Unequal Coverage documents the everyday experiences of individuals across the United States as they attempted to access coverage and care in the five years following the passage of the Affordable Care Act (ACA). The contributors to this edited volume employ research methods rooted in ethnography and focused on how reform was actually experienced on the ground by frontline health care workers, the newly insured, and those who remained uninsured. The book argues that while the ACA did extend social protections to some groups previously excluded from health insurance, its design- and controversy-plagued implementation also created new forms of exclusion. Access to affordable coverage options were highly segmented by state of residence, income, and citizenship status. To explain and contextualize the stratified experiences of health reform that the book’s authors documented across nine states, Unequal Coverage explores interrelated themes from medical anthropology: stratified citizenship, risk, and responsibility. In the years since its enactment, some 20 million uninsured Americans gained access to insurance coverage. And yet, the law remained unpopular and politically vulnerable. This book illustrates lessons learned from the contentious implementation of the ACA and reveals how the law became a flashpoint for battles over inequality, fairness, and the role of government.