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Using data from American Community Survey, we find that Medicaid take\u2010up rate increased 8.88 percentage points (pp) among rent\u2010burdened households and 7.54 pp among non\u2010rent\u2010burdened households in expansion states. Conditional on household income and demographic characteristics, rent\u2010burdened households exhibit a 1.5 pp higher likelihood of Medicaid enrollment, with an additional decline of 0.7 pp in employer\u2010sponsored insurance and 1.0 pp in directly purchased insurance enrollment. These effects were more pronounced among individuals aged over 26 and those in states without state\u2010run exchanges. The findings show the importance of tailored Medicaid policies to assist households facing housing burdens, especially for those ineligible for housing vouchers.<\/jats:p>","DOI":"10.1002\/hec.4912","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T06:25:43Z","timestamp":1731565543000},"page":"415-430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Health Insurance Coverage Changes Under the Affordable Care Act Among High Housing Cost Households, 2010\u201318"],"prefix":"10.1002","volume":"34","author":[{"given":"Yu","family":"Cao","sequence":"first","affiliation":[{"name":"EAPCE Research Center World Bank Group  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Su","sequence":"additional","affiliation":[{"name":"SKEMA Centre for Sustainability Studies SKEMA Business School  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan","family":"Wang","sequence":"additional","affiliation":[{"name":"Brown School of Business and Leadership Stevenson University  Owings Mills Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9500-405X","authenticated-orcid":false,"given":"Chengcheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Towson University  Towson Maryland 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