Older Americans who were enrolled in Medicare health plans had advantages over those who opted for private insurance plans or were covered through their employers, according to a study from Commonwealth Fund, a private health-policy advocacy foundation. The group surveyed 4,000 U.S. adults in 2010 to compare access to medical care and ease of payment of medical bills. Twenty-three percent of Medicare beneficiaries could not afford necessary care, while the same was true for 37 percent of employer-sponsored health plans and those who purchased their own insurance. Twenty percent of adults with coverage from their jobs and 33 percent of adults who purchased their own coverage reported dissatisfaction with their insurance, while only 8 percent of people with Medicare rated their insurance poorly. 

Those with non-Medicare coverage were twice as likely to report problems with medical bills, and were also more likely to have higher out-of-pocket expenses. Thirteen percent of Medicare plan holders could not afford necessities such as rent and food, while 27 percent of employer-sponsored plan holders and 33 percent of those with individual plans could not afford those essentials.  

Medicare patient satisfaction was dependent on which plan they had; those with the tradition plan were happier with the coverage and were more likely to be able to afford care than those with Medicare-Advantage plans. Researchers call for attention to the experiences of all individuals regardless of insurance policy as the country moves to expand health care insurance through the Affordable Care Act. The study's authors believe state insurance exchanges established in 2014 may be a way for states to offer Medicare to more people.