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The law originally mandated that states had to expand Medicaid eligibility, but the U. Supreme Court ruled in that the federal government could not force states to expand eligibility. Almost half of the states in the U. In addition, after the ACA was implemented, researchers found chronically ill patients reported slightly better access to health care, with 2. However, they did not find that these patients were more likely to have a personal physician after the ACA's passage.

The authors acknowledged the study has limitations since the subjects self-reported via a telephone survey and they only have data from to understand the effects of the ACA's implementation.

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Another factor limiting access to health insurance may be immigration status or insurance plans with high co-payments or high deductibles, the researchers said. Christine Eibner, an economist and professor at the Pardee RAND Graduate School in Santa Monica, California, said the study is significant since it uses actual data and not just hypothetical models for its findings.

More research will be needed to understand why patients aren't getting more care and whether these numbers have continued to improve in the last two years, said Eibner, who was not involved in this study. John Graves, an assistant professor in the Department of Health Policy at Vanderbilt University Medical Center, said new data coming out now about the ACA has given a clearer picture on health coverage after the major law's implementation, and that picture shows that people are continuing to seek out health coverage.

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