Schools, low-wage employers offer pathway to enrolling uninsured

More than one-third of the nation's uninsured are eligible for low-cost healthcare through Medicaid or substantial tax credits, making it a promising group for targeted outreach, according to an Urban Institute report.

Although healthcare subsidies authorized by the Affordable Care Act have significantly reduced the number of uninsured individuals, nearly 33 million nonelderly U.S. residents still don't have health coverage, according to the report. However, 37.5 percent of that population (12.4 million people) are eligible for low cost plans through Medicaid or qualify for the largest premium tax credits for marketplace-based coverage.

This population is the most promising in terms of reducing the rate of uninsured, according to the Urban Institute, which is funded by the Robert Wood Johnson Foundation. Although modest reductions could be seen among individuals facing increasing ACA penalties, the largest portion of uninsured individuals can be accessed with targeted outreach efforts though public schools, employers and other non-health public assistance programs, as well as family courts and support programs for single parents.

For example, more than 45 percent of of those eligible for Medicaid or the Children's Health Insurance Program and 24 percent of families eligible for tax credits have at least one school-age child, meaning outreach efforts through public schools that assist families in enrollment can make a significant impact. Additional targeted efforts can focus on children that receive free and reduced-priced lunch, which serves as a strong signifier the family may be eligible for Medicaid or tax breaks.

Similarly, two-thirds of uninsured families eligible for Medicaid and more than half of those eligible for healthcare subsidies have at least one family member receiving a non-health public benefit, including the supplemental nutrition assistance program and earned income tax credit. Employers in low-wage industries can also serve as a significant avenue for enrollment since 75 percent of individuals are eligible for tax credits and over half are eligible for Medicaid. Approximately half of uninsured Medicaid eligible children live with a single parent.  

Key demographics--including minorities, low income individuals, and young people--have been notoriously elusive even as insurers have beefed up enrollment efforts during open enrollment. Previous studies have shown that many people are unaware they qualify for federally subsidized health plans and several insurers have used the tax season as an opportunity to enroll uninsured individual facing ACA penalties.

For more:
- read the Urban Institute's report

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