The tally provides important new evidence that the marketplaces, or exchanges, created by the law have substantially expanded access to insurance nationally, one of the legislation’s central goals.
Some of the law’s leading opponents have claimed that most of the people who enrolled for coverage already had insurance. But the new survey data from the nonprofit Kaiser Family Foundation indicates that just 39 percent of enrollees were previously covered.
Among those who did not have insurance already, most had lacked coverage for two years or more.
“The exchanges played a key role in helping people get coverage,” said Liz Hamel, who directs survey research at Kaiser. The foundation is not connected to the Kaiser Permanente health plan.
The nationwide poll surveyed 742 adults, ages 18 to 64, who bought their own health care plans. It was conducted from April 3 to May 11 and has a margin of error of plus or minus 4 percentage points.
The survey also found that those who did previously have coverage and subsequently bought a plan on the new marketplace more often than not saved money.
Forty-six percent of people who switched from an old plan reported that they were paying less for their coverage this year. By comparison, 39 percent of people who switched plans said they were paying more.
Many of these people had been in plans that were canceled last fall because the plans did not meet the law’s new insurance standards.
The wave of cancellations, which contradicted President Barack Obama’s promise that people who liked their existing insurance plans could keep them, posed an early crisis for the new marketplaces.
The insurance marketplaces — a centerpiece of the law — allow Americans who do not get coverage through an employer to choose among plans in their area, all of which must meet new basic standards and cannot turn away sick customers.
Consumers making less than four times the federal poverty level — about $94,000 a year for a family of four — qualify for government subsidies in most parts of the country.
Strong enrollment this year helped mute some criticism of the marketplaces, which were launched last fall amid technology problems and cancellations. However, questions have lingered about who signed up for insurance, what happened to those who lost their previous health care plans and how consumers view their new coverage.
The Kaiser report adds to a growing body of survey data indicating that the health care law has dramatically cut the ranks of the nation’s uninsured.
A succession of Gallup polls this spring has shown a precipitous drop in the uninsured rate. Other research has picked up gains in employer-based coverage, in government Medicaid programs and in healthcare plans sold on the new marketplaces as well as directly from insurers.
The Kaiser survey suggests that many consumers found plans on the new marketplaces that they could afford.
Significant majorities of all customers on the new marketplaces also said they were satisfied with the choice of hospitals and primary-care doctors.
Overall, seven in 10 people who got marketplace plans rated their coverage as excellent or good, according to the survey. A majority, 55 percent, said the plan was an excellent or good value for what they paid.
Those figures come close to the levels of satisfaction that Americans with employer-provided coverage report, though people who get coverage through an employer remain the most satisfied with their insurance.
The vast majority of consumers who bought marketplace plans are receiving government subsidies to help offset the cost of their premiums, according to data from the U.S. Department of Health and Human Services.