In addition to expanding insurance coverage for millions of Americans, the Affordable Care Act also improved care affordability and access--though large gaps persist, particularly for low-income adults, a new study found.
In the Health Affairs study, researchers examined data from the Health Reform Monitoring Survey from September 2013, right before the first open enrollment period started, to March 2015, after the second open enrollment period ended.
They found that in 2015, 73.9 percent of nonelderly adults reported having a usual source of care, up from 70.4 percent. Low-income adults experienced a 5.2 percentage point increase in the number who had a usual source of care, the study found. But the increase in care access was not statistically significant for those in states that did not expand Medicaid, while those in expansion states experienced a 4.9 percentage point increase. Medicaid expansion states have also experienced a greater drop in the number of uninsured individuals.
The share of adults who reported a routine check-up in the past year also increased during the time period the researchers studied, from 60.6 percent to 64 percent, and the share of adults who reported trouble obtaining healthcare decreased, from 18.7 percent to 16.4 percent.
In terms of affordability, the share of all nonelderly adults who reported forgoing care due to cost in the past year dropped from 35 percent to 32.3 percent. That difference was even greater--10.5 percentage points--for low-income adults, which the study says "likely reflects the strong cost-sharing protections in Medicaid and the cost-sharing subsidies for coverage through the marketplace in nonexpansion states."
Fewer adults also reported problems paying family medical bills, in particular low-income adults, as that share dropped from 34.7 percent to 24.2 percent from September 2013 to March 2015.
Despite these findings, the researchers note that healthcare access and affordability problems persist. For example, 44.8 percent of low-income adults reported an unmet need for care caused by costs, and 16.4 percent of all nonelderly adults had trouble accessing care in the last year.
With policy changes on the horizon that may affect care access and affordability, the study concludes by recommending continued monitoring of the ACA's effects to evaluate whether the law is meeting its goals and refine it if needed.
To learn more:
- here's the study
Number of uninsured Americans at all-time low
Racial disparities in coverage, care persist despite ACA
Medicaid expansion, state exchanges drive greater drops in uninsured
Many U.S. adults experience high healthcare cost burdens