ACA increased coverage and access for patients with chronic illness

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Nearly 1 in 7 patients with a chronic disease still lack coverage.
Nearly 1 in 7 patients with a chronic disease still lack coverage.

(HealthDay News) — Millions of Americans with a chronic illness gained health insurance coverage after the Affordable Care Act went into effect in 2010, according to a study published in the Annals of Internal Medicine.

Researchers reviewed data from the Behavioral Risk Factor Surveillance System, an annual survey conducted by the US Centers for Disease Control and Prevention. The team analyzed the responses of 606,277 adults with at least 1 chronic disease in the year before and the year after the ACA was implemented.


States that expanded Medicaid under the ACA experienced a larger increase in coverage of the chronically ill, the investigators found. On average, Medicaid-expansion states increased coverage by 5.6 percentage points, from 82.8% with insurance before the ACA to 88.5% after the law went into effect. But even states that didn't expand Medicaid experienced an increase, rising 4.2 percentage points from 77.0% before to 81.2% after the ACA was enacted.

However, nearly 1 in 7 of those with a chronic disease still lacked coverage, including 20% of chronically ill black patients and one-third of chronically ill Hispanics, the researchers found.


  1. Torres H, Poorman E, Tadepalli U, et al. Coverage and access for americans with chronic disease under the Affordable Care Act: A quasi-experimental study. Ann Intern Med. 2017. doi:10.7326/m16-1256
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