An analysis of a 2014 survey by the Kaiser Family Foundation finds that previously uninsured Americans who obtained health coverage that year experienced improved access to care and a decrease in financial insecurity, though they remained concerned about cost.  The analysis of the 2014 Kaiser Survey of Low-Income Americans and the ACA finds that about 11 million previously uninsured nonelderly adults obtained health coverage during 2014, the year the ACA’s new coverage options were fully implemented.  About half the newly insured adults were under 35, two-thirds were in households with at least one full or part-time worker and many were racial minorities.  Contrary to assumptions that those with health problems would be more likely to sign up, newly insured adults had a similar health profile to people who already had coverage prior to 2014, and were more likely to report being in good or excellent health than their uninsured counterparts.

The newly insured variously obtained coverage through Medicaid (36%), the ACA marketplaces (22%), employer coverage (26%), or some other means (16%).  The comprehensive survey of 10,502 adults was conducted between September 2, 2014 and December 15, 2014.  Key findings include:

• As expected, the newly insured were more likely than those who remained uninsured to have a usual source of care (63% vs. 46%), and more likely to have a regular doctor at a source of care (44% vs. 25%);

• They were more likely than the remaining uninsured to have used medical services (64% vs 52%), or to have had a checkup or received preventive care (47% vs 27%).  There were no significant differences across covered groups – including those who already had coverage – in the share reporting they had to wait longer than they thought reasonable for an appointment, with low rates reporting this as an issue;

• Although cost was the biggest factor in their choice of health plan, 44 percent of the newly insured said they had trouble affording their monthly premium.  Moreover, even though 85 percent of marketplace enrollees received premium subsidies, 41 percent of the newly insured with such coverage reported difficulty affording their premiums;

• However, compared to the uninsured, the newly insured report lower rates of difficulty paying medical bills (36% vs. 17%), and were considerably less likely to report living with worry about their ability to afford medical care in the future.

The analysis also finds that the newly insured were more likely than those who already had coverage to say they do not understand the details of their health plan, suggesting that additional education and consumer assistance may be needed. The full survey report, How Does Gaining Coverage Affect People’s Lives? Access, Utilization and Financial Security among Newly Insured Adults, including a discussion of survey methodology, is available at kff.org.