A recent post from Health Affairs estimates that 30 million Americans will still not have insurance coverage by 2016, well beyond the implementation of the Affordable Care Act's (ACA) key provisions. The Uninsured After Implementation Of The Affordable Care Act: A Demographic And Geographic Analysis characterized states based upon their proclivity for expanding Medicaid: completely undeclared, leaning toward expansion, or leaning away from expansion. Using data from the Census Bureau's 2012 Current Population Survey, the researchers found that 29.8 million people would remain uninsured if all undeclared states opt-in to expansion, while 31 million would remain uninsured if all undeclared states chose to opt-out of expansion. Additionally, researchers found that 80% of those remaining uninsured would be US citizens in either scenario.

According to a new survey released by the Commonwealth Fund, 84 million Americans were either uninsured or under-insured in 2012. In addition, 75 million Americans in 2012 were either actively paying or having difficulty paying their medical bills, indicating that medical debt is still a prominent issue. Findings were not bleak for all demographics, however, as the 2012 Biennial Health Insurance Survey also found that the proportion of uninsured individuals ages 19-25 decreased from 48% to 41% in 2012. This phenomenon is most attributable to the Affordable Care Act's (ACA) provision that allows children to remain on their parents' health insurance until age 26.

Effective January 2014, the Affordable Care Act (ACA) establishes a new minimum Medicaid eligibility level of 138 percent of poverty for non-disabled adults who were not previously eligible for the program. As with current Medicaid, legal immigrants who have been in the country for five years or fewer are not eligible for this coverage. Nationally, 21.5 million currently uninsured nonelderly adults may meet the income and citizenship criteria to be eligible for Medicaid after the expansion. A brief recently released by the Kaiser Family Foundation uses the American Community Survey to describe the low-income uninsured adult population -- the target group for the Medicaid expansion under the Affordable Care Act -- by state. Many people in this target population have substantial health needs and face barriers to health care, and nearly half have incomes of 50 percent of poverty or less.

The Supreme Court's ruling on the Affordable Care Act (ACA) upheld the individual mandate and made the expansion of Medicaid coverage to nonelderly adults with incomes below 138 percent of the federal poverty level optional for states. In a new brief, authors from the Urban Institute estimate the number of uninsured Americans in each state who could be eligible for Medicaid if every state takes advantage of the option of expanding Medicaid coverage. According to the report, almost half of the nation's uninsured could qualify for Medicaid under the ACA. Of 22.3 million low-income uninsured Americans who could be potentially eligible for Medicaid under the ACA, 67 percent (15.1 million) are adults not currently eligible for Medicaid. Of this group, 11.5 million have incomes below poverty and would not qualify for any other subsidized coverage.

In a new issue brief entitled "The Income Divide in Health Care: How the Affordable Care Act Will Help Restore Fairness to the U.S. Health System," The Commonwealth Fund Health Insurance Tracking Survey of U.S. adults finds nearly three of five adults in families earning less than 133 percent of the federal poverty level were uninsured for a time in 2011. Two of five were uninsured for one or more years. Low- and moderate-income adults who were uninsured during the year were much less likely to have a regular source of health care than people in the same income range who were insured all year. In addition, uninsured lower-income adults were more likely than insured adults in the same income group to cite factors other than medical emergencies as reasons for going to the emergency room. These included needing a prescription drug, not having a regular doctor, or saying that other places cost too much. The report suggests that the Affordable Care Act (ACA) will substantially narrow these inequities through a set of affordable coverage options.