AFFORDABLE CARE ACT Tracking Survey

Survey Finds Americans Gaining Health Insurance Coverage and Access to Care

At the end of the Affordable Care Act’s first open enrollment period, The Commonwealth Fund's latest tracking survey, conducted April 9–June 2, 2014, finds that the uninsured rate among adults ages 19 to 64 declined from 20 percent in July–September 2013 to 15 percent in April–June 2014. By June, 60 percent of those who had selected a private coverage through the marketplace or newly enrolled in Medicaid had used their plan.

Latest Results
Coverage
15%
The uninsured rate among adults 19-64 declined from 20 percent in
July–September 2013 to 15 percent in
April–June 2014.
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Awareness
68%
Nearly seven of 10 adults who are potentially eligible for new health coverage are aware of the marketplaces.
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use & experience
43%
More than two of five adults who are potentially eligible for new coverage have visited a health insurance marketplace, up from 24 percent in December.
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Value of Coverage
60%
Six of 10 adults with new coverage have used their plans to go to the doctor or hospital or fill a prescription.
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Explore Survey

Coverage

15%
Current uninsured rate among working-age adults in the U.S.,
down from 20 percent
in July–September 2013
18%
Uninsured rate of young adults
(ages 19–34), down from 28 percent in July–September 2013
23%
Uninsured rate among Latinos, down from 36 percent
in July–September 2013

The Share of Americans Who Are Uninsured Is Falling

The survey suggests that so far the Affordable Care Act is on track to meet the Congressional Budget Office’s first-year projections for reducing the number of people without health insurance.

Uninsured rates in the United States

The nation's uninsured rate among working-age adults fell from 20 percent to 15 percent,
or by an estimated 9.5 million people, as the central coverage provisions of the
Affordable Care Act went into effect in 2014.

Percent uninsured see details

  • JULY–SEPT. 2013
  • APR–JUNE 2014
Adults ages 19–64

Coverage expansions having significant effect
on the health insurance coverage of young adults

Among those ages 19–34, the uninsured rate fell from 28 percent in July–September 2013 to 18 percent in April–June 2014, the largest decline of any age group. This translates to an estimated 5.7 million fewer uninsured young adults.

Percent uninsured by age see details

  • JULY–SEPT. 2013
  • APR–JUNE 2014
Adults ages 19–64

Coverage provisions targeted at low- and moderate-income
Americans are having their intended effect

Among adults with incomes under 138 percent of poverty, the uninsured rate dropped from 35 percent to 24 percent. Among adults with incomes in the next higher income group, between 138 percent to 250 percent of poverty, the uninsured rate fell from 32 percent to 22 percent.

Percent uninsured by income see details

  • JULY–SEPT. 2013
  • APR–JUNE 2014
  • Adults ages 19–64


Across racial and ethnic groups,
Latinos made the strongest gains in coverage

Latinos are the most likely of any racial or ethnic group to lack health insurance. The latest survey finds evidence that the ACA’s coverage provisions are helping Latinos gain health insurance. The percent uninsured fell from 36 percent in July–September 2013 to 23 percent in April–June 2014.

Percent uninsured by race see details

  • JULY–SEPT. 2013
  • APR–JUNE 2014

Adults ages 19–64


Are Americans Enrolling in Affordable Care Act Health Plans?

Of adults who visited the marketplaces, half selected
a private plan or enrolled in Medicaid. Larger shares of
young adults enrolled in Medicaid than older adults.

Percent enrolling in a health plan,
Apr.–June 2014
see details
51%
Adults ages 19–64 who visited the marketplaces
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Awareness

68%
Potentially eligible adults who are aware of health insurance marketplaces
59%
Potentially eligible adults who are aware of financial assistance to pay for health insurance
54%
Potentially eligible adults who are aware of Medicaid expansion under the health reform law

Are Americans Aware of the Health Insurance Marketplaces?

Awareness of the health reform law's new insurance options and of the availability of financial assistance to pay for health plans climbed over the enrollment period. Awareness of the marketplaces and financial assistance doubled among those potentially eligible for coverage.

Awareness of the health insurance marketplaces

Nearly seven of 10 American adults who are potentially eligible for the
health reform law's insurance options are aware of the new marketplaces
where they can shop for health plans.

