The number of Americans reporting they did not receive needed healthcare because of its cost dropped for the first time since 2003, from 80 million in 2012 to 66 million, according to the just-released 2014 Biennial Health Insurance Survey from The Commonwealth Fund in New York City.

Also, the number saying they had trouble paying their medical bills or were paying off medical debt fell from 75 million in 2012 to 64 million, which is the first time it declined since this question was initially asked in 2005.

The survey, discussed in the new brief, The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect, was fielded between July and December 2014.

It asked respondents about their health insurance status, access to healthcare, and medical bill problems and debt over the previous 12 months.

(The brief is available online at go to

The survey found improvements on nearly every measure, including the percentages of adults who reported that, because of the cost, they:

  • did not visit a doctor or clinic when they had a medical problem, which fell from 29% in 2012 to 23% in 2014;
  • did not fill a prescription, which fell from 27% to 19%; • skipped a recommended test, treatment, or follow-up visit, which declined from 27% to 19%;
  • did not see a specialist, which dropped from 20% to 13%.

In addition, the share of adults who said they had trouble paying their medical bills, or could not pay them at all, fell from 30% in 2012 to 23% in 2014.