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Study Finds ACA Marketplace Improved Coverage, Access

The Affordable Care Act (ACA) marketplace improved coverage and access to care among previously uninsured adults, new research from Harvard Medical School and the Harvard T.H. Chan School of Public Health has found.

For the study, published in Health Affairs, researchers reviewed data on adults who had been uninsured for at least six months in the year before implementation of major ACA policies. After ACA implementation, uninsurance rates among previously uninsured adults fell by 11 percentage points.

Researchers also found improvements in medical service use, access, and diagnosis of certain chronic conditions. The proportion of adults reporting difficulty accessing necessary care decreased by 2 percentage points, while hospital stays became 2.5 percent more likely; emergency department use remained the same.

The study found lower-income adults who were eligible for subsidized premiums and cost-sharing assistance through the marketplace showed particularly significant improvement, as demonstrated in increased outpatient visits and prescriptions filled.

Anna Goldman, MD, lead researcher on the study and a primary care physician at association member Cambridge Health Alliance, explained, “Our findings suggest that subsidized insurance through the ACA’s marketplace had a range of positive impacts for lower- and middle-income adults who lacked insurance prior to the ACA. Our study shows that the ACA succeeded in improving outcomes for this vulnerable population.”

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About the Author

Katherine Susman is a research associate at America's Essential Hospitals.