Affordable, quality health care. For everyone.

This series of Commonwealth Fund surveys tracks the implementation and impact of the Affordable Care Act's coverage expansions. Recent analysis of the survey finding showed that, for people with low and moderate incomes, the Affordable Care Act’s tax credits have made premium costs roughly comparable to those paid by people with job-based health insurance.

Overall, the majority of marketplace enrollees expressed confidence in their ability to afford care if they were to become seriously ill.

The Complete Series

The marked gains in health insurance coverage made since the passage of the Affordable Care Act (ACA) in 2010 are beginning to reverse, according to new findings from the latest Commonwealth Fund ACA Tracking Survey.

ACA gains reversing

The latest installment of the Commonwealth Fund ACA Tracking Survey, conducted in February and March, found that the uninsured rate among working-age people is at 15.5 percent, up from 12.7 percent in 2016, meaning an estimated 4 million people lost coverage.

ACA helping consumers get health care

The survey found 1.8 million people had selected plans through the marketplaces by the end of January 2018, about 3.7 percent fewer than the prior year. There was an overall increase in enrollment this year in states that run their own marketplaces and a decrease in those states that rely on the federal marketplace.


The uninsured rate among 19-to-64-year-old adults was 14 percent in 2017, or an estimated 27 million people, statistically unchanged from one year earlier. Uninsured rates ticked up significantly in three subgroups: 35-to-49-year-olds, adults with incomes of 400 percent of poverty or more (about $48,000 for an individual), and adults living in states that had not expanded Medicaid.

This survey is the fourth in a series of Commonwealth Fund surveys to track the implementation and impact of the Affordable Care Act.

The latest Commonwealth Fund Affordable Care Act Tracking Survey finds the share of uninsured working-age adults was 13 percent in March–May 2015, compared with 20 percent just before the major coverage expansions went into effect. 

At the close of the Affordable Care Act’s first open enrollment period, an estimated 9.5 million fewer U.S. adults were uninsured.

Conducted December 11–29, 2013, The Commonwealth Fund's second Affordable Care Act Tracking Survey interviewed a nationally representative sample of adults who are potentially eligible for the health reform law’s new insurance options, whether private plans or Medicaid.

More than half of U.S. adults who are potentially eligible for health coverage under the Affordable Care Act, but who have not yet signed up for a plan, say they will likely try to enroll or to find out about financial help by the end of March 2014, the close of the open enrollment period.

The Affordable Care Act’s health insurance marketplaces are opening for enrollment on October 1, 2013. The Commonwealth Fund Health Insurance Marketplace Survey, 2013, finds that only two of five adults are aware of the marketplaces or of potential financial help that may be available to them to pay for plans purchased though the marketplaces.