Publication date: Jan 12, 2025

To characterize health insurance gap patterns related to age-19 Medicaid and age-26 commercial age-eligibility cutoffs. This descriptive analysis spans 2014-2018, after Affordable Care Act implementation, but before COVID-19 emergency provisions. We defined insurance gaps as ≥3 consecutive months without observed enrollment, preceded and followed by ≥1 month of enrollment and stratified results by insurance source and clinical severity (e. g., with chronic, complex, or disabling conditions or not). The Colorado all-payer claims database provided data for enrollees aged 10-29, 52% (649,346) of whom were initially Medicaid insured, whereas 47% (576,596) were commercially insured. The percent of enrollees with insurance gaps peaks within six months of turning age-19 and age-26-at 8. 9% Medicaid and 8. 7% commercial, respectively. The percentage point difference between ages 27-28 and 11-18 was 3. 3 percentage points higher for prior Medicaid recipients (p 

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