Health Affairs September 18, 2019
The Affordable Care Act (ACA) expanded coverage to 20 million Americans and improved the quality of private health insurance for millions more. Low- and moderate-income individuals experienced the greatest coverage gains: the uninsurance rate dropped by almost 10 percentage points for those whose income is at or below the federal poverty level (FPL) and over 11 percentage for those just above the FPL. Much of this progress is attributed to Medicaid expansion and the availability of marketplace subsidies, the latter of which brought federal financial assistance to individuals purchasing private health insurance. Both policies are targeted to low- or middle-income people.
Despite this progress, significant premium affordability gaps remain, especially for those on the lower half of the income scale....
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