Since the implementation of Obamacare, the number of Americanswithout health insurance has dropped to 24 million from 37million.

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Related: Sanders says Aetna move shows need for Medicare forall

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That’s still a lot of folks without insurance. The New YorkCity-based Commonwealth Fund, which has been persistentlytracking the insurance coverage rate in the U.S., decided to findout what the composition of the 24 million looked like.

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Essentially, the result of its research doesn’t come up withany surprising results. Those who remain without coverage tend tobe young minorities without large incomes.

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Related: Why use ACA exchanges?

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Or, as Commonwealth puts it in a review of its findings: “As ofFebruary-April 2016, of the estimated 24 million uninsured adults,88 percent — approximately 21 million — had incomes less than 138percent of poverty, were young adults under age 35, were Latino,and/or were working in small firms.”

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The Latino portion of the 24 million does pop out a bit. As morepeople have acquired coverage, the Latino percentage of theuninsured has increased substantially, from 29 percent in 2013 to40 percent in the most recent survey.

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When age was removed as a factor, and the uninsured were viewedthrough the lens of income, the survey found that the percent ofthose without coverage who earned less than 138 percent of thepoverty level fell from 35 percent to 24 percent.

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The decrease among young adults ages 19-35 in that incomecategory was impressive as well, dropping from 28 percent to 18percent. Blacks in that catergory without coverage fell from 21percent to 13 percent. Latinos in that range reported the lowestdecrease: 36 percent to 29 percent.

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Other factors

Commonwealth noted that many among the uninsured qualify byincome for subsidized insurance, but face various obstacles toobtaining it. The very complexity of the system currently in placeprobably discourages some from obtaining coverage. And becauseMedicaid expansion is as yet incomplete, many can’t accesscoverage.

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“One-third (34%) of adults who were uninsured in 2016 haveMedicaid-eligible incomes but live in one of the 20 states that hadnot yet expanded eligibility for Medicaid at the time of thesurvey,” Commonwealth reported. “This includes adults who fall intothe so-called coverage gap — that is, those with incomes under 100percent of poverty who are neither eligible for their state’sexisting Medicaid program nor marketplace subsidies (22%) — andthose with incomes between 100 percent and 138 percent of povertywho are eligible for marketplace subsidies (12%).”

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Among the major issues cited by the report that need to beaddressed to make coverage available to more Americans:

  • The ACA’s exclusion of undocumented immigrants from the coverageexpansions.

  • The lack of Medicaid expansion in 19 states, including two ofthe nation’s largest states.

  • Less awareness of the marketplaces in some demographicgroups.

  • Concerns about plan affordability and subsidy eligibility.

  • Difficulty selecting plans during the enrollment process.

  • Lack of assistance in selecting plans.

The bottom line, the report said, is that coverage will continueto be inaccessible to millions until a smoother, more consistenthealth system emerges.

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.