10:31 am
Mon November 25, 2013

Families USA: 71% of Individual Health Care Market Eligible for Subsidies


A study released last week by Families USA claims that less than one percent of those with individual health coverage are likely to lose their current insurance. 

The group's study shows that the individual market -- those who buy their own health insurance rather than participate in group plans -- involves 5.7% of Americans under 65. That's 15.2 million people, according to Families USA Executive Director Ron Pollack.

"Over 10.8 million people, who have individual health coverage, are in households with incomes below 400 percent of the federal poverty level.  400 percent of poverty for an individual is approximately 46,000 dollars in annual income. For a family of four, that's 94,200 dollars," Pollack says.  "Another way of saying this is that almost 3 out of 4 -- 71 percent -- of those with individual health coverage become eligible for substantial premium subsidies or expanded Medicaid."

However, North Carolina is one of the states which did not accept the expansion of Medicaid. Pollack says there are approximately 407,000 people in the state, or about 5% of the under-65 population, who have individual health care policies. And of that number, Pollack says, "...267, 000 have incomes below 400 percent of poverty, and 66 percent of those have individual coverage, and so they are eligible for subsidies or Medicaid.  And, of course North Carolina is one of the states that has not yet accepted the Medicaid expansion, and so some group of people below the federal poverty level, but with higher incomes than with the current Medicaid standards, may not get this help. But a very small percentage of them have individual coverage today because they cannot afford it with their meager income."

Pollack says that because of the Affordable Care Act, the "overwhelming majority" of those with individual coverage will have access to better coverage, and will pay lower premiums.

Families USA describes itself as a "national nonprofit, non-partisan organization, dedicated to the achievement of high-quality, affordable health care for all Americans. The group has been a strong supporter of the Affordable Care Act, and has recently joined a public relations effort to help counter negative publicity generated by the botched roll-out of the government website mandated by the new law.

To read the full Families USA report, click here.