{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:44:00Z","timestamp":1791477840552,"version":"4.3.4"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Housing is a critical social determinant of health, and individuals living in substandard housing often face greater healthcare needs and financial burdens. Expanding health insurance is therefore especially important for this population. However, little is known about whether the Affordable Care Act's Medicaid expansion affected disparities in coverage by housing quality. We examined whether Medicaid expansion improved insurance coverage equitably among low-income individuals living in homes with and without basic housing necessities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using nationally representative survey data from 2010-2019, we compared changes in insurance coverage before and after expansion in states that expanded Medicaid eligibility vs those that did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Medicaid expansion increased Medicaid coverage by more than 12% points and reduced uninsurance by 6%-7% points relative to non-expansion states among individuals lacking at least one basic housing necessity. However, compared with individuals with complete housing necessities, those lacking at least one basic housing necessity experienced slightly smaller increases in Medicaid coverage and smaller reductions in uninsurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Medicaid expansion improved coverage among individuals facing housing-related disadvantage but did not eliminate disparities. Eligibility-based expansions can extend coverage to structurally disadvantaged populations, but additional efforts to address non-financial barriers may be needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/haschl\/qxag115","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:21:49Z","timestamp":1780312909000},"source":"Crossref","is-referenced-by-count":1,"title":["The impact of Medicaid expansion on coverage among those lacking housing basics, 2010-2019"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9500-405X","authenticated-orcid":false,"given":"Chengcheng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Towson University , Towson, MD 21252 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6834-2896","authenticated-orcid":false,"given":"Deborah","family":"Freund","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, University of California , Los Angeles, CA 90095 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5214-7133","authenticated-orcid":false,"given":"Gerald F","family":"Kominski","sequence":"additional","affiliation":[{"name":"Fielding School of Public Health, University of California , Los Angeles, CA 90095 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8172-0939","authenticated-orcid":false,"given":"Petra W","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Rand Corporation , Santa Monica, CA 90401 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"issue":"3","key":"2026061611421283500_qxag115-B1","doi-asserted-by":"publisher","first-page":"893","DOI":"10.17310\/ntj.2011.3.06","article-title":"The impacts of the Affordable Care Act: how reasonable are the projections?","volume":"64","author":"Gruber","year":"2011","journal-title":"National Tax J"},{"issue":"1","key":"2026061611421283500_qxag115-B2","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1002\/pam.21961","article-title":"Early impacts of the Affordable Care Act on health insurance coverage in Medicaid expansion and non-expansion states","volume":"36","author":"Courtemanche","year":"2017","journal-title":"J Policy Anal Manage"},{"issue":"2","key":"2026061611421283500_qxag115-B3","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1111\/jrh.12234","article-title":"Medicaid expansion under the Affordable Care Act and insurance coverage in rural and urban areas","volume":"33","author":"Soni","year":"2017","journal-title":"J Rural Health"},{"issue":"S2","key":"2026061611421283500_qxag115-B4","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1111\/1475-6773.14034","article-title":"Effects of Medicaid expansion on insurance coverage and health services use among adults with disabilities newly eligible for Medicaid","volume":"57","author":"Creedon","year":"2022","journal-title":"Health Serv Res"},{"issue":"4","key":"2026061611421283500_qxag115-B5","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1001\/jama.2015.8421","article-title":"Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act","volume":"314","author":"Sommers","year":"2015","journal-title":"JAMA"},{"issue":"1","key":"2026061611421283500_qxag115-B6","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1377\/hlthaff.2021.01150","article-title":"The ACA Medicaid expansion and perinatal insurance, health care use, and health outcomes: a systematic review","volume":"41","author":"Bellerose","year":"2022","journal-title":"Health Aff"},{"issue":"1","key":"2026061611421283500_qxag115-B7","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1377\/hlthaff.2015.0917","article-title":"Both the \u2018private option\u2019 and traditional Medicaid expansions improved access to care for low-income adults","volume":"35","author":"Sommers","year":"2016","journal-title":"Health Aff"},{"key":"2026061611421283500_qxag115-B8","first-page":"21","volume-title":"The Medicaid Program. 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