ACA Enrollees Found to Have Limited Access to Doctors 

By Consumers for Quality Care, on September 18, 2024

A new KFF analysis shows that those enrolled in Affordable Care Act (ACA) plans have in-network access to just 40% of the doctors near their homes, Axios reports. Though more consumers have health coverage today than ever before, that coverage is good only so long as it allows consumers to see local medical professionals and get the care that they need.  

KFF’s latest analysis is consistent with its previous research which found that consumers on ACA plans are more likely to find out that a particular doctor or hospital is outside of their network, compared to those with employer-based coverage.  

KFF noted that about 25 percent of enrollees in ACA plans had in-network access to only 25 percent or less of local area doctors and that more than a quarter of all doctors do not accept consumers on ACA plans.  

They also found network coverage in large metro areas particularly limited, and though some ACA plans had greater in-network coverage, those plans often charged higher premiums.  

CQC urges lawmakers to strengthen the ACA by expanding in-network coverage for enrollees, ensuring that consumers have adequate access to care.