The Promise of the Affordable Care Act, the Practical Realities of Implementation

More than 30 million people are set to gain access to health insurance in the near future as part of the Affordable Care Act (ACA). One of the health reform law's key objectives is to ensure Americans have and retain access to affordable health coverage, even if they lose their job, get divorced, or graduate from college without a job offering health benefits already lined up. This brief examines how state and federal policy-makers can best ensure seamless health coverage under ACA for individuals and families who lose health insurance because of a professional or personal life transition.

In this brief, researchers at the University of California at Berkeley look at past experience with the state Children's Health Insurance Program (CHIP), Medicaid expansions, the recent implementation of the federal high-risk pools (PCIP), and other public programs for insights. The authors contend that these experiences demonstrate that while outreach and education are essential, such efforts alone are not sufficient to assure that those eligible will enroll in the program.