There are hundreds of thousands of metropolitan United States taxi and for-hire vehicle (FHV) drivers who lack health insurance and have limited access to primary care. The Affordable Care Act provided increased opportunities for insurance coverage. The current study used a 1,864 person 2015-2018 NYC taxi/FHV driver dataset, which included health insurance coverage and primary care access information. The data revealed an increase in insurance coverage and primary care uptake across the four years, from 40% to 63% and 52% to 60%, respectively. Drivers' age, region of birth, and hours driving per week predicted insurance coverage, and drivers' age, region of birth, hours driving per week, and insurance status predicted primary care coverage. Recommendations for addressing the pervasive low rates of insurance and primary care coverage among this understudied marginalized population are presented.