Other contributors address how the ACA affects marginalized populations. Carrie Fry, Thomas McGuire, and Richard Frank link Medicaid expansion to lower rates of recidivism among the formerly incarcerated. Radhika Gore, Ritu Dhar, Sadia Mohaimin, Priscilla Lopez, Anna Divney, Jennifer Zanowiak, Lorna Thorpe, and Nadia Islam study primary care practices serving South Asian immigrants in New York City and highlight the importance of social context and organizational constraints in designing population health interventions. The issue also examines the economic effects of the ACA, especially on access to private and public health insurance. Both Mark Hall and Jean Abraham study instability in ACA health insurance markets, with Hall focusing on uncertainty arising from political factors and Abraham examining the factors that lead local markets to face high premiums and low insurer participation. Philip Rocco and Andrew Kelly explore the mechanisms included in the ACA to try to spur innovations in care delivery that both improve health and generate long-term cost savings.
As the COVID-19 pandemic affects healthcare in unprecedented ways, affordable healthcare access is critical. This RSF journal issue offers a timely, thoughtful consideration of one of the most pressing issues in American life.