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How Many People Are in the Coverage Gap? Nationally, nearly four million poor uninsured adults fall into the “coverage gap” that results from state decisions not to expand Medicaid, meaning their income is above current Medicaid eligibility but below the lower limit for Marketplace premium tax credits. These individuals would have been newly-eligible for Medicaid had their state chosen to expand coverage.
In the past year, the number of people falling into the coverage gap has declined as more states have taken up the Medicaid expansion. Since September 30, 2013, four states (Ohio, New Hampshire, Indiana and Pennsylvania) have opted to expand their Medicaid programs, extending ACA-related assistance to approximately 760,000 uninsured nonelderly adults. Adults left in the coverage gap due to current state decisions not to expand Medicaid are spread across the states not expanding their Medicaid programs but are concentrated in states with the largest uninsured populations (Table 1). A quarter of people in the coverage gap reside in Texas, which has both a large uninsured population and very limited Medicaid eligibility (Figure 2). Eighteen percent live in Florida, ten percent North Carolina, higher in South Carolina and eight percent in Georgia. There are no uninsured adults in the coverage gap in Wisconsin because the state is providing Medicaid eligibility to adults up to the poverty level. SPECIAL ENROLLMENT DISCOUNT
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