MENLO PARK — Nearly 70 percent of California's previously uninsured adults have gained health insurance coverage under the Affordable Care Act — and most of them say their health care needs are being met, according to the latest survey of the Kaiser Family Foundation.

But the survey released Thursday by the Menlo Park-based group also found that plenty of challenges for the newly insured remain when it comes to paying for and accessing care. That applies both to those enrolled in plans through Covered California, the state's health insurance exchange established under the Affordable Care Act, and Medi-Cal, the state's program for the low-income and disabled that was greatly expanded under the health care law.

The survey results didn't surprise some consumer health advocates.

"We have a long way to go towards affordability when half of the newly insured say they have a hard time affording health care, even as subsidies have been successful in expanding access and getting more low-income Californians insured,'' said Carmen Balber, executive director of the Santa Monica-based Consumer Watchdog.

But the latest data was welcomed by many health care experts.

"For me, it was really the size of the gains in people's sense of financial security and in their health care,'' said Mollyann Brodie, director of public opinion and survey research at the foundation.

"I had hoped and thought that those numbers would go up, but I did not expect them to improve in those gaps as much as they did," Brodie said. "It appears that getting health insurance really helps people to feel more financially secure and health secure."

The foundation's survey is the third of a series it began in 2013 that aims to track how the health care law, commonly called Obamacare, has affected the lives of the previously uninsured.

Since its debut in the fall of 2013, Covered California has enrolled 1.3 million Californians, while Medi-Cal has enrolled almost 4 million since January 2014.

Both the exchange and Medi-Cal have had problems. In the Covered California plans, many of the complaints have focused on the narrow networks of doctors and hospitals. And access to Medi-Cal doctors — already a chronic problem in a state that offers one of the lowest Medicaid reimbursements in the nation — only worsened with the expanded number of Medi-Cal enrollees.

But the survey found 83 percent of Medi-Cal enrollees and 63 percent of Covered California enrollees are mostly satisfied with their plans.

Other survey highlights:

• Of the Californians who didn't have insurance in 2013, 86 percent said it was difficult to afford health care. But in the latest survey, only 49 percent of the newly insured who were surveyed said it's difficult to pay for health care.

   

   

• The recently insured are about half as likely to say they have had problems paying medical bills in the past year (23 percent now compared with 45 percent in 2013).

   

   

• When asked how well their health needs are being met, 86 percent of the recently insured now say they are being somewhat or very well met — up from 51 percent of the uninsured group in 2013. But 28 percent say that in the past 12 months they have had to wait longer than they thought was reasonable for a medical appointment.

   

  

   

   

   

• Sixteen percent of the recently insured say a doctor's office told them in the past 12 months that they would not accept them as a new patient. The share was highest for those enrolled in Covered California plans (23 percent), compared with Medi-Cal plans (17 percent) and employer-sponsored plans (6 percent.)

Richmond resident Paula Genosick is among those who said she cannot easily find a doctor or hospital willing to take her Medi-Cal plan, which she receives at no cost.

"I've tried to make doctor's appointments, but I could not get in — except for one appointment for vision,'' said Genosick, a part-time cashier at Home Depot. As a result, she said, she had to twice seek medical care at the emergency room at the Kaiser Permanente hospital in Richmond. That's where doctors removed shards of glass from her foot and treated her strained back.

In San Jose, 48-year-old Dawn Hendricks — who had gone without health insurance since 2010 — this year enrolled in a Valley Health Plan offered on the Covered California exchange after she became a caregiver for her 63-year-old husband, who is disabled.

The premiums are only $25 a month, she said, and co-pays for things like prescription drugs are usually less than $5.

While she's happy to finally be insured, she said it takes a long time to get an appointment — at least a month, if not more, to see a doctor for her carpal tunnel syndrome in both arms, something she said she acquired after years of working in retail.

A Covered California plan has been a relief for Oakland resident Jeff ErnstFriedman, a partner at a small social media and marketing agency that does not offer health insurance.

Since signing himself and his 2-year-old son up for a Blue Shield plan last year (his wife is insured through her employer), he has had no access issues with doctors. And, he said, the $500 monthly premium is manageable.

"It's less than perfect, but better than nothing,'' said ErnstFriedman, 35. "What's comforting about it is to know that there is a financial cap and that we won't be financially decimated if something catastrophic happens."

The survey found that 41 percent of the remaining uninsured aren't eligible because they are illegal immigrants. Of the rest, 43 percent are eligible for coverage but had been uninsured for two years or more. About 26 percent of the remaining uninsured are likely eligible for Medi-Cal, and another 25 percent are likely eligible for subsidized plans under Covered California.

The survey, conducted from Feb. 18 to May 13, included 1,105 adults. The margin of error is plus or minus 5 percentage points for the survey of recently insured Californians.

Contact Tracy Seipel at 408-920-5343. Follow her at Twitter.com/taseipel.