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Many Americans still lack health insurance

Although the rolls of the uninsured have dropped dramatically since the Affordable Care Act, better known as Obamacare, took effect in January, a nagging 15 percent of the population remains uninsured, according to a new survey sponsored by the Transamerica Center for Health Studies. Still, the percentage of Americans without health coverage has dropped markedly from 22 percent to 15 percent over the past 11 months, according to the poll of 2,624 adults under the age of 64.

It's worth noting that the U.S. Census Bureau normally does a good analysis of changes in insurance coverage from year-to-year, but the government recently changed its survey methodology, which made year-to-year comparisons impossible. The government data, which was released in August, found that 86.6 percent of the population had health insurance during 2013 and just 13.4 percent had no coverage.

However, the government uses a narrow definition of what constitutes an insured person. If you had insurance at any time during the year, the Census Bureau now considers you insured. Someone who was covered for a month or two, but lost a job and is no longer covered, would still appear insured via the Census formula. The government's methodology only considers people to be uninsured if they had no coverage at any point during the year.

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By contrast, Transamerica's study looked at those who said they were insured in July 2014, explaining the relatively minor difference in reported insurance coverage.

The people most likely to lack health coverage are either young or Latino, according to Transamerica. Among the uninsured, 44 percent are between the ages of 18 and 34, and 33 percent are Latino.

This uninsured population cited affordability and ignorance of the law as the primary reasons they lack coverage. Some 11 percent said health coverage was simply too expensive. Another 27 percent said that paying the Obamacare financial penalty, which is levied against those without coverage, was cheaper than buying a policy. Fully 46 percent of uninsured Americans said they simply did not know the law compelled them to buy insurance or face penalties. Another 43 percent didn't know that they could go to a state health exchange to apply for subsidies to help them pay health insurance premiums.

When asked what they could afford, just 42 percent of uninsured respondents thought they could afford a premium of as much as $100 a month. The rest said even that was impossible. However, even without the cost of paying premiums, the uninsured population says they're struggling with health costs. Only 22 percent said they were able to afford their routine health expenses, such as doctor's visits and medications.

Notably, the median household income of those who remain uninsured is $37,300, according to the survey. That's less than half the median income ($75,200) of the households who have been consistently insured before and after the Obama care law, according to Transamerica's research. But that's more than the median income ($33,200) of those who became recently insured under Obamacare.

Among the newly insured, more than three-quarters are satisfied with their coverage. And only a minority of those who have been continuously insured have noticed a difference in coverage under Obamacare, according to the study. Among those who have experienced a change in coverage under the program, 48 percent said the change was a hike in premiums, deductibles, co-payments or other out-of-pocket expenses.

The really good news: Concerns about companies being reluctant to hire because they'd have to shoulder some of the cost of health coverage appear to have been overblown. Some 33 percent of surveyed employers said they intend to hire more workers over the next two years, compared to just 20 percent in 2013.

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