Despite Record ACA Enrollment, Report Reveals Underinsured Americans Are in Crisis

AJMC November 21, 2024
Giuliana Grossi

Despite significant progress in expanding health insurance coverage since the Affordable Care Act (ACA) was enacted, millions of Americans still face critical gaps in access to and affordability of health care.¹ In 2023, 8% of Americans—26 million people—remained uninsured, a marked improvement from the 16% uninsured rate before the ACA.

While a record 21 million individuals enrolled in marketplace plans, in 2024, nearly 1 in 4 working-age adults remained underinsured, grappling with high out-of-pocket costs and deductibles that make timely care unattainable. Findings from The Commonwealth Fund published today reveal alarming trends: 57% of underinsured adults avoided necessary medical care due to cost, 2 in 5 reported worsened health as a result, and nearly 30% are burdened with medical debt—half...

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