ASPPH logo


Member Research & Reports

Member Research & Reports

Harvard Survey Finds State Policies Impact ACA Enrollment

A new survey by researchers at Harvard T.H. Chan School of Public Health finds that the variable approaches states have taken to implementing the Affordable Care Act (ACA) have had major effects on whether low-income adults are aware of the law, whether they have applied and obtained coverage, and whether or not they think the law has helped them.

The study, one of the most in-depth analyses of the recent enrollment experiences of adults under the health reform law, focused on three states with markedly different ACA policies: Arkansas, Kentucky, and Texas. They found that insurance application rates, successful enrollment, and positive experiences with the ACA were highest in Kentucky, followed by Arkansas, with Texas performing worst. Latinos were equally likely to apply for coverage as other groups, but much less likely to complete the process and obtain coverage. Surprisingly, more than half of low-income adults in the study said they had heard little or nothing about the law’s new coverage options.

The study appears in the June issue of the journal Health Affairs.

“Although millions of Americans have gained health insurance under the ACA, our findings suggest that there is still a huge need to increase awareness, especially among low-income populations,” said lead author Dr. Benjamin Sommers, assistant professor of health policy and economics at Harvard Chan School. Read more