The Kaiser Family Foundation decided to do a longitudinal study of the uninsured and the effects of the Affordable Care Act on their lives and health. They chose California as a relatively representative population and began by establishing baselines in 2013, prior to the full implementation of the law. (Note that the state isn't entirely representative, since it's one of the now 30 states to have accepted Medicaid expansion.) What they've found is that a full 68 percent of the previously uninsured population is now covered, but that's
just the beginning.
Recently insured residents now report very different experiences than they did in 2013 when they were uninsured, although many still report problems paying for and accessing care:
• The share of recently insured saying it is difficult to afford health care fell sharply from 86 percent in 2013 to 49 percent now.
• The recently insured are about half as likely to say they have had problems paying medical bills in the past year (23% now compared to 45% in 2013). This is similar to the share of the general public reporting that they or a family member have had problems paying bills in other Kaiser surveys.
• When asked how well their health needs are being met, 86 percent of the recently insured now say that they are being somewhat or very well met—up from about half (51%) in 2013.
• Those who recently obtained coverage also are more likely to report they have a usual place of care now than in 2013 (76% compared to 60% in 2013).
Head below the fold to read what those statistic really mean.
Those are some really significant improvements, as highlighted by KFF President and CEO Drew Altman. "[W]e are seeing striking gains in financial security and access for people who got coverage," he says. "Like health insurance generally, their coverage is not a cure-all and they still face problems paying for and getting care, but they are far better off than they were before."
That's true of California and it's true of the country as a whole, especially the states that took Medicaid expansion. But as Altman points out, the study still finds holes. There are still people who remain uninsured even with Medicaid expansion and the reason is primarily money. They rank healthcare costs at the most financially challenging thing for them, with 85 percent saying health care is either "very" or "somewhat" difficult to pay for. Even half of the people who did become insured under Obamcare say that paying for health care is difficult.
So by no means is healthcare reform finished. Not when so many states continue to resist expanding Medicaid. But beyond that, keeping coverage when you can finally get it is still a financial stretch for too many. But there's no denying this step in reform has made a massive difference in millions of lives.