By Karen Pallarito
HealthDay Reporter
THURSDAY, Jan. 15, 2015 (HealthDay News) -- Although problems persist, more Americans had significantly less trouble getting and paying for needed medical care in 2014, as the health insurance expansions of the Affordable Care Act kicked in, a new survey suggests.
The number of working-age adults who said they didn't get the care they needed because of the cost dropped to 66 million in 2014 from 80 million in 2012 -- the first decline since 2003, according to The Commonwealth Fund's latest Biennial Health Insurance Survey.
At the same time, fewer adults -- 64 million in 2014 versus 75 million in 2012 -- reported medical bill problems, and that's the first decrease since 2005.
"This new report provides evidence that the Affordable Care Act's new subsidized options for people who lack insurance from employers are helping to reverse national trends in health care coverage and affordability," Commonwealth Fund President Dr. David Blumenthal said in a news conference with reporters Wednesday afternoon.
Uninsured rates tumbled to their lowest levels in more than a decade, the survey found. A total of 29 million working-age adults (16 percent of the population) were uninsured in 2014, down from 37 million (20 percent of the population) in 2010.
It is "the first statistically significant decline measured by the survey since it began in 2001," noted Sara Collins, vice president for health care coverage and access at The Commonwealth Fund, which publishes the nation's longest-running nonfederal survey of health insurance coverage.
The Affordable Care Act, or "Obamacare," broadened access to health coverage through Medicaid and private health insurance subsidies. Just 26 states and the District of Columbia expanded Medicaid in 2014, after the U.S. Supreme Court allowed states to opt out of that requirement.
Beginning in September 2010, the health reform law made it possible for young adults under the age of 26 to remain on their parents' health insurance plans.
The survey shows young adults realized the greatest gains in coverage of any age group. Among 19- to 34-year-olds, 19 percent were uninsured in 2014, down from 27 percent in 2010.
Low-income adults also saw vast improvements in their insurance status. Among adults with incomes below 200 percent of the federal poverty level , or $47,100 for a family of four, the percentage remaining uninsured fell to 24 percent in 2014 from 36 percent in 2010.
Under the Affordable Care Act, individuals and families with incomes up to 400 percent of the federal poverty level, or $94,200 for a family of four, may qualify for subsidies to defray the cost of health insurance coverage purchased through the law's federal and state exchanges. Those with incomes up to 250 percent of poverty, or $58,875 for a four-person family, may be eligible for reduced cost sharing.
However, the survey found that uninsured Americans, including low-income people in states that did not expand Medicaid, are still having problems paying medical bills. Fifty-seven percent who were uninsured during the year skipped needed care because of the cost, and 51 percent reported medical bill problems.
"The Affordable Care Act was all about creating access to the health care system for more consumers, and it's done that," said Katie Vahle, co-founder of CoPatient, a Boston-based company that reviews and negotiates medical bills. But the coverage expansion "doesn't eliminate medical debt."
Her company advocates for people who find themselves struggling with medical expenses, often because they selected "bronze" level coverage that pays for only 60 percent of their health care costs, or they inadvertently used health care providers who were not part of their health plan network.
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