Minimizing Care Gaps for Individuals Churning between the Marketplace and Medicaid: Key Considerations for States

The ACA has created new health insurance coverage opportunities for millions of low-income Americans. Many of these individuals, however, are likely to "churn" in and out of eligibility for Medicaid and marketplace coverage due to fluctuating income and changing family circumstances. Adults who change health insurance coverage are less likely to have a usual source of care and may delay care during coverage transitions. This brief outlines key steps that states can take to reduce the potential gaps in coverage caused by churn. It includes examples from states that have begun to address this issue and outlines concrete strategies for states to mitigate the impact of coverage transitions.