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The Affordable Care Act (ACA) has brought major changes to the US health insurance system: In January 2014, Medicaid was expanded to nearly all adults with family incomes at or below 138 percent of the federal poverty level in 24 states and the District of Columbia, and enrollment under the new health insurance Marketplaces officially began in all states and the District of Columbia. We use the June 2014 Health Reform Monitoring Survey (HRMS) to examine changes in health insurance coverage since the beginning of the previous year for nonelderly adults. The HRMS was designed to provide early feedback on ACA implementation to complement the more robust assessments that will be possible when the federal surveys release their estimates of changes in health insurance coverage later in 2014 and in 2015.

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