Abstract: We present a new ground-based visual transmission spectrum of the hot Jupiter WASP-43b, obtained as part of the ACCESS Survey. The spectrum was derived from four transits observed between 2015 and 2018, with combined wavelength coverage between 5300 and 9000 A and an average photometric precision of 708 ppm in 230 A bins. We perform an atmospheric retrieval of our transmission spectrum combined with literature Hubble Space Telescope/WFC3 observations to search for the presence of clouds/hazes as well as Na, K, H alpha, and H2O planetary absorption and stellar spot contamination over a combined spectral range of 5318-16420 A. We do not detect a statistically significant presence of Na i or K i alkali lines, or H alpha in the atmosphere of WASP-43b. We find that the observed transmission spectrum can be best explained by a combination of heterogeneities on the photosphere of the host star and a clear planetary atmosphere with H2O. This model yields a log evidence of 8.26 0.42 higher than a flat (featureless) spectrum. In particular, the observations marginally favor the presence of large, low-contrast spots over the four ACCESS transit epochs with an average covering fraction T = 132 K 132 K. Within the planet's atmosphere, we recover a log H2O volume mixing ratio of -2.78(-1.47)(+1.38), which is consistent with previous H2O abundance determinations for this planet.