegal immigrants.

People who are eligible for financial assistance but still don't get insurance face increasing penalties. Some of those without it in 2014 were forced to forfeit $95 -- or 1 percent of their income, depending on which was higher -- from tax refunds filed in the spring.

For the 2015 tax year, the cost will go up to $325, or 2 percent of income. Deductions for uninsured children will be half those of adults, and the maximum penalty for a family will be $975.

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