Monitoring the Impact of Health Reform on Americans Ages 50-64

New data from the Urban Institute and the AARP Public Policy Institute show that health coverage improved for 50- to 64-year-olds under the Affordable Care Act (ACA) alongside improvements in affordability and access measures. The briefs in this series compare results from December 2013, during the first Marketplace open enrollment period, with results from March 2015, shortly after conclusion of the second Marketplace open enrollment period.

In the first brief in this series, we discuss a 47.4 percent drop in the uninsured rate for 50- to- 64-year-olds. Most gains occurred in Medicaid and private nongroup coverage. In March 2015, the uninsured rate for this age group was lowest in states that chose to expand their Medicaid programs.

The second and third briefs describe changes in health care affordability and access for 50– to 64–year–olds since early ACA implementation. Among those surveyed, fewer reported having unmet needs due to cost, difficulty paying medical bills, or difficulty getting an appointment. More report having a usual source of care other than the emergency room, and fewer report having trouble accessing care.

Despite overall improvements, there is still work to be done. Those who are lower-income, Hispanic, or in fair or poor health continue to remain uninsured at higher rates and report more problems with affordability and access to care. At the end of each brief, we provide policy recommendations for further improving health coverage, access and affordability for 50- to 64-year-olds and reducing disparities.