  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 5,300 \r{A}-9,000 \r{A} and an average photometric precision of 708 ppm
in 230 \r{A} bins. We perform an atmospheric retrieval of our transmission
spectrum combined with literature HST/WFC3 observations to search for the
presence of clouds/hazes as well as Na, K, H$\alpha$, and $\rm H_2O$ planetary
absorption and stellar spot contamination over a combined spectral range of
5,318 \r{A}-16,420 \r{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 $\rm H_2O$. This model yields a log-evidence of
$8.26\pm0.42$ 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 $f_\text{het}
= 0.27^{+0.42}_{-0.16}$ and temperature contrast $\Delta T = 132\text{ K} \pm
132\text{ K}$. Within the planet's atmosphere, we recover a log $\rm H_2O$
volume mixing ratio of $-2.78^{+1.38}_{-1.47}$, which is consistent with
previous $\rm H_2O$ abundance determinations for this planet.
