Introduction: The uninsured population in the United States has increased dramatically over the past few years. Hospitals and physicians bear the financial burden of the uninsured by compensating for the billions of dollars in bad debt or uncompensated care they incur each year. Emergency rooms and other healthcare facilities are left with billions in uncompensated care due to 47 million uninsured Americans. Uncompensated care in 2006 was $31.2 billion. Majority of individuals accounting for uncompensated care are those living at or below the federal poverty level and those individuals who can afford health coverage but freely choose to forgo purchasing health insurance.

Under the Affordable Care Act of 2010 the number of uninsured Americans will be decrease by 32 million, helping reduce the annual cost of uncompensated care. The purpose of this research was to analyze the effects of the uninsured population on the insured population in terms of quality of, cost, and access to health care.

Methodology: The methodology for this study was a literature review. Four electronic data bases were used with a total of 31 articles referenced for this research.

Results: Uncompensated care was shown to increase health insurance premiums of the insured population by $1,000 annually. Cost-shifting represents around 1.7% of private health insurance costs. An estimated $14 billion could be funded through cost shifting. Under the Affordable Care Act, the uninsured population is estimated to decrease substantially, thus reducing annual uncompensated care costs.

Discussion/Conclusion: Effects of the uninsured population on the insured exhibited mixed results. When discussing effects on the insured due to the billions in uncompensated care, health insurance premiums were shown to increase and rises in cost shifting were noted. Reducing the population of uninsured Americans has a direct correlation with reducing uncompensated care costs.