Fact Check: Health insurance is essential for access to medical care in the U.S.

Fact Check: "Health insurance is essential for access to medical care in the U.S."

What We Know

Health insurance plays a critical role in determining access to medical care in the United States. According to the 2025 Marketplace Integrity and Affordability Final Rule, the Centers for Medicare & Medicaid Services (CMS) emphasizes that health insurance coverage is vital for consumers to access affordable healthcare services. The Affordable Care Act (ACA) has facilitated coverage for millions, with over 24 million consumers selecting plans during the 2025 Open Enrollment Period, which indicates a significant reliance on health insurance for accessing medical care.

Research has shown that individuals with health insurance are more likely to receive necessary medical services. A report from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) found that gains in health insurance coverage have been associated with improved access to care, as evidenced by an increase in the percentage of children and non-elderly adults reporting annual physician visits from 2010 to 2023 (ASPE report).

Furthermore, the CMS has noted that the expansion of financial assistance through the ACA has made health insurance more affordable, thereby increasing access to care for many Americans (CMS press release).

Analysis

The claim that health insurance is essential for access to medical care in the U.S. is supported by a substantial body of evidence. The ACA has significantly increased the number of insured individuals, which correlates with improved access to healthcare services. The 2025 Marketplace Integrity and Affordability Final Rule outlines various measures aimed at ensuring that consumers can access affordable health insurance, thereby enhancing their ability to obtain medical care.

However, it is important to consider the reliability of the sources. The CMS is a government agency responsible for overseeing health insurance programs, which lends credibility to its reports and findings. The ASPE report also comes from a reputable government source, providing data that supports the connection between insurance coverage and access to care.

While some critics argue that the ACA has not fully addressed issues of affordability and access, the overall trend indicates that health insurance remains a critical factor in accessing medical care. The Commonwealth Fund's 2025 Scorecard also highlights disparities in health care access among uninsured populations, reinforcing the notion that health insurance is crucial for receiving timely and appropriate medical services.

Conclusion

Verdict: True
The claim that health insurance is essential for access to medical care in the U.S. is substantiated by multiple credible sources and data. The evidence shows a clear link between having health insurance and improved access to healthcare services, particularly in light of the expansions made under the ACA. As such, health insurance is indeed a fundamental component of accessing medical care in the United States.

Sources

1. 2025 Marketplace Integrity and Affordability Final Rule
2. Start a 2025 health plan application now!
3. Over 24 Million Consumers Selected Affordable Health Coverage in ACA ...
4. Healthcare Insurance Coverage, Affordability of Coverage, and Access to ...
5. U.S. Health Care Rankings by State 2025 | Commonwealth Fund