The ACA Is Reducing Financial Barriers to Care

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Expanded insurance coverage has not only brought a significant decline to the uninsured rate, but also reduced cost-related access to care issues, according to the Commonwealth Fund Biennial Health Insurance Survey, 2014.

Since launching the Biennial Health Insurance Survey in 2001, this most recent report marks the first time that the number and share of adults who are uninsured has declined significantly. Fewer Americans are also reporting medical-related financial difficulties, according to the findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014.

In addition to the uninsured rate being down, the researchers found stark differences between uninsured and insured adults when it comes to having a regular doctor and receiving preventive care. Nearly all insured adults have a regular doctor compared with just 71% of those who spent some time uninsured during the last year. Insured individuals are also far more likely than their uninsured counterparts to have their cholesterol checked in the past 5 years (79% vs 51%), and were substantially more likely to have received timely cancer screenings.


Expanded insurance coverage has also reduced cost-related access to care issues. The number of adults who have problems paying medical bills was down 14.6% in 2014 from 2012, from 75 million people to 64 million people. And while 43% of adults (80 million people) did not get the healthcare they need because of the cost in 2012, only 36% (66 million) in 2014 reported the same.

In 2014 only 19% of adults did not fill a prescription because of the cost compared with 23% in 2003 and 27% in 2012.

“Overall, these declines are most likely driven by the increased number of Americans with health insurance,” the authors wrote. “As in past surveys, adults who had spent any time uninsured in 2014 reported cost-related problems getting care at about two times the rate of adults who were insured all year.”

Up to 59% of uninsured adults alone did not receive care in the past 12 months because of the cost. Meanwhile, just 28% of adults insured all year reported they did not receive needed healthcare because of the cost, which is an improvement from 34% in 2012. Commonwealth Fund’s researchers speculate that the drop for insured individuals could either reflect the law’s new consumer protections in the individual market, such as the ban on preexisting condition exclusions, or the fact that the economy improved since 2012.

“But, while there were minor improvements reported by insured adults in cost-related access and medical bill problems, rates of these problems remain high, especially among adults with low incomes,” the authors wrote.