Effects of Obtaining ACA Coverage for Newly Insured, Low-Income Americans

Researchers Rachel Garfield and Katherine Young of the Kaiser Family Foundation and the Kaiser Commission on Medicaid and the Uninsured put their heads together to try to better understand the impact that gaining coverage through the Affordable Care Act (ACA) has had on the lives of the newly insured adult population. In the 2014 enrollment period, 11 million nonelderly adults were “newly insured,” or obtained health coverage after a period where they were uninsured.

Their report was based on the 2014 Kaiser Survey of Low-Income Americans and the ACA, which surveyed 10,502 non-elderly adults between September 2 and December 15, 2014. The researchers noted that about three-fourths of the survey responses were completed before November 15, the start of the second open enrollment period. Demographically, the report was restricted to individuals from low-income families.

The Kaiser Family Foundation conducted its first survey of low-income families and the ACA in 2013; the survey provided a “baseline snapshot” of health insurance coverage, healthcare use and barriers to care, and financial security among the insured and uninsured populations at the beginning of the implementation of the ACA. Last year’s report found that lack of coverage for many uninsured adults is a long-term issue and that many adults who are uninsured have tried to obtain health insurance in the past but were not able to access affordable coverage.

The report added new demographics to the playing field, describing that half of the newly insured adults are under the age of 35 and are more likely to be female than their counterparts who remained without coverage. The report also explained that upon obtaining coverage, one-fifth of the newly insured who had a usual site of care changed the place they go to citing insurance as the reason for the switchover.

Nearly two-thirds (64%) of newly insured adults in 2014 said they have used at least one medical service since gaining coverage and nearly half of utilized a preventive visit or check-up.

The report also detailed how the newly insured view their coverage because they believe this is important in determining the likelihood that an individual reenrolls in coverage or changes plans. Because many responses indicated that newly insured individuals did not understand the details of their plans, the researchers highlight the importance of additional education for the enrollees.

However, newly insured adults continue to face financial insecurity and are more likely than those who had coverage before 2014 to worry about future medical bills.

“Comparison between newly insured adults and those who have had coverage since before 2014 shows some areas for ongoing attention as policymakers strive to translate coverage to care,” the authors wrote. “Ongoing monitoring of newly insured adults’ access and utilization is important to assess whether this population continues to face challenges or whether these differences subside over time.”