Health Affairs July 12, 2019
Understanding how Americans move between different health insurance options is critical to measuring the effects of the Affordable Care Act coverage expansions and other insurance policies, such as the repeal of the individual mandate and Medicaid work requirements. Because the benefits of health insurance can only accrue if coverage is continuous and long lasting, rates of uninsurance do not capture the dynamic and longitudinal nature of health insurance enrollment.
Coverage transitions are built into the structure of US health insurance, with time-limited life events such as pregnancy qualifying individuals for public coverage via Medicaid, and changes in income beyond a cutoff of 138 percent of the federal poverty level triggering switches to new types of health insurance, sometimes with vastly...
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