Americans’ Experiences with ACA Marketplace and Medicaid Coverage: Access to Care and Satisfaction

From  the Issue Brief published by the Commonwealth Fund:

… Three years after the Affordable Care Act’s major health insurance expansions went into effect, nearly 28 million people are estimated to have coverage either through the marketplaces or through Medicaid. Yet there remains considerable controversy over how well these reforms are working for Americans.

The fourth Commonwealth Fund Affordable Care Act (ACA)Tracking Survey interviewed a nationally representative sample of 4,802 working-age adults, of whom 881 have new marketplace or Medicaid coverage under the health reform law, to find out how their insurance is affecting their lives. The survey firm SSRS conducted the interviews between February 2 and April 5, 2016. [This issue brief]  examines the law’s effects on insurance coverage and how people are using their coverage to get health care.

The key findings include:

  • The uninsured rate for adults ages 19 to 64 was 12.7 percent in February–April 2016, compared with 13.3 percent in March–May 2015, 14.8 percent in April–June 2014, and 19.9 percent in July–September 2013.
  • Uninsured rates among low-income adults have fallen the most but remain substantially higher than those for adults with higher incomes.
  • Nearly half of adults in Marketplace plans and three of five adults enrolled in Medicaid were uninsured before getting their new insurance.
  • Over half of adults who were uninsured before getting their new coverage had been uninsured for more than two years
  • Seven percent of adults who had employer insurance for less than a year previously had insurance through the marketplaces.
  • Most marketplace and Medicaid enrollees continue to be satisfied with their coverage
  • Three of five adults with marketplace of Medicaid coverage who had used their plan said they would not have been able to access or afford this care before.
  • Eight of ten adults with new coverage said their ability to get health care has improved or stayed the same


Read the full issue brief.