Health coverage rates among undergraduate and graduate students have increased since the enactment of the Patient Protection and Affordable Care Act in 2010, from an estimated 81 percent in 2010 to 92 percent in 2022, according to GAO's analysis of Census data. However, as of 2022, an estimated 1.6 million students still lacked coverage, including greater proportions of students from certain historically disadvantaged racial and ethnic groups, students in Medicaid non-expansion states, and certain nonworking students. Multiple stakeholders and administrators at selected colleges said that some students face barriers to coverage, including costs, a lack of covered care year-round for out-of-state students, and a lack of affordable options in Medicaid non-expansion states. The Government Accountability Office (GAO) was asked to review college student access to health coverage. This report examines: (1) how health coverage among students has changed since the enactment of the Patient Protection and Affordable Care Act and barriers students face in obtaining coverage; (2) factors selected colleges considered in deciding whether to offer health coverage and how these colleges helped students navigate coverage options; and (3) federal agencies' actions to support colleges' efforts to help students obtain coverage. GAO analyzed the most recent data available from Census Bureau surveys on students' health coverage and a nongeneralizable American College Health Association survey. GAO interviewed administrators from 12 colleges selected to reflect variation in size, degree program length, and other college characteristics; representatives from 17 stakeholder groups, such as student organizations and companies that administer student health plans; and officials from HHS and Education.