Many Americans who have obtained private health insurance through the Affordable Care Act continue to have problems affording health care.
According to a Kaiser Family Foundation report based on focus groups six states, low-income individuals with new private insurance report continued problems with:

• medical debt
• affording care that is not covered by their insurance plans
• handling out-of-pocket expenses, including deductibles
• unexpected bills for treatment they thought was covered

Such patients pose a challenge for many Pennsylvania safety-net hospitals because of their inability to afford their co-pays and deductibles, leaving these hospitals with unexpected uncompensated care and bad debt. Because they care for more low-income patients than the average hospital, this is a bigger problem for the state’s safety-net hospitals.
For a closer look at how the study and focus groups were conducted and what they found, go here for the Kaiser Family Foundation report Is ACA Coverage Affordable for Low-Income People? Perspectives from Individuals in Six Cities.