16 states built there own exchange, 27 relied on healthcare.gov, and 7 partners with the federal government. 27 accepted Medicaid expansion, and 24 states did not.
One study found that the uninsured roles have been reduced by 5.4 million through March, and it fell predominantly in the low and middle-income adult category – meaning the law accomplished part of its stated goals. In states that instituted expanded Medicaid, the uninsured rate fell by 4%, opposed to 1.5% in states without Medicaid Expansion.
Our ability to pay for the bill, and mid- and long-term effects, remains to be seen.