We don't. Millions of those are people who've changed jobs in the last year. Millions of others are elligible for medicaid and have not bothered to sign up. Some are young people ,including some with solid incomes, who feel they are healthy and don't need it. The true number and I don't have the textbook(yes, it's included in a book in UNO's MPH program) in front of me, is less than 10 million.