Medicaid expansion was associated with an early increase in insurance rates among hospitalized patients and a decline in ICU utilization rates among patients hospitalized with ACSCs. Further work is needed to explore whether this effect will be sustained. Of 5,067,190 total admissions, we identified 567,160 (11.2%) with ACSCs over the course of the study. The overall ICU admission rate (as a proportion of all hospitalizations) was 12.1%, while the ICU admission rate for patients admitted for ACSCs was 20.9%. Among expansion states, rates of uninsurance among hospitalized patients fell from 12.7% to 4.5% over the course of the study, while rates of Medicaid coverage increased from 19.0% to 26.6%.

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