Usual Source of Care Among Adults Aged 18-64 Years Post-ACA, 2010-2017.

Shahbazi, Sara; Goodson, John D · Ann Fam Med · 2025

cross_sectional · Level IV

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Abstract

This study assessed changes in self-reported usual source of care (USC) across income groups and rural-urban settings after Affordable Care Act implementation, using 2010-2017 Medical Expenditure Panel Survey data. Multivariable regression estimated adjusted percentage changes in USC and reasons for lacking one. Usual source of care prevalence rose modestly (67% to 68%), with significant gains among low-income adults (+4.96% rural, +2.45% urban) and a small decline among urban high-income adults. Affordability-related barriers decreased, while accessibility and individual preference barriers increased. Findings suggest that insurance expansion alone may not ensure continuous care, especially given persistent non-financial access challenges.

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