Study: Increased Insurance Coverage Didn’t Reduce Access to Care

More people getting health insurance under the Affordable Care Act didn’t lead to challenges in accessing care for those who were already insured, a new Health Affairs study shows.

The findings could assuage concerns about how access to doctors was affected under the ACA. They suggest that having more insured people in a geographical area does not make it more difficult for others in the same area to access preventative care and specialists.

The study looked at 41,512 adults between 2008 and 2014, and considered how access changed, especially when insurance coverage levels spiked between 2013 and 2014.

We found no consistent evidence that there were negative impacts on continously-insured adults of rising insurance rates,” Steven Hill, one of the report’s authors, said in an interview.

The researchers also found the broader findings held among two key subgroups: Medicaid beneficiaries and adults living in regions with shortages of medical professionals.

Insurance coverage spiked the most between 2013 and 2014, with the proportion of insured adults increasing by at least 4 percentage points in many places in the United States. But from 2008 through 2014, the researchers did not find any indication of reduced access to care.

One argument against the ACA had been that it would make it more difficult for people to access care. The study suggests three different ways that increasing the number of people with health insurance could have made it more difficult for people to access care: doctors’ ability and willingness to increase their capacity for services; nuances in how providers in an area accept different types of insurance; and the effect of ACA provisions meant to increase health care capacity. The research does not conclude any specific findings related to these discussion points.

The study’s authors suggest that states may use their findings in making decisions about whether to expand Medicaid or to increase enrollment in private insurance or health savings accounts. Of course, states’ decision-making on those issues could also be affected by whether Republicans in D.C. are successful in their efforts to overhaul the 2010 health care law.


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