Percent who are aware of marketplaces, July–Sept. 2013* to Apr.–June 2014 see details

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

*The phrasing of the question about awareness of health insurance marketplaces was modified between the July–September 2013 and April-June 2014 surveys. The description of what a marketplace is was slightly changed and in the April-June 2014 survey the question referred directly to the state-specific name of the marketplace in the state where the respondent reported residing, when this was relevant.


Awareness of financial assistance to pay for health insurance

Six of 10 potentially eligible adults are aware that financial assistance for health insurance is available under the Affordable Care Act, up from three of 10 in July–September 2013.

Percent who are aware of financial assistance, July–Sept. 2013* to Apr.–June 2014 see details

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

*The phrasing of the question about awareness of the availability of financial assistance for purchasing health insurance through the health insurance marketplaces was modified between the July–September 2013 and April-June 2014 surveys. In the April-June 2014 survey the question referred directly to the state-specific name of the marketplace in the state where the respondent reported residing, when this was relevant.


Awareness of Medicaid expansion

Similar numbers of respondents in October, December, and April-June knew that the health reform law makes Medicaid available to more Americans.

Percent who are aware of Medicaid expansion, Oct. 2013 to Apr.–June 2014 see details

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

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Use & experience

43%
Potentially eligible adults who have visited the marketplaces to shop for a health plan
41%
Potentially eligible young adults 19–34 who have visited the marketplaces

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?

People's ability to compare health plan benefits and premiums improved from October to December, but finding an affordable plan that meets their needs continued to be a challenge.

Three of five adults (59%) who visited the marketplaces tried to find out if they were eligible for financial help to pay for their health plans or Medicaid. Of those who tried to find if they were eligible, half said it was somewhat or very easy to find out.

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 (59% in December)

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.

There was little change since October in the overall assessment of the marketplaces. Despite improvements in the ability to compare plans and benefits, seven of 10 adults who have visited the marketplaces still rate their experience as fair or poor.

Rating experience with the marketplace, Oct. 2013 to Dec. 2013 (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


How Are People Accessing the Marketplaces?

The December tracking survey showed that visiting the marketplaces more than once is common. Of those who visited more than once, three of 10 said their experience improved between their first and last visits.

Percent visiting marketplaces more than once see details

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

Change in experience using the
marketplace
see details

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

Bars may not sum to 100 percent because of "don't know" responses or refusal to respond

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Special Topics

The Value of New Health Insurance Coverage

Adults Are Using Their New Insurance
to Access Health Care

One of the biggest concerns in the first years of the rollout of the Affordable Care Act’s coverage expansions is that many people with new coverage might not be able to find physicians, or get appointments in a timely fashion. The survey asked adults who had newly enrolled in coverage about their experience using their new health plans.

Sixty percent of adults who gained new coverage under the ACA this year 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 new insurance.

Percent who used their new plans to go to a doctor or hospital, or fill a prescription (Apr.–June 2014) see details
60%
Adults ages 19–64 with new coverage
Percent who would not have been able to access or afford this care without their new plan (Apr.–June 2014) see details
62%
Adults ages 19–64 who used new coverage

More than half of adults with new coverage said their plan included all or some of the doctors they wanted.

Percent who said plan included all or some of the doctors they wanted
(Apr.–June 2014)
see details
54%
Adults ages 19–64 with new coverage

A large majority of adults with new 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
75%
Adults ages 19–64 with new coverage who tried to find primary care or general doctor

The survey findings indicate that the majority of adults who found a primary care or general doctor were able to get an appointment relatively quickly.

Percent who got appointment within one week or two weeks
(Apr.–June 2014)
see details
68%
Adults ages 19–64 with new coverage who found a primary care doctor

More than three of five adults with new 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 (Apr.–June 2014) see details
58%
Adults ages 19–64 with new coverage who needed specialist

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

The survey asked adults who had selected a private plan through the marketplaces or newly enrolled in Medicaid about their views of their new health insurance.

The vast majority of adults with new coverage were optimistic that their new plan would improve their ability to get health care.

Percent who are very or somewhat optimistic that plan will improve ability to get needed health care (Apr.–June 2014) see details
81%
Adults ages 19–64 with new coverage

More than half of adults with new insurance 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
(Apr.–June 2014)
see details
58%
Adults ages 19–64 with new coverage

More than three-quarters of adults with new coverage said they were satisfied with their new insurance.

Percent who were very or somewhat satisfied with their new health insurance plan
(Apr.–June 2014)
see details
78%
Adults ages 19–64 with new coverage
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