AFFORDABLE CARE ACT Tracking Survey

Most Affordable Care Act Coverage Enrollees are Satisfied with Their Insurance and Getting Care They Could Not Have Afforded Before

The latest wave of The Commonwealth Fund's Affordable Care Act (ACA) Tracking Survey indicates that the share of working age adults who are uninsured was 13 percent in March—May 2015, compared with 20 percent just before the law’s major coverage expansions went into effect. ACA coverage is helping people gain access to health care: more than six of 10 adults who used their marketplace or Medicaid plans to obtain care reported that they could not have afforded or accessed it previously.

Latest Results
Coverage
13%
The uninsured rate
among adults 19–64
has declined from
20 percent in Jul–Sep 2013.
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Coverage
59%
More than half of adults enrolled in marketplace plans or Medicaid were previously uninsured.
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Awareness
59%
Nearly six of 10 adults
who are uninsured are aware of the marketplaces.
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Value of Coverage
86%
Nearly nine of 10 adults who are currently insured through the ACA marketplaces or newly insured in Medicaid are satisfied with their health insurance.
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Explore Survey

Coverage

13%
Current uninsured rate among working-age adults in the U.S., down from 20 percent
in July–September 2013
19%
Current uninsured rate among
young adults (ages 19–34) down
from 28% in July–September 2013

The Percentage of U.S. Adults Who Are Uninsured Continues to Fall

The survey finds declines in the rate of uninsurance among U.S. adults since the law’s major reforms took effect in 2014.

Uninsured rates in the United States

The percentage of adults ages 19–64 who are uninsured fell to 13 percent in March–May 2015, down from 20 percent in July–September 2013. This represents an estimated decline of 12.1 million uninsured adults since the coverage expansions took effect.

Percent uninsured see details

Adults ages 19–64

Coverage gains across all age groups in
the wake of the law’s insurance expansions

In March–May 2015, the uninsured rate among older adults ages 50 to 64 continued to decline. While young adults have made dramatic gains in coverage since the law took effect, in this wave of the survey there was no significant change from the prior year in the uninsured rate among adults under age 50.

Percent uninsured by age see details

Adults ages 19–64

Low- and moderate- income groups have made significant gains in coverage since the major expansions took effect

Uninsured rates continued to fall among adults with incomes between 138 and 249 percent of poverty.
In contrast, the survey findings indicate no further declines in uninsured rates among people
with incomes under 138 percent of poverty in 2015.

Percent uninsured by income see details

Adults ages 19–64


More than half of adults who enrolled in marketplace plans or
Medicaid were uninsured before getting their new plan

Status of current marketplace and Medicaid enrollees
prior to getting new plan (Mar–May 2015)
see details

Adults ages 19–64 who are currently enrolled in marketplace coverage
or have had Medicaid for less than 2 years


Uninsured rates among low-income adults in states
that have not expanded Medicaid are more than twice that
of those in Medicaid expansion states

Percent uninsured see details


Adults ages 19–64 with incomes below 100 percent of poverty

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Awareness

59%
Uninsured adults who are aware
of health insurance marketplaces
46%
Uninsured adults who are aware of financial
assistance to pay for health insurance

Are Uninsured Americans Aware of the Health Insurance Marketplaces?

While awareness of the marketplaces and financial assistance to help pay for health insurance rose significantly among uninsured adults from 2013 to 2014, it did not change between 2014 and 2015.

Awareness of the health insurance marketplaces

Nearly six of 10 American adults who are uninsured are aware of the new marketplaces where they can shop for health plans.

Percent who are aware of marketplaces, July–Sept. 2013 to March–May 2015 see details

Adults ages 19–64 who are uninsured

Note: Question wording was slightly different between the three surveys.


Awareness of financial assistance to pay for health insurance

Fewer than half of uninsured adults are aware that financial assistance for health insurance is available under the Affordable Care Act, unchanged from April–June 2014.

Percent who are aware of financial assistance, July–Sept. 2013 to March–May 2015 see details

Adults ages 19–64 who are uninsured

Note: Question wording was slightly different between the three surveys.

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Use & experience

Are Americans Using the Health Insurance Marketplaces?

More than two of five adults who are potentially eligible for
coverage had visited a marketplace by June.

Visits rose from 17 percent in October to 24 percent in December. By June, 43 percent of the potentially eligible population had visited a marketplace.

