In 2015, when health insurer enthusiasm about the Affordable Care Act was peaking, ACA coverage expansion programs seemed to have a noticeable effect on U.S. residents' access to medical care.

Susan Hayes and other analysts at the New York-based Commonwealth Fund, a nonprofit organization that has strongly supported the goals of the ACA, published a report supporting that conclusion in a new look at federal government health survey data.

Before ACA coverage expansion programs came to life, some critics asked whether the programs would actually expand the amount of care people were getting, or simply increase the amount of cash providers received for care they would have provided anyway.

In the new issue brief, the Commonwealth Fund analysts write that the percentage of adults who said they had gone without care in the past year because of cost fell to 13 percent in 2015, from 16 percent in 2013.

The percentage of adults with chronic health problems, such as asthma or pre-diabetes, who had not had a checkup or other routine care in the previous two years, fell to 13 percent, from 14 percent. In theory, an increase in access to care for people at a high risk of developing catastrophic health problems could reduce the number of people with disabilities, the number who need long-term care services, and the number who die.

The ACA did not expand dental coverage for adults.

The Commonwealth Fund analysts found that the percentage of U.S. adults who had not had a dental visit within the past year increased to 16 percent in 2014, from 15 percent in 2012. That's a sign that the ACA itself, rather than general economic or health insurance trends, helped improve people's access to care, the analysts say.

The analysts found four states in which at-risk adults' access to checkups improved by 4 percentage points.

The no-checkup rate for at-risk adults fell to 17 percent, from 21 percent, in Oklahoma; to 14 percent, from 17 percent, in California; to 11 percent, from 15 percent, in Kentucky; and to 6 percent, from 10 percent, in Rhode Island.

The no-checkup rate for at risk-adults fell by 3 percentage points in Arizona, Mississippi and the District of Columbia.

Problems with operating losses and ACA insurer stabilization programs began to reduce insurers' interest in late 2015. Some health coverage ownership figures began to reverse this year, and analysts do not yet have the data to know what has been happening to coverage access this year or might happen to access in 2017.

Instant Insights /

7 states where ACA helped at-risk adults get checkups

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