Brooklyn Law Review


The passage of the Patient Protection and Affordable Care Act (“ACA”) in 2010 represented a watershed moment for healthcare in the United States. As is well-noted, the federal courts are still wrangling over the constitutionality of the law, and there is significant uncertainty regarding the extent to which the ACA will survive these legal battles. Unquestionably, the ACA has expanded access to health insurance for many millions of Americans. Prior to the advent of the ACA, Medicaid income eligibility for adults without dependents was approximately 61 percent of the Federal Poverty Line. Empirical studies since the advent of the ACA have generally proven positive in exploring the relationship between the expansion of available health insurance upon personal finances. This Essay is one of the first empirical efforts to specifically address the association between the ACA and the rate of bankruptcy filings across the country. The studies just described tended to focus on medical bills, rather than bankruptcy specifically. Similarly, most legal scholars have focused primarily on the causal relationship between the presence of overwhelming medical debt and the need to file for bankruptcy relief. Years of research have proven inconclusive on this front, largely because of the difficulties associated with defining and measuring “medical debt.” Stated differently, our findings suggest that by more robustly providing health insurance coverage for low-income Americans, the ACA has had some effect on the risk of filing for bankruptcy protection. Although future research is still needed to uncover causal mechanisms on the role possessing health insurance may have on an individual’s ultimate decision to file for bankruptcy relief, our preliminary findings suggest that the ACA may lower one’s risk for bankruptcy.