Percent who visited marketplace, Oct. 2013 to Apr.–June 2014 see details

Adults ages 19–64 who are uninsured or have individual coverage


How Easy Is It for People to Use the Marketplaces?

More adults who visited the marketplaces found it easy to compare benefits and costs of plans. Few found it easy to compare plans by providers available.

More than three of five adults tried to find out about their eligibility for financial assistance or Medicaid. Of those who tried to find if they were eligible, 63% said it was somewhat or very easy to do so.

How easy or difficult was it to... (percent) see details

Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace

*Only asked of respondents who tried to find out if they were either eligible for financial assistance to help pay for their plan, or if they were eligible for Medicaid (63% in Apr–June 2014)

Segments may not sum to indicated total because of rounding; bars may not sum to 100 because of "don't know responses" or refusal to respond


How Do Visitors Rate the Marketplaces?

Assessment of the marketplace experience remains low.

Despite improvements in the ability to compare plans and benefits, a majority of adults (62%) who have visited the marketplaces rated their experience as fair or poor.

Rating experience with the marketplace
October 2013 to Apr–June 2014 (percent)
see details

Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace

Segments may not sum to indicated total because of rounding; bars may not sum to 100 because of "don't know responses" or refusal to respond


Three of Five Adults with Marketplace Coverage
Found it Easy to Pay Their Premiums

Ability to afford premium costs Apr–June 2014 (percent) see details

Adults ages 19–64 who pay all or some of premium

Segments may not sum to indicated total because of rounding; bars may not sum to 100 because of "don't know responses" or refusal to respond

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Value of Coverage

The Value of New Health Insurance Coverage

Adults Are Using Their Marketplace or
Medicaid Coverage to Access Health Care

Since the ACA’s major coverage expansions went into effect, there has been concern about difficulty new enrollees might have finding doctors, getting timely appointments, and whether they would be satisfied with their choice of doctors because of insufficient provider capacity or limited provider networks. The survey asked adults who had newly enrolled in coverage about their experience using their new health plans. In the latest survey, 68 percent of adults who gained marketplace or Medicaid coverage under the Affordable Care Act said they had used their plans to go to a doctor or hospital, or fill a prescription. Of those, 62 percent said they would not have been able to access or afford this care prior to getting their marketplace or Medicaid coverage.

Percent who used their marketplace
or Medicaid coverage to go to
a doctor or hospital, or fill
a prescription
see details
Adults ages 19–64 with marketplace or Medicaid coverage
Percent who would not have been able
to access or afford this care without their new plan
see details
Adults ages 19–64 who used marketplace or Medicaid coverage

A large majority of adults with marketplace or Medicaid coverage who tried to find a primary care physician or general doctor found it very or somewhat easy to do so.

Percent who said it was somewhat or very easy to find a new primary care or general doctor (Apr.–June 2014) see details
Adults ages 19–64 with marketplace or Medicaid coverage who tried to find primary care or general doctor

Sixty percent of those who found a primary care or general doctor got an appointment
relatively quickly.

Percent who got appointment within one week or two weeks see details
Adults ages 19–64 with marketplace or Medicaid coverage
who found a primary care doctor

More than half of adults with marketplace or Medicaid coverage who needed to see a specialist were able to get an appointment within two weeks.

Percent who got specialist appointment within one week or two weeks see details
Adults ages 19–64 with marketplace or Medicaid coverage
who needed specialist

Adults with marketplace or Medicaid coverage who have used their plans are satisfied with the doctors covered.

Percent very or somewhat satisfied
with the doctors covered
(March—May 2015)
see details
91%
Adults ages 19–64 who have used marketplace or Medicaid coverage to obtain health care

Adults with Marketplace Plans or Medicaid Held Positive Views of Their New Health Insurance

More than half of adults with marketplace or Medicaid coverage said they were better off now than they were before.

Percent who said they are better
off now than before they had their new health insurance plan
see details
Adults ages 19–64 with marketplace or Medicaid coverage

More than eight of 10 adults with
marketplace or Medicaid coverage were very or somewhat
satisfied with it.

Percent who were very or
somewhat satisfied with their
new health insurance plan
see details
Adults ages 19–64 with marketplace or Medicaid coverage

A Majority of Adults With Marketplace Coverage were Confident They Could Afford Care They Needed or Get High Quality Care

Confidence in ability to… Apr—June 2014 (percent) see details

Percent adults ages 19-64

Segments may not sum to indicated total because of rounding; bars may not sum to 100 because of "don't know responses" or refusal to respond

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