CHA News Article

Report Examines Changing Landscape of Health Care Coverage and Access
Compares states’ progress in the ACA’s first year

A new report compares access to affordable health care across the U.S. after the first year of the Affordable Care Act’s (ACA) major coverage expansions. Published by The Commonwealth Fund, the report finds that in 2014, uninsured rates for working-age adults declined in nearly every state compared with 2013. There was at least a three-percentage-point decline in 39 states. For children, uninsured rates declined by at least two percentage points in 16 states. The share of adults who said they went without care because of costs decreased by at least two points in 21 states, while the share of at-risk adults who had not had a recent checkup declined by that same amount in 11 states. According to the report, wide variation in insurance coverage and access to care persists, highlighting many opportunities for states to improve.

The analysis takes a closer look at this shift by comparing states’ performance on six indicators of access to care and affordability from The Commonwealth Fund’s State Scorecard on Health System Performance, 2015 Edition. The scorecard is intended to help policymakers, health system leaders and the public identify opportunities and set targets for improvement. The indicators include uninsured rates for working-age adults and for children, and three others that assess adults’ access to care: adults who went without care because of cost in past year, at-risk adults without a doctor visit and adults without a dental visit in the past year. To gauge the affordability of care, The Commonwealth Fund examined the percentage of individuals under age 65 in each state who have high out-of-pocket medical costs relative to their incomes.

The full report is available on The Commonwealth Fund’s website