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J Law Med Ethics
December 2016
Linda J. Blumberg, Ph.D., is a senior fellow in the Health Policy Center at the Urban Institute where she has conducted extensive work related to the Affordable Care Act (ACA). She received her Bachelor of Arts in economics from the University of Illinois at Urbana-Champaign (Champaign, IL) and a Ph.D. in economics from the University of Michigan (Ann Arbor, MI). John Holahan, Ph.D., is an Institute Fellow in the Health Policy Center at the Urban Institute where he previously served as center director for more than 30 years. Much of his work centers on Medicaid and Medicare reform, coverage, costs, and the economic impact of the Affordable Care Act (ACA). Dr. Holahan received his Bachelor of Art degree from the University of Notre Dame (Notre Dame, IN) and a Ph.D. from Georgetown University (Washington, DC).
We provide an overview of the characteristics of those who have gained insurance coverage due to the ACA as well as the characteristics of the remaining uninsured. We also describe the implications for the broader sharing of health care risks required under the law, and how they vary by individuals' health status. Finally, we assess the implications of state decisions to expand or not expand Medicaid eligibility under the law, how those decisions affect state finances, health care providers, residents, and how the effects may vary for those states using waivers to expand eligibility using strategies designed to be more broadly politically acceptable.
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