Association for Public Policy Analysis & Management

Access to healthcare services for consumers is often a complex undertaking. Under the best circumstances, consumers have (1) access to an affordable insurance plan, are (2) able to select a provider, and (3) are able to see that provider when necessary for either preventive or urgent services. The Affordable Care Act (ACA), despite various shortcomings, has improved the first two steps in the process and implicitly assumes that by doing so the desirable third step will be achieved. However, we have only very limited empirical information about the third step. This paper assesses the ease of scheduling an appointment and the wait time until the appointment occurs for participants in an ACA marketplace. It does so by comparing experiences for consumers of plans sold on the California insurance marketplace, Covered California, to comparable plans sold outside of the marketplace. We do so using the results of a representative “secret shopper” survey of general practice physicians in five Covered California pricing regions conducted during the summer of 2015. In addition, we assess the correctness of provider directories and potential differences between plans sold on and off the insurance marketplace, topics of much recent controversy.