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In 2014, provisions of the Patient Protection and Affordable Care Act (ACA) went into effect, aiming to increase the availability of health insurance coverage, particularly among the working-age (aged 18-64), low-to-middle income population (below 400 percent of poverty). The model-based estimates produced by the Small Area Health Insurance Estimates (SAHIE) program of the U.S. Census Bureau are vital for studying the effects of the ACA at the county level. The data are the only source for 1-year estimates of health insurance coverage for all U.S. counties. SAHIE are model-based enhancements of the American Community Survey (ACS) data, providing more information for the approximately 74 percent of U.S. counties not published in the 1-year ACS. This paper uses SAHIE to examine trends in county-level health insurance coverage rates for the working-age population by income group for 2012 through 2014.
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