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Research Letter
Health Care Reform
April 2017

Health and Health Care Use Among Individuals at Risk to Lose Health Insurance With Repeal of the Affordable Care Act

Author Affiliations
  • 1University of Minnesota, School of Public Health, Division of Health Policy and Management, Minneapolis
  • 2National Bureau of Economic Research, Cambridge, Massachusetts
  • 3Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
  • 4Department of Medicine, Massachusetts General Hospital, Boston
  • 5National Bureau of Economic Research, Cambridge, Massachusetts
  • 6Department of Health Policy and Management, Yale University School of Public Health, New Haven, Connecticut
  • 7Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
  • 8Associate Editor, JAMA Internal Medicine
JAMA Intern Med. 2017;177(4):590-593. doi:10.1001/jamainternmed.2016.9541

Approximately 20 million individuals have gained health insurance under the Affordable Care Act (ACA),1 including young adults covered under parental insurance, those purchasing private insurance on exchanges, and those covered through state Medicaid expansion. As of mid-2016, 10.4 million individuals had private insurance policies through the exchanges, of whom 84% had incomes below 400% of the federal poverty level (FPL) and received premium tax credits.2 Enrollment is projected at 13.8 million by the end of the open enrollment period in 2017.3 State Medicaid expansion covered individuals with incomes below 138% FPL and included childless adults who were ineligible for Medicaid prior to the ACA. By 2016, over 14.6 million adults were enrolled in Medicaid under the “new adult” category, of which 11 million were newly eligible under the ACA.4 Results of the 2016 US election suggest that the ACA may be repealed or modified. Health and health care use by individuals at risk of losing health insurance should be better understood.