Since its passage in 2010, the Affordable Care Act (ACA) has been both celebrated and derided for its anticipated consequences. Implementation of the ACA has varied significantly from state to state, especially with respect to the expansion of Medicaid benefits. As is often the case with health care financing, the states have served as the “laboratories of democracy.” Unfortunately, the result has been a series of single-arm trials. As such, although we now have sufficient data to study post-ACA outcomes in specific populations, an objective, state-by-state assessment of the ACA’s successes and failures remains elusive.
Nathan H, Dimick JB. Assessing the Effect of the Affordable Care Act on Surgical Populations. JAMA Surg. 2016;151(12):e163635. doi:10.1001/jamasurg.2016.3635