OBJECTIVES: To identify factors associated with receipt of disease-modifying anti-rheumatic drugs (DMARDs) among patients with rheumatoid arthritis (RA) and enrolled in a Patient Protection and Affordable Care Act (ACA) insurance exchange plan in 2015. METHODS: Member-level data were extracted from a large nationally representative and statistically de-identified administrative claims database. Patients were included if they were (1) 18 years or older; (2) diagnosed with RA anytime during 2015; and (3) enrolled in an ACA plan in 2015. Logistic regression was used to identify factors associated with DMARD receipt. RESULTS: The sample included 21,002 RA members, of which 61.7% received DMARDs (females=75.1%, mean age=52.5(±10.6)). Factors associated with more likelihood of receiving DMARD were: female (OR: 1.31); living in East North Central (OR: 1.63), West North Central (OR: 2.28), or South Atlantic area (OR: 1.17), compared to Pacific Area; with Gold (OR: 1.47), Platinum (OR: 1.53) or Silver (OR: 1.14) level compared to Bronze level plans; median household income $40k-100k vs. $100+k (OR: 1.08); living in the area with no primary care shortage (OR: 1.24); and living in area with the majority people achieved Bachelor’s degree vs. high school education (OR: 1.11). Factors associated with less likelihood of receiving DMARD included: higher HCC risk score (OR: 0.99); younger age (18-29 years (OR: 0.66); 30-44 years (OR: 0.68); 45-64 years (OR: 0.86) compared to 65+ years); living in Mid Atlantic (OR: 0.71) compared to Pacific area; and lower median household income $0-39k vs. $100+k (OR: 0.91). CONCLUSIONS: This study provides new evidence that can be used to identify subgroups of members to effectively target interventions to improve arthritis management. Among the ACA insurance exchange enrollees, females were more likely to receive recommended treatment; members enrolled in Bronze level plans, had lower level of education and lower income were less likely receiving DMARD for RA.