The ability of U.S. adults to access basic health care services has declined in nearly every state over the last decade, according to two recent reports. Adults without health insurance saw larger declines in the ability to obtain basic health care services, compared to those with coverage. In 2010, almost half of uninsured adults (48.1 percent) had an unmet health need due to cost, compared to 11.2 percent of insured adults.
One report, released by the Robert Wood Johnson Foundation and prepared by researchers at the Urban Institute, examines three key health access indicators: having unmet medical needs due to cost; having a routine check-up and having a dental visit during the year.
The authors find a marked deterioration across all three measures between 2000 and 2010, specifically that:
- · The share of adults experiencing unmet medical needs due to cost rose by 6.0 percentage points from 2000 to 2010. For uninsured adults, it rose by 10.8 percentage points.
- · The share of adults receiving a routine check-up decreased nationwide by 5.1 percentage points, with the share among uninsured adults decreasing by 11.6 percentage points.
- · The share of adults receiving a dental visit dropped by 3.9 percentage points, while the share among uninsured adults fell by 9.0 percentage points.
- · The researchers expect the downward trends in access to continue if the coverage provisions in the Affordable Care Act (are ruled unconstitutional.
The second study, a published article by the same Urban Institute research team and appearing in Health Affairs Journal, also concludes that eliminating the ACA or curtailing its coverage expansion provisions could result in continued erosion of Americans’ access to care.
The “second study” link:
http://www.rwjf.org/coverage/product.jsp?id=74326&cid=XEM_A5978
The report also found that children, many of whom qualify for public coverage, generally maintained or improved their access to care during the same period. The authors conclude that this provides a reason for optimism about the ability of the coverage expansion in the ACA to improve access to care for adults.
This paper’s analysis of national survey estimates found that access to health care and use of health services for adults ages 19–64, the primary targets of the ACA, deteriorated between 2000 and 2010, particularly among those who were uninsured.
More than half of uninsured U.S. adults did not see a doctor in 2010, and only slightly more than a quarter of these adults were seen by a dentist. The authors also found that children, many of whom qualify for public coverage through Medicaid and the Children’s Health Insurance Program, generally maintained or improved their access to care during the same period.
According to the foundation, this information provides a reason for optimism about the ability of the coverage expansion in the ACA to improve access for adults, but it suggests that eliminating the law or curtailing the coverage expansion could result in continued erosion of adults’ access to care.
