While millions of Americans have gained insurance coverage since the Affordable Care Act (ACA) expanded access to health insurance coverage in January 2014, little is known about how access to and affordability of care are changing under the ACA. A new study, being released as a Web First by Health Affairs, found that between September 2013 and March 2015, there was a 3.4 percentage-point increase in the share of nonelderly adults with a connection to a health care system.
Among low-income adults targeted by the ACA’s Medicaid expansion provision, the increase was 5.2 percentage points. The authors, Adele Shartzer, Sharon K. Long, and Nathaniel Anderson, also found that the share of adults during the same time period who had a routine check-up in the past 12 months rose 3.4 percentage points. (See exhibit below.) The study used data from the Health Reform Monitoring Survey (HRMS), which has been conducted periodically via the Internet since early 2013.
The authors also noted that access to care in the United States is still not universal: 25.7 percent of nonelderly adults reported that they did not have a usual source of care in March 2015 — and these adults were more likely to be young (18–29), male, Hispanic, and have a low income compared with adults with care. “There are still large gaps in access and affordability, particularly for low-income adults,” the authors concluded. “Measures to improve health insurance and health care literacy…can further increase access to care and affordability for people across the income spectrum.”
This study, which was supported by the Robert Wood Johnson Foundation, will also appear in the January issue of Health Affairs.
Shartzer and Long are affiliated with the Urban Institute, in Washington, D.C.; Anderson was with the Urban Institute when the study was conducted.
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