Under contract with MACPAC, SHADAC designs and conducts quantitative analysis to explore the magnitude and type of churn occurring in the pre- and post-ACA insurance market at the state levels as well as the characteristics of churners. This analysis uses data from the Survey of Income and Program Participation. SHADAC designs and executes the analysis, which will include construction of state-specific weights, production of descriptive statistics, and regression analysis to measure the impact of different policies and other factors on churn. 

Through provisions designed to improve access to affordable health coverage, the ACA is expected to reduce the number of people who cycle between Medicaid coverage and uninsurance — a concept commonly called “churn.” However, people experiencing transitions between health insurance plans still face barriers related to the continuity of care, potentially aggravating health conditions and increasing costs of care. As states look for ways to monitor and project churn, as well as consider policies for reducing the scope or impacts of the phenomenon, this paper describes possible methods and data sources for producing state-level churn estimates.

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