Health insurance coverage in the U.S. has improved, but consumers still struggle with many of the same issues that plagued their predecessors, according to a new analysis of state-level data.

Health insurance coverage has improved for consumers since the Affordable Care Act was enacted in 2010.

But consumers still face significant hurdles in getting the coverage they need, according a new report released Thursday by the Urban Institute and the American Action Forum.

And that’s despite some notable improvements, according the report, which was produced by the University of California, San Diego, and the National Consumer Law Center.

In a survey of more than 1,000 insurance consumers across the country, the report found that more than 40 percent of the respondents say they have coverage that’s too expensive.

They also say they need more help paying their bills, with one-third saying they have difficulty finding insurance because they’re out of work, too sick to work or are otherwise ineligible.

The report found consumers are facing a range of issues that are not being addressed by the ACA:Higher out-of-pocket costs for some individuals and families, a lower rate of premium growth and coverage gaps in states with fewer insurers.

Insurance costs have increased in states that expanded Medicaid, and for many, there are still major gaps in coverage that could result in higher out-pocket expenses.

For example, more than a third of consumers in Alabama said they have to pay a higher deductible than their income would allow them to cover.

“The problem is, we’re spending $1,800 a month for coverage that is only going to make things worse,” said Laura Miller, director of health policy research for the Urban Center.

“We’re spending about $1.25, which is about $400 a month.

We need to make sure that we can get the coverage that we need, and we’re not spending that money.”

Miller and others are calling for lawmakers to fix the gaps in insurance coverage that can result in customers having to pay more for the same coverage.

And the report also calls for policymakers to look beyond the narrow scope of what’s needed to improve coverage for low-income Americans.

“While the Affordable Healthcare Act was designed to make insurance coverage affordable, the ACA has also created a significant barrier to coverage,” the report said.

“Insurance coverage is still unaffordable for some Americans, and they need help getting it.

Rather, it is a solution in search of a problem.””

The ACA is not the solution to the affordability challenge.

Rather, it is a solution in search of a problem.”

The report also found that the number of uninsured has increased significantly in some states since the ACA took effect, from 2.4 million in 2016 to 4.2 million in 2020.

The Urban Institute’s report said states with the lowest uninsured rates saw their rates of premium increases fall by nearly a third in the first four years of the ACA.

But the report noted that some states, including Texas, Florida and Texas, experienced rates of price growth of over 100 percent over that period.

In Florida, the median annual premium increased from $9,500 in 2016, to $18,000 in 2020, and then to $28,000 by 2020.

But average costs have dropped by nearly 50 percent over the same time period, and consumers are saving about $5,500 more per year.

The institute noted that most of the states with low rates of growth in premiums were in the South, including Louisiana, Alabama, Mississippi, Arkansas and Georgia.

In addition, a handful of states, like Louisiana, Tennessee and Texas that were in recession and had very few people insured experienced large premium increases in 2020.

“This report shows that many states are struggling to attract and retain qualified and healthy consumers,” said David A. Shulkin, the president of the American Council of Insurance Commissioners.

“That’s why we must do everything we can to help these states reach and maintain their potential for high-quality and affordable coverage.”