Table 1.

Financial Strain, Health Care Access and Utilization by FPL and Time, NHIS 2011-2016 (N = 133°672).

Outcome	≥400% FPL			300-399% FPL			200-299% FPL			125-199% FPL			0-124% FPL
	Pre-ACA	Post-ACA	P value	Pre-ACA	Post-ACA	P value	Pre-ACA	Post-ACA	P value	Pre-ACA	Post-ACA	P value	Pre-ACA	Post-ACA	P value
Financial strain
Couldn’t afford prescription medication in past 12 months due to cost	0.030	0.025	.027	0.030	0.025	<.001	0.111	0.086	<.001	0.168	0.125	<.001	0.192	0.146	<.001
Delayed care due to cost in past 12 months	0.061	0.053	.003	0.121	0.110	.061	0.183	0.148	<.001	0.248	0.181	<.001	0.229	0.174	<.001
Didn’t get needed care due to cost in past 12 months	0.032	0.027	.019	0.079	0.062	<.001	0.128	0.103	<.001	0.198	0.152	<.001	0.203	0.152	<.001
Problems paying medical bills in past 12 months	0.078	0.067	<.001	0.182	0.157	<.001	0.249	0.210	<.001	0.331	0.331	<.001	0.617	0.547	.0168
Worried about paying medical bills in past 12 months	0.399	0.372	<.001	0.036	0.030	.044	0.623	0.577	<.001	0.700	0.630	<.001	0.617	0.547	<.001
Access
Currently uninsured	0.049	0.036	<.001	0.127	0.095	<.001	0.237	0.161	<.001	0.373	0.234	<.001	0.354	0.236	<.001
Waited too long in physician’s office in past 12 months	0.035	0.029	.004	0.021	0.017	.002	0.037	0.040	.451	0.053	0.050	.505	0.067	0.060	.028
Utilization
≥1 Physician visit in past 12 months	0.856	0.860	.314	0.809	0.806	.691	0.754	0.768	.054	0.710	0.742	<.001	0.727	0.758	<.001
≥1 ED visit in past 12 months	0.137	0.130	.082	0.157	0.160	.658	0.187	0.172	<.001	0.233	0.240	.268	0.303	0.299	.5667

Note. Pre-ACA is an indicator for the years 2011-2013. Post-ACA is an indicator for the years 2014-2016. All P values are shown for chi-squared analyses. All statistics represent proportions. FPL = Federal Poverty Level; NHIS = National Health Interview Survey; ACA = Patient Protection and Affordable Care Act; ED = emergency department.