Anupam Jena and coauthors published a research letter in JAMA Internal Medicine that identified the characteristics of those most at risk of losing coverage with repeal of the Affordable Care Act. The article indicates that some of the U.S.’s most vulnerable populations in terms of sickness or poverty would suffer the most from Obamacare’s repeal.

The researchers identified three adult groups of non-retirement age that most risk losing insurance:

• Adults with income below 400 percent of the federal poverty level, whose premiums would drastically increase
• Childless adults with below 138 percent of FPL covered through Medicaid but not by Social Security, who were newly eligible under the ACA
• Medicaid-enrolled children/adults in families whose children did not receive disability and were 50-138 percent FPL, who would become ineligible post-ACA

These groups have high rates of chronic diseases and health care utilization. If the ACA tax credits are removed and Medicaid expansion is rolled back, they stand to lose coverage and experience increased health care costs overall. 

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