title: Implementing federal health reform in the States: who is included and excluded and what are their characteristics?
abstract: OBJECTIVE
  To estimate the characteristics and number of nonelderly adults eligible and ineligible for Affordable Care Act (ACA) expansions.
  
  
  METHODS
  Two secondary data sources are used in this analysis: the 2008 Panel of the Survey of Income and Program Participation (SIPP) and the 2009 American Community Survey (ACS).
  
  
  METHODS
  We use multiple imputation to incorporate model-based uncertainty into the prediction of immigration status into the ACS from the SIPP. Key variables include place of birth, year of entry to the U.S., and health insurance coverage.
  No primary data are used in this study.
  
  
  RESULTS
  We estimate that potentially 3.5 million nonelderly adults will be excluded from the ACA Medicaid Expansion and 2 million from the health insurance exchanges because of their immigration status. We also find significant differences in estimates of excluded nonelderly adults across states.
  
  
  CONCLUSIONS
  Over 15 percent of income-eligible uninsured nonelderly adults will be potentially excluded from the ACA coverage expansions due to their immigration status. Policy makers must be careful to exclude ineligible nonelderly adults before estimating the impact of the ACA on coverage rates.
authors.affiliation: State Health Access Data Assistance Center, University of Minnesota, Minneapolis, MN.
authors.forename: Brett
authors.initials: B
authors.lastname: Fried
authors.forename: Jessie Kemmick
authors.initials: JK
authors.lastname: Pintor
authors.forename: Peter
authors.initials: P
authors.lastname: Graven
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Blewett
mesh_terms: D000328:Adult; D004608:Eligibility Determination / Q000592:standards*; D005260:Female; D018166:Health Care Reform; D006801:Humans; D008297:Male; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D014481:United States; D055815:Young Adult
keywords: Health reform; Medicaid; eligibility; health insurance exchange; immigration status