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About 78% of patients at federally operated Indian Health Service hospitals and health centers reported having health coverage in fiscal year 2018, up from 64% in FY 2013, according to a released yesterday by the Government Accountability Office. The share of patients with Medicaid coverage rose by 12 percentage points over the period to 53%, while the share with Medicare or private coverage each rose by 2 percentage points to 11% and 20%, respectively, GAO said. Coverage rose twice as much in states that expanded Medicaid (14 points) than in states that did not (8 points). According to officials interviewed for the study, increased coverage and associated collections over the period helped IHS facilities to continue operating and offer more services to the American Indians and Alaska Natives they serve. The Affordable Care Act gave states the option to expand their Medicaid programs and created new coverage options beginning in 2014.