As we examine the effects of the Affordable Care Act, there is great interest in the newly insured both to assess whether the law has been effective at enrolling its target population and to understand their health care needs.  This paper uses the March 2014 round of the Health Reform Monitoring Survey, which is s a quarterly survey of the nonelderly population that is exploring the value of cutting-edge Internet-based survey methods to monitor the Affordable Care Act (ACA) before data from federal government surveys are available.   The March 2014 survey has a total sample size of 8,427 respondents, though 80% of the responses were provided by March 6, 2014 and so the enrollment surge at the end of March is not captured.  We focus on the newly insured population, which we define as nonelderly adults who report being uninsured just prior to enrolling in their current coverage (N=514) and compare them to those who had health insurance all of the previous 12 months (“long-term insured”).

We found that about a third of the newly insured reported enrolling in employer sponsored coverage (31.7%), more than a third in Medicaid (39.0%), and 18.6% in non-group coverage.  Half (49.9%) of the newly insured were between the ages of 18 and 34, and half (49.3%) reported incomes below 138% of the federal poverty level (FPL).  Looking at their health care needs and use, 18% of the newly insured reported being in fair or poor health and 12.6% reported that their physical health was not good 20 or more days during the previous month.  Six in ten (60.8%) of the newly insured reported having a usual source of care compared with 80.2% of the long-term insured.  Just under half (47.7%) reported having received a checkup within the past 12 months, while 67.8% of the long-term insured reported having a recent checkup.   

We also examined the newly insured by state groups based on whether the state had expanded Medicaid coverage or not, operated its own marketplace or participated in the federal health care marketplace, and had a high expected gain in the insured population or a low expected gain.  Overall, 62.7% of the newly insured lived in states participating in the federal marketplace, though the characteristics of respondents was largely similar in state-based marketplaces and federally facilitated marketplaces.  Over half (54.9%) of respondents lived in states expanding Medicaid.  A slightly higher percentage of the newly insured in states that expanded Medicaid reported having incomes less than 138% FPL relative to the newly insured in states that did not expand Medicaid (51% vs. 47% respectively). 

These results provide an early look at the characteristics of the newly insured as of the first quarter of 2014, just as the first open enrollment period came to a close.  The survey results suggest that the newly insured differ from the long-term insured in key demographics and health status measures.