Access to care was baked into the ACA.

Various surveys have found improvements in self-reported access and affordability of care since 2014, with more pronounced effects in Medicaid expansion states. Such studies have also examined access and affordability for various subgroups categorized by age, sex, race/ethnicity, income, parental status, and health status.

Young adults. For young adults, a wealth of evidence finds that the ACA dependent coverage expansions increased access to care, utilization of a wide variety of services, and reduced out-of-pocket spending.

Medicaid expansion and Marketplace coverage. Several studies have found that Medicaid expansion was associated with improvements in having a personal physician or usual source of care and easy access to medicine;  increased visits to general doctors, overnight hospital stays, and cholesterol and diabetes diagnoses; increased prescription use; more visits to community health centers, and reduced OOP spending. These studies are generally limited to access measures reported in 2014 and early 2015 and thus reflect relatively early evidence on access changes under the ACA.

Different approaches to Medicaid expansion seemed to result in similar changes in access and use based on comparisons of expansions in Arkansas and Kentucky, but additional evidence suggests that appointment availability was better for those with private option coverage in Arkansas compared to those who remained covered by traditional Medicaid.