Most people with coverage through US health reform law are satisfied, survey finds

BMJ 2015; 350 doi: (Published 16 June 2015) Cite this as: BMJ 2015;350:h3288
  1. Michael McCarthy
  1. 1Seattle

A large majority, 86%, of people who obtained insurance through the US Affordable Care Act either by purchasing private plans through the insurance marketplaces created by the law or by enrolling through the expanded Medicaid program are very or somewhat satisfied with their coverage, says a report by the Commonwealth Fund, a non-partisan foundation that focuses on healthcare.

The finding that millions of these people are happy with their coverage poses a problem for Republicans who have vowed to repeal the law.

The survey,1 which was conducted from March to May this year, found that the uninsured rate among US adults aged 19 to 64 had fallen to 13%—down from 20% in 2013, just before the law’s major coverage reforms were put in place.

Overall, about 22 million people have obtained coverage through the exchanges or through Medicaid, half of whom were uninsured before obtaining coverage, the survey found. “This represents an estimated decline of 12.1 million uninsured adults since the coverage expansions took effect,” the report said.

About 68% of the adults who had enrolled in an exchange plan or Medicaid reported that they had since sought medical care or had filled a prescription. Of these, 62% said that they would not have been able to access or afford the care before getting their new insurance.

Despite concern that newly insured people would find it difficult to find healthcare providers, most of those surveyed reported that they were able to find primary care doctors relatively easily: 60% who found a new primary care doctor got an appointment within two weeks, including 46% who got one within a week.

Among those who needed to see a specialist, 53% reported being able to get an appointment within two weeks, including 38% who got it within a week. Also, 19% reported waiting two weeks to a month to see a specialist, and 21% waited more than a month, but the report noted that their experience was comparable to that of many insured consumers.

Despite the law an estimated 25 million working age adults remain uninsured in the United States, the survey found. Those who remained uninsured were disproportionately younger, poorer, and Latino. “One factor behind these higher rates of uninsurance in these groups may be the decision by 22 states not to expand eligibility for Medicaid: adults in these states comprise 41% of the overall population but 57% of the remaining uninsured,” the report said.


Cite this as: BMJ 2015;350:h3288


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