QuickTake: Few Adults Have Difficulty Finding a Doctor, but the Problem Is More Common for Low-Income Adults Than for Higher-Income Adults

 

Laura Skopec and Stephen Zuckerman

September 24, 2015

 

The Urban Institute has been using the Health Reform Monitoring Survey (HRMS) to examine trends in health insurance coverage and access to care since the first quarter of 2013. Recent HRMS data show an estimated 15.0 million (95% confidence interval [11.9 million, 18.1 million]) adults ages 18 to 64 gained coverage between September 2013, just before the first open enrollment period for the Affordable Care Act’s (ACA) health insurance Marketplaces, and March 2015, just after the close of the second open enrollment period (Long et al. 2015). During this period, the uninsurance rate for low-income adults (those with family income at or below 138 percent of the federal poverty level [FPL]) fell 16.2 percentage points, from 39.0 percent to 22.7 percent (Shartzer et al. 2015). However, as of September 2014, low-income adults continued to face more difficulty accessing providers than higher-income adults (those with family income at or above 400 percent of FPL), despite improvements in coverage and access as the ACA was implemented (Karpman, Weiss, and Long 2015).

 

This QuickTake explores reported difficulty finding a general doctor or specialist by family income. We used data on a nationally representative sample of nonelderly adults (ages 18 to 64) from the March 2015 round of the HRMS, drawing on the following questions. The HRMS first asked respondents, regarding their experiences obtaining health care in the past 12 months, “Did you have trouble finding a doctor or other health care provider who would see you?” Those who answered “yes” were then asked, “Which of the following types of providers did you have trouble finding: a general doctor, a specialist, a hospital, a dentist?” Those who indicated that they had trouble finding a general doctor or specialist are the focus of this analysis.

 

As of March 2015, 4.4 percent of nonelderly adults reported difficulty finding a general doctor or specialist in the past 12 months. Low-income adults in were nearly four times as likely as higher-income adults to report difficulty finding a general doctor or specialist (7.5 percent and 1.9 percent, respectively; figure 1).

 


Among only those insured for all of the past 12 months, low-income adults were still four times more likely than higher-income adults to report difficulty finding a general doctor or specialist over the past 12 months (7.2 percent and 1.8 percent, respectively; figure 2). In addition, among adults uninsured for part or all of the past 12 months, low-income adults were more likely than higher-income adults to report difficulty finding a general doctor or specialist (8.5 percent compared with 3.8 percent, respectively).

 

 

In general, continuous insurance coverage appears to have less effect on difficulty finding a general doctor or specialist for low-income adults than for higher-income adults. The share of full-year insured low-income adults reporting difficulty finding a general doctor or specialist was not significantly different from that of adults who were uninsured for part or all of the year in the same income group (7.2 percent and 8.5 percent, respectively). In contrast, full-year insured adults with family incomes between 139 and 399 percent of FPL were significantly less likely to report difficulty finding a general doctor or specialist than adults in that income group who were uninsured for all or part of the past year (3.5 percent and 9.2 percent, respectively).

 

Even among full-year insured adults who did not report difficulty finding a general doctor or specialist in the past 12 months, low-income adults were nearly three times as likely as higher-income adults to report difficulty getting an appointment that led them to have an unmet need for care (11.4 percent and 3.9 percent, respectively; data not shown).

 

Overall, few adults report difficulty finding a physician. Regardless of insurance status, low-income adults report more difficulty finding a general doctor or specialist than higher-income adults, and they are more likely to report difficulty getting an appointment that led to an unmet need for care even when they do not report difficulty finding a general doctor or specialist, though in both cases the share reporting these problems is fairly small. Some evidence also shows that continuous insurance does not significantly change the share of low-income adults reporting difficulty finding a general doctor or specialist over the past 12 months.

 

References

 

Karpman, Michael, Adam Weiss, and Sharon K. Long. 2015. QuickTake: Access to Health Care Providers Improved between September 2013 and September 2014. Washington, DC: Urban Institute.

 

Long, Sharon K., Michael Karpman, Genevieve M. Kenney, Stephen Zuckerman, Douglas Wissoker, Adele Shartzer, Nathaniel Anderson, and Katherine Hempstead. 2015. Taking Stock: Health Insurance Coverage under the ACA as of March 2015. Washington, DC: Urban Institute.

 

Shartzer, Adele, Sharon K. Long, Michael Karpman, Genevieve M. Kenney, and Stephen Zuckerman. 2015. QuickTake: Insurance Coverage Gains Cross Economic, Social, and Geographic Boundaries. Washington, DC: Urban Institute.

 

About the Series


This QuickTake is part of a series drawing on the HRMS, a quarterly survey of the nonelderly population that explores the value of cutting-edge Internet-based survey methods to monitor the Affordable Care Act before data from federal government surveys are available. Funding for the core HRMS is provided by the Robert Wood Johnson Foundation and the Urban Institute.

 

For more information on the HRMS and for other QuickTakes in this series, visit www.urban.org/hrms.

 

 

Urban Institute Robert Wood Johnson Foundation