The New England Journal of Medicine, April 3, 2013
Provisions of the Patient Protection and Affordable Care Act (ACA) are expected to reduce the number of adults who delay seeking needed medical care because of cost. Reforms are expected to improve the ability to obtain care, in part, by extending Medicaid access to adults with incomes at or below 133% of the federal poverty line. A recent Supreme Court ruling gave greater latitude to state approaches to Medicaid expansion. Various state strategies for implementing reforms may amplify geographic variation in the prevalence of delayed care. Estimating the existing variation in and correlates of delayed care may assist states that are planning to improve access within and beyond the framework provided by the ACA.