Exhibit 1. Low-Income Adults Have Higher Rates of Being Uninsured for Long Periods of Time * Combines Insured now, time uninsured in past year and Uninsured.

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Health Insurance Coverage of Young Adults John Holahan The Urban Institute February 4, 2008 THE URBAN INSTITUTE.

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Exhibit 1. There Were 14.8 Million Uninsured Young Adults in 2009, Up by 4 Million in the Past Decade Uninsured young adults ages 19–29 (in millions) Source:

Adults ages 19–64 with individual coverage or who tried to buy it in past three years who: Total Health problem No health problem

Chart 1 Cost Shifts to Workers: Increased Premiums and Cost-Sharing * Premiums increased more than a little. Increased cost-sharing includes cuts in benefits.

Figure ES-1. Uninsured Rates High Among Adults with Low and Moderate Incomes, 2001–2005 Percent of adults ages 19–64 Note: Income refers to annual income.

Exhibit 1. Nearly Two of Five Young Adults Spent Some Time Uninsured in the Past Year Notes: FPL refers to federal poverty level. Numbers may not sum to.

THE COMMONWEALTH FUND Source: McCarthy and Leatherman, Performance Snapshots, Data: National Health Interview Survey (National.

Exhibit 1. One-Quarter of Adults Reported a Gap in Coverage in 2011; More Than Half Were Uninsured for Two Years or More * Combines Insured now, time uninsured.

Adults ages 19–64 with individual coverage or who thought about or tried to buy it in past three years who: Total Health problem No health problem

HEALTH INSURANCE COVERAGE OF WORKING-AGE ADULTS. One-Third of Working-Age Adults Were Currently Uninsured or Had a Recent Gap* 164 million adults age.

Exhibit 1. The Impact of Health Reform: Percent of Women Ages 19–64 Uninsured by State Source: Urban Institute and Kaiser Commission on Medicaid and the.

Exhibit 1. Percent of Adults Under Age 65 with a Usual Source of Care, by State, 2012 Percent Data source: 2012 Behavioral Risk Factor Surveillance System.

Note: FPL refers to federal poverty level. * A composite of the following four indicators measures access to a medical home: 1) having a regular doctor.

Exhibit 1. Continuously insured adults with private coverage or Medicaid rated the quality of their health care as excellent or very good at higher rates.

Exhibit 1. Fifteen Million Young Adults Ages 19–25 Enrolled in or Stayed on Their Parents’ Health Plan in Past 12 Months Distribution of 15 million adults.

Exhibit 1. Only One of Three Small-Firm Workers Was Insured Through Their Employer in 2010 ^ Includes both part-time and full-time workers who are not.

Exhibit 1. Two of Five Insured Adults with Incomes Below the Federal Poverty Level Spent 5 Percent or More of Their Income on Medical Out-of-Pocket Costs.

Exhibit 1. Uninsured Rates Declined Among Whites, Blacks, and Latinos in 2014 Source: The Commonwealth Fund Biennial Health Insurance Surveys (2010, 2012,

Insured, Uninsured and the Underinsured (US data). Olayinka Oladimeji Pharmaceutical Management for Underserved Populations. 03/21/07.

Exhibit 1. Adults with Marketplace Coverage with Incomes Under 250 Percent of Poverty Paid Monthly Premiums Comparable to Those with Employer Coverage.

Exhibit 1. More Adults Who Visited the Marketplaces Found It Easy to Compare Benefits and Costs of Plans; Few Found It Easy to Compare Plans by Providers.

Insured Women Are More Likely to Receive Cancer Screenings Than Uninsured Women, 2016 Percent of women Notes: “Continuously insured” refers to adults.

Among Marketplace Visitors Who Did Not Enroll or Get Coverage Elsewhere, Three-Quarters Said They Could Not Find an Affordable Plan Can you tell me the.

More Than One-Quarter of Insured Adults Were Underinsured in 2016

Lower-Income Adults with Marketplace Plans More Likely to View Their Premiums as Affordable Than Adults with Higher Incomes How easy or difficult is it.

Uninsured Adults and Those with Coverage Gaps Reported Medical Bill Problems at Higher Rates Than Did Those Continuously Insured, 2016 Percent of adults.

Uninsured Adults and Those with Coverage Gaps Reported Cost-Related Access Problems at Higher Rates Than Did Those Continuously Insured Percent of adults.

Percent of uninsured adults ages 19–64 Income level Race Age Firm size

The uninsured rate among working-age adults increased to 15.5 percent

Paid less than $125 Percent of adults ages 19–64 with single policies

Adults ages 19– Uninsured now 15%

Overall, how satisfied are you with your health insurance?

State Uninsured Rates by Poverty and Firm Size

Across Income Groups, Increasing Numbers of U. S

Percent adults ages 19–64 insured all year who were underinsured*

Percent adults ages 19–64 who pay all or some of premium

Uninsured Adults Are Less Likely to Receive Cancer Screenings, 2016

Four of Five Adults with New Coverage Said They Were Very or Somewhat Optimistic That Their New Coverage Would Improve Their Ability to Get the Care.

Distribution of 8.6 Million Uninsured Adults Ages 50–64 by Federal Poverty Level and Provisions of the Affordable Care Act Uninsured adults ages 50–64.

Percentage-point reduction in uninsured adults between 2012 and 2014

Adults with marketplace plans or Medicaid express the least confidence in being able to keep their coverage in the future. You said you currently have.

Deductibles Have Become a Growing Factor in Underinsurance Rates

Percent of women ages 19–64 Total <133% FPL 133%–249% FPL

Two of Five Insured Adults with Incomes Below the Federal Poverty Level Spent 5 Percent or More of Their Income on Medical Out-of-Pocket Costs Percent.

Percent of adults ages 19–64* Total <133% FPL 133%–249% FPL

16 Million Adults Under Age 65 Were Underinsured in 2005

Adequately insured 48% Uninsured anytime 15% Uninsured anytime 36%

About Three of Five Privately Insured Adults with Low Incomes Reported That It Was Difficult or Impossible to Afford Their Deductible How easy or difficult.

Reasons for Skipping Cancer Screening Tests

Inadequate Coverage Is Associated with More Cost-Related Problems Getting Needed Care Percent of adults ages 19–64 who had any of four access problems.

Seven of 10 Adults with Marketplace Plans Rate Their Coverage as Excellent, Very Good, or Good Now thinking about (your current health insurance coverage/

Subsidized private insurance

Medicaid <133% FPL 26 million

More Adults with Lower Incomes Found It Easy to Find an Affordable Plan Than Did Adults with Higher Incomes How easy or difficult was it to find a plan.

Uninsured Adults with Low and Moderate Incomes Are Less Likely to Be Up to Date with Recommended Preventive Tests Percent of adults ages 19–64, income.

Two of Five Adults Uninsured or Underinsured 25 Million Underinsured 60 Percent Increase in Underinsured from 2003 to 2007 Percent of adults (ages 19–64)

Overall, how satisfied are you with this new health insurance?

Percent of adults ages 19–64 Total <200% FPL 200% FPL or more

Uninsured young adults = 13.2 million

Premium tax credits have made the cost of marketplace plans similar to employer plans for low-income adults, but adults with higher incomes pay more Percent.

Premium Affordability: Insurance-Related Premium Subsidies

Larger Shares of Adults with Marketplace Coverage Have Plans with High Deductibles Compared to Those with Employer Plans No deductible Less than $1,000.

The Share of Women Spending 10 Percent or More of Their Income on Health Care Climbed over the Past Decade, Especially for Women with Low Incomes Percent.

Percent of adults ages 19–64

When Low-Income Adults Have a Medical Home and Insurance, Their Rates of Having Cost-Related Access Problems Decline Percent of adults ages 19–64 with.

Under the Affordable Care Act, Young Adults Will Benefit from Newly Subsidized Sources of Health Insurance Percent of young adults ages 19–29 Total

Percent adults insured all year ages 19–64 who were underinsured*

Reasons for Loss of Employer-Sponsored Insurance and Medicaid

Half of Young Adults Who Lost a Job with Health Benefits from November 2009 to November 2011 Became Uninsured Became uninsured 52% Adults ages 19–29 who.

Uninsured young adults ages 19–29 Federal Poverty Level Percent

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Exhibit 1. Low-Income Adults Have Higher Rates of Being Uninsured for Long Periods of Time * Combines Insured now, time uninsured in past year and Uninsured now. Note: FPL refers to federal poverty level. Source: The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults, Percent of adults ages 19–64 Total133%–249% FPL 400%+ FPL <133% FPL 250%–399% FPL Uninsured for one year or more Uninsured for two years or more Uninsured during the year*

Exhibit 2. Factors in Decision to Visit an Emergency Room, Adults with Low and Moderate Incomes * Respondent used ER at least once in past 12 months to get care for themselves or family member in evenings or on weekends. ** Combines Insured now, time uninsured in past year and Uninsured now. Note: FPL refers to federal poverty level. Source: The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults, Percent of adults ages 19–64 who used ER in past year,* income less than 250% FPL

Exhibit 3. Uninsured Adults with Low and Moderate Incomes Are Less Likely to Be Up to Date with Recommended Preventive Tests Notes: FPL refers to federal poverty level. Preventive tests: blood pressure checked in past year; cholesterol checked in past five years (in past year if has hypertension or heart disease); Pap test in past year for females ages 19–29, in past three years for ages 30–64; mammogram in past two years for females ages 40–64; and colon cancer screening in past five years for adults ages 50–64. * Combines Insured now, time uninsured in past year and Uninsured now. Source: The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults, Percent of adults ages 19–64, income less than 250% FPL

Pap test*Colon cancer screening** Mammogram*** ^ Total Insured all year Uninsured during the yearTotal Insured all year Uninsured during the yearTotal Insured all year Reasons for skipping cancer screenings: Did not think I needed it 30%33%26%38% 37%26%27% Did not get around to making an appointment Too expensive No doctor or appointment available Could not take time off work Other Exhibit 4. Reasons for Skipping Cancer Screening Tests * Did not have Pap test in past year for females ages 19–29, in past three years for ages 30–64. ** Did not have colon cancer screening in past five years for adults ages 50–64. *** Did not have mammogram in past two years for females ages 40–64. ^ Sample size too small to report mammogram results for uninsured during the year. Source: The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults, Percent of adults ages 19–64 who skipped recommended preventive care

Exhibit 5. Medicaid Is an Important Source of Coverage for Families and Children with Low and Moderate Incomes Notes: FPL refers to federal poverty level. * Had Medicaid in past two years, but does not currently receive Medicaid and does not have children who receive Medicaid/CHIP. Source: The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults, Percent of adults ages 19–

Exhibit 6. Medicaid Is Particularly Important for Low- and Moderate-Income Families with Children * Children under age 26. Note: FPL refers to federal poverty level. Source: The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults, Percent of adults ages 19–64 with children*

Four levels of cost-sharing: 1st tier (Bronze) actuarial value: 60% 2nd tier (Silver) actuarial value: 70% 3rd tier (Gold) actuarial value: 80% 4th tier (Platinum) actuarial value: 90% Exhibit 7. Premium Tax Credits and Cost-Sharing Protections Under the Affordable Care Act Federal poverty levelIncome Premium contribution as a share of income Out-of- pocket limits Actuarial value: silver plan <133% S: <$14,484 F: <$29,726 2% (or Medicaid) S: $1,983 F: $3,967 94% 133%–149% S: $14,484 – <$16,335 F: $29,726 – <$33, %–4.0%94% 150%–199% S: $16,335 – <$21,780 F: $33,525 – <$44, %–6.3%87% 200%–249% S: $21,780 – <$27,225 F: $44,700 – <$55, %–8.05% S: $2,975 F: $5,950 73% 250%–299% S: $27,225 – <$32,670 F: $55,875 – <$67, %–9.5%70% 300%–399% S: $32,670 – <$43,560 F: $67,050 – <$89, % S: $3,967 F: $7,933 70% 400%+ S: $43,560+ F: $89,400+ S: $5,950 F: $11,900 Notes: Actuarial values are the average percent of medical costs covered by a health plan. Premium and cost-sharing credits are for the silver plan. Source: Federal poverty levels are for 2011; Commonwealth Fund Health Reform Resource Center: Whats in the Affordable Care Act? (PL and ), Catastrophic policy with essential benefits package available to young adults and people whose premiums are 8%+ of income