More than 8 years ago, President Obama signed the Patient Protection and Affordable Care Act into law. It is arguably one of the most important pieces of legislation of his administration.1 As a result of optional Medicaid expansion under the Affordable Care Act, millions of Americans in 32 participating states and the District of Columbia have gained access to affordable and high-quality health insurance.2 However, the remaining states have chosen not to participate in the Medicaid expansion, creating an organic opportunity to appropriately study outcomes between expansion states and nonexpansion states. Such an opportunity can prove fruitful for studying trauma in the United States, which still remains the leading cause of death and disability among individuals younger than 44 years.3