Churning on and off of health coverage as a result of changing life circumstances is a longstanding problem. For millions of Americans, the Affordable Care Act means an end to the worst form of churning—the loss of insurance coverage entirely. But as George Washington University’s Sara Rosenbaum and colleagues explain in a new Commonwealth Fund issue brief, the law introduces a new risk: individuals and families with changes in income may move between Medicaid and subsidized private coverage through the marketplaces. The researchers offer strategies to ease these transitions and help keep people continuously insured.