Millions of Americans could lose insurance for periods of time under the Affordable Care Act, according to a new report in Health Affairs co-authored by Benjamin Sommers, assistant professor of health policy and economics at HSPH. Under the package, Americans can move between two programs: Medicaid and state-run insurance exchanges, both of which determine eligibility based on income. For people whose income fluctuates during the year, the study found, eligibility will shift, creating a “churn” between programs that can result in one- or two-month periods without coverage.
“The frequency of those changes may be so frustrating that an individual may just decide, I’m not going to keep doing this for what can be inconsistent coverage over time,” Sommers told NPR’s Marketplace. The report estimates that within six months of the law’s implementation, more than 35 percent of all adults with family incomes below 200 percent of the federal poverty line will be affected by a shift; within a year 50 percent, or 28 million, will be affected.