The goal of the project is to inform federal and state policymakers of the relevant tradeoffs of creating eligibility for near-poor adults in Medicaid versus an opportunity for ACA-Marketplace coverage. The research draws on a natural experiment resulting from Wisconsin’s 2014 Section 1115 demonstration waiver that rolled-back existing Medicaid coverage for parents and caretaker adults with incomes between 100-200 percent of the federal poverty level (FPL), directing them instead to seek Marketplace options. The researchers will estimate whether and for how long near-poor adults, previously Medicaid eligible, enroll in federally-subsidized commercial insurance, and will compare access to care for this population between their time when Medicaid-enrolled to their time under commercial coverage. The work will inform policymakers as they consider changes to Medicaid and ACA eligibility, and the effects of fully subsidized public coverage relative to partially subsidized private coverage for near-poor adults. Deliverables will include a project work plan and final narrative and financial reports. The grantee will also produce paper(s) suitable for publication and present findings at national research meetings and to other stakeholder audiences as appropriate, including policymakers at the federal, state, and local levels, as part of the deliverables for this grant.