Final answer:
Approximately 31 million Americans lacked health insurance in 2020, often due to small companies or low-paying jobs not offering health benefits. The ACA helped by ensuring people with preexisting conditions could get insurance, but a significant number of Americans remain uninsured or underinsured.
Step-by-step explanation:
In the United States, a significant number of Americans without health insurance work for small companies or earn low wages that do not include health benefits. Around 31 million Americans were uninsured in 2020, despite efforts to reduce this number through government programs and the Patient Protection and Affordable Care Act (ACA), also known as Obama Care.
Before the ACA, as many as 45 million Americans were uninsured, which included children and young adults. Post ACA, although the number has decreased, it remains substantial. The ACA brought much-needed reforms, including mandating that people with preexisting conditions could not be denied coverage, resulting in 20 million additional Americans gaining health insurance. However, many jobs, especially temporary, part-time, and low-paid roles, offer no health benefits, contributing to the uninsured population.
Furthermore, being insured doesn't always equate to sufficient coverage, as some people are underinsured, spending a significant portion of their income on costs not covered by insurance. Despite the improvements, a sizable portion of Americans, including those with income above the poverty line but without employer-provided insurance, and those below the poverty line who do not receive Medicaid, remain without health insurance.