In an article recently published in JAMA Network Open, Heidi Allen, Sarah H. Gordon, Dennis Lee, Aditi Bhanja and Benjamin D. Sommers use data from Colorado to compare individuals with similar incomes across coverage types, highlighting the key differences between Medicaid and Marketplace insurance.

The Affordable Care Act (ACA), which turns 10 on March 23, dramatically changed Medicaid, making it available to millions of previously ineligible low-income adults. As some states continue to debate whether to expand Medicaid and policymakers propose more far-reaching changes to the program, it is critical to provide timely evidence on how the program is working and what the potential effect of major changes would be.

Across the country, changes to Medicaid policy are under way. They hold the potential to dramatically alter the landscape of health care for millions of low-income individuals. Meanwhile, the 2018 midterm election results may lead to further Medicaid expansion in five states, three through ballot initiatives (Idaho, Nebraska, and Utah) and two with the election of new governors supportive of expansion, who replace outgoing governors who opposed it (Kansas and Maine). If all five states expand Medicaid, an estimated 500,000 people are expected to gain coverage.