This report presents the results of an analysis of the potential impacts of the Patient Protection and Affordable Care Act (enacted in March 2010) on public transit agencies and operations. The report concludes that the provision of the law likely to have the largest and most direct impacts on transit agencies is the broadened eligibility for Medicaid, which is expected to increase the number of Medicaid enrollees by about 16 million (or roughly 30 percent) by 2019. This expansion of the Medicaid program is particularly significant for public transit, because transit agencies currently participate in the management and provision of non-emergency medical transportation, a service to which many Medicaid participants are entitled. However, other provisions to increase the number of Americans with health insurance outside of Medicaid and to improve the availability of health care in underserved areas could also affect the demand for transit. The report uses five case studies to illustrate how the Affordable Care Act could affect transit systems operating in different geographic and policy environments. The report also assesses ways in which transit agencies and government agencies can monitor and communicate the effects of federal health care reform on public transit.

Status: Published as NCHRP Research Results Digest 383.