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Uninsured and Underinsured Frequently Asked Questions


How many people lack health insurance in the United States?

In 2012, the percentage of people without health insurance decreased to 15.4 percent from 15.7 percent in 2011. The number of uninsured people in 2012 was 48.0 million.

Source: Income, Poverty, and Health Insurance Coverage in the United States: 2012, U.S. Census Bureau, 2013


How many rural Americans are without health insurance?

A greater proportion of rural residents than urban residents are uninsured or covered through public sources. As population density and proximity to urban areas decrease, rural uninsured rates increase. In the smallest and most remote rural areas (population less than 2,500), the uninsured rate is 23% compared to an urban rate of 19%.

Between 1997 and 2005, public sources of coverage – Medicaid, CHIP, Medicare, and TRICARE – have been particularly important in offsetting loss of private coverage in rural areas.

Compared to urban adults, rural adults are more likely to be not employed or to work for employers that do not sponsor health insurance coverage.

Source: Profile of Rural Health Insurance Coverage: A Chartbook, Maine Rural Health Research Center, 2009


Who are the rural uninsured?

The rural uninsured often work for small firms and are paid low wages.

  • Workers employed by small firms represent 69% of the uninsured in rural, not adjacent areas compared to 59% in adjacent and urban areas.
  • In rural, not adjacent areas, low-wage workers represent 67% of the uninsured, compared to 53% in urban areas.

Source: Profile of Rural Health Insurance Coverage: A Chartbook, Maine Rural Health Research Center, 2009.


What are Health Insurance Marketplaces and why do they exist?

Provisions of the Affordable Care Act (ACA) state that insurance plans cannot limit or deny coverage because of a preexisting condition and that all consumers must carry a form of health insurance. All states must provide health insurance marketplaces (also called exchanges or marketplaces) where consumers, health care providers, and small businesses can learn about the different health insurance options, enroll in health plans, and explore eligibility for financial assistance.

They must be in place by October 2013 and every state can choose how it will operate the marketplace. You can access each state’s marketplace website as they become available on the healthcare.gov website.


How can my patients and community members access information on the new health insurance marketplaces?

Visit healthcare.gov – the official government site with information on the Affordable Care Act and the new health insurance options.

Marketplace Call Center: Customer service representatives (CSRs) are available to answer questions 24 hours a day, 7 days a week, including some federal holidays regarding, for example:

  • The health insurance marketplace
  • Eligibility determinations/redeterminations
  • Comparing qualified health plans
  • Enrollment in plans
  • Plan complaints
  • Appeals
  • Password resets on Healthcare.gov
  • Requests for marketplace publications
  • Small Business Health Options Program (SHOP)

Toll-free: 1.800.318.2596
TTY/TDD: 1.888.871.6594



Last Reviewed: 11/4/2013

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Funding for this project was supported by Grant Number U56RH05539 from the Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services. The contents of this website are solely the responsibility of the authors and do not necessarily represent the official views of the funder.