The number of Americans reporting they did not seek needed health care because they couldn’t afford it dropped for the first time since 2003, falling from 80 million in 2012 to 66 million, according to The Commonwealth Fund’s 2014 Biennial Health Insurance Survey.

The survey also found the number of people who had trouble paying their medical bills or were paying off medical debt also fell from 75 million in 2012 to 64 million — the first time the measure declined since this question was initially asked in 2005.

“These declines are remarkable and unprecedented in the survey’s more than decade-long history,” said Sara Collins, vice president for Health Care Coverage and Access at The Commonwealth Fund and the study’s lead author. “They indicate that the Affordable Care Act is beginning to help people afford the health care they need. We also found sharp declines in the uninsured rate nationwide. Unfortunately, we’re still seeing high uninsured rates in states that haven’t expanded Medicaid.”

The survey was fielded between July and December 2014 and asked respondents about their health insurance status, access to health care, and medical bill problems and debt over the previous 12 months. It found improvements on nearly every area, including the percentages of adults who reported that, because of the cost, they:

--did not visit a doctor or clinic when they had a medical problem, which fell from 29 percent in 2012 to 23 percent in 2014;

--did not fill a prescription, which fell from 27 percent to 19 percent;

--skipped a recommended test, treatment, or follow-up visit, which declined from 27 percent to 19 percent; and

--did not see a specialist, which dropped from 20 percent to 13 percent.

The Commonwealth Fund is a private foundation that supports independent research on health policy reform.