Due to coverage implemented by the Affordable Care Act in 2014, more Americans were able to obtain coverage in 2015, according to a study by the Commonwealth Fund.

Sarah Collins is the Vice President for Healthcare Coverage and Access for the foundation. She said in North Carolina alone, 400,000 people gained health insurance last year.

“People in North Carolina who have family incomes under $50,000 have made gains and coverage and access to care as well,” she said. “So the uninsured rate of people in that income range has dropped from about 42 percent in 2013 to 32 percent in 2015.”

The 10 percent difference is one of the smallest nationwide, with Kentucky’s number of insured climbing 25 percent higher. Collins said the available subsidies that help pay for plans in the marketplace are to thank for the spike in coverage.

“Most people who are buying coverage on their own through the marketplaces are getting a subsidy to help them pay for that coverage,” she said. “And that has just made a dramatic difference in people’s ability to access both insurance and being able to afford insurance, many people for the first time. And being able to access the healthcare they need in a timely way.”

But the Affordable Care Act faces an uncertain future, as the new administration will have to decide whether to keep, amend or get rid it of it altogether. Collins said this would leave many people without health insurance.

“The repeal would mean a loss of a lot of subsidies that most people who are buying coverage on their own in North Carolina are getting to help them afford that care,” she said. “That was kind of the point of the Affordable Care Act, to allow people to afford care through subsidies.”

She also said requiring people to obtain insurance keeps them from only attempting to get it when they are already sick and keeps insurance companies from then turning them down.

“Having people come into the health system when they need care other than waiting until they’re very, very sick is better for everybody and keeps costs at a steady rate of change rather than big jumps when people come into the system when they’re very ill,” Collins said.

The Commonwealth Fund health care evaluation also found that the percentage of uninsured children has gone down, and that people in most states were less likely to say that costs stopped them from going to the doctor when they needed healthcare.